The Critical Role of Cardiac Ultrasound in Detecting Congenital Heart Disease in Preterm Infants

A recent article published in the Journal of Perinatology titled "Detection of Congenital Heart Disease by Neonatologist-Performed Cardiac Ultrasound in Preterm Infants" by Bradley MacDonald, Deane Yim, James Ramsay, and Andrew Gill highlights the pivotal role of cardiac ultrasound in identifying congenital heart disease (CHD) in preterm infants. The study underscores the importance of early detection and prompt referral to cardiology, which can significantly impact the management and outcomes of these vulnerable patients.

The study assessed the frequency of de novo CHD detection via neonatologist-performed cardiac ultrasounds (NPCU) in infants born at less than 30 weeks of gestation. Conducted over nearly two decades (2004-2023), the cross-sectional study found that out of 2088 infants who underwent NPCU, 109 (5.2%) were diagnosed with CHD, with major and critical CHD being promptly referred to cardiology. This highlights the essential role of NPCU in the early identification and management of CHD in preterm infants, emphasizing the need for specialized training and collaboration between neonatologists and cardiologists.

CHD is one of the most common birth defects, occurring in approximately 1% of live births, with about 25% classified as critical. Early detection of CHD is crucial because it can reduce the risk of death and long-term morbidity. The study’s findings suggest that NPCU is an effective tool for early detection, enabling timely intervention and improved outcomes for infants with significant cardiac anomalies.

The study also highlights the importance of optimizing NPCU training to ensure accurate diagnosis and referral. Neonatologists performing NPCU should be well-versed in identifying both functional and anatomical abnormalities. In Australia and New Zealand, over 40% of neonatal intensive care units (NICU) perform NPCU, driven by the availability of advanced echocardiography equipment and the need for rapid hemodynamic assessment in critically ill infants.

The success of NPCU depends on structured training programs that include both functional and anatomical assessments, as well as close collaboration with pediatric cardiologists. The study suggests that while NPCU is not primarily designed as a screening tool for CHD, it can effectively identify significant cardiac anomalies that warrant further cardiology evaluation.

Despite the benefits, NPCU also presents challenges, including the potential for false positives and the need for continuous training and supervision. The study acknowledges that the accuracy of NPCU can vary based on the experience of the performing clinician and the availability of cardiology oversight. Prospective studies and standardized training protocols are essential to enhance the reliability and accuracy of NPCU in detecting CHD in these vulnerable patients.

At SonoSim, we recognize the critical role of ultrasound in neonatal care and the importance of early CHD detection. Our comprehensive training is designed to enhance the skills of healthcare professionals, providing them with the knowledge and expertise needed to perform accurate cardiac ultrasounds. By offering realistic simulation and structured training topics, SonoSim supports the development of proficient neonatologists capable of identifying and managing congenital heart disease effectively. Through continuous education and practice, we aim to improve patient outcomes and support the essential collaboration between neonatologists and cardiologists.

SonoSim offers an extensive range of echocardiography training designed to equip healthcare professionals with the necessary skills to accurately diagnose and manage cardiac conditions across various patient populations. Our cardiac training covers a wide spectrum of topics, including the assessment of congenital heart defects, myocardial function, and more. This training provides a robust foundation for anyone looking to enhance their cardiac ultrasound skills.

Check out all the options for Cardiac Ultrasound Training from SonoSim.