Dawaa Reference

Clinical reference

Congenital anomaly of the circulatory system

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources3 sources

ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class KD55 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care · Tetralogy of Fallot - StatPearls (NCBI Bookshelf NBK513288) - https://www.ncbi.nlm.nih.gov/books/NBK513288/

Verified against2 documents
  • No dose - referral pathway, no medicine given in primary care
  • Congenital anomaly of the circulatory system - disease-level clinical article (congenital-heart-anomaly-full.txt)

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (3)

  • The parent's own observation is a crucial clinical indicator: worsening heart failure, the child cannot keep pace with siblings, sweating, tiring quickly, and failure to thrive [failure to thrive · sweating]
  • Assess cardiac reserve by asking about age-appropriate activities
  • Ask about past hospitalisations for chest infections, previous surgery and previous anaesthetic experience

Signs — what you find (4)

  • The examination points that matter are cyanosis, finger clubbing and signs of congestive cardiac failure [cyanosis · finger clubbing]
  • Record age-specific vital signs, growth charts, weight, height and head circumference
  • About 8% of children with congenital cardiac defects have other congenital abnormalities as well
  • Half of children with trisomy 21 have a congenital heart defect, so the examination matters particularly there

Tests (6)

  • Echocardiography is the essential non-invasive tool, defining both the shape and the function of the defect
  • The 12-lead ECG is the gold standard for arrhythmia and for confirming sinus rhythm
  • Chest radiograph is a screening tool for chamber size, great vessel anatomy and pulmonary vascularity, but its sensitivity for pulmonary vascularity is only 24% to 68%
  • A child in congestive cardiac failure may have iron-deficiency anaemia; a cyanosed child may have erythrocytosis from desaturated haemoglobin
  • Cyanosis can prolong the prothrombin time and partial thromboplastin time
  • MRI quantifies ventricular volumes, valve regurgitation and flow, and shows extracardiac vascular anatomy and previous scar tissue

If not this — what else fits (2)

  • Airway abnormalities are more likely in children with congenital heart disease, especially those born premature or weighing under 10 kg
  • A high haematocrit needs exchange transfusion before surgery, to prevent the neurological consequences of high blood viscosity

SourceStatPearls "Perioperative Management of Patients With Congenital Heart Disease" (NBK585103) - an anaesthesia chapter; this card is scoped to its clinical history, physical examination and laboratory sections

Presentation findings are traced to the source above.

1

NO DRUG THERAPY IN PRIMARY CARE (REFERRAL & ADVICE)

1st line
Adult dose and duration

Umbrella category for structural heart defects present at birth (examples given include tetralogy of Fallot and patent ductus arteriosus); the GP's role is early recognition (murmur, cyanosis, failure to thrive) and referral to paediatric cardiology, which manages any medical or surgical treatment. - Refer, with advice

Paediatric dose

Children follow the same pathway: recognise and refer. No primary-care medicine is implied.

Dose source

No dose - referral pathway, no medicine given in primary care

Why

Umbrella category for structural heart defects present at birth (examples given include tetralogy of Fallot and patent ductus arteriosus); the GP's role is early recognition (murmur, cyanosis, failure to thrive) and referral to paediatric cardiology, which manages any medical or surgical treatment.

Cautions
  • Cyanosis, poor feeding, failure to thrive, or a new murmur in an infant needs urgent paediatric cardiology referral.
  • No medicine is prescribed for this in primary care - this entry is for recognition and referral. Anything given is decided by the service it is referred to.
  • RED FLAG - Children with Tetralogy of Fallot may develop sudden hypercyanotic (tet) spells requiring immediate emergency intervention.

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.