RT Book, Section A1 Artman, Michael A1 Mahony, Lynn A1 Teitel, David F. SR Print(0) ID 1140363347 T1 Approach to the Infant With Excessive Pulmonary Blood Flow T2 Neonatal Cardiology, 3e YR 2017 FD 2017 PB McGraw-Hill Education PP New York, NY SN 9780071834506 LK accesscardiology.mhmedical.com/content.aspx?aid=1140363347 RD 2024/03/29 AB Respiratory distress in the setting of normal peripheral perfusion and without overt cyanosis is the least common manifestation of symptomatic cardiovascular disease in the newborn. Particularly in the absence of a murmur, the diagnosis of heart disease is often delayed or missed entirely because respiratory distress alone in an acyanotic infant with normal perfusion is most often caused by lung disease rather than intrinsic cardiac disease. Furthermore, symptoms usually develop gradually over the first few days or weeks of life, and the respiratory symptoms, such as tachypnea with feeding, are often subtle. It may take several weeks or more to recognize that the infant is growing poorly and that heart disease may be the cause. This chapter reviews structural cardiovascular defects that can cause respiratory distress with normal systemic perfusion; obstructive structural heart disease is discussed in Chapter 8; cardiomyopathies and arrhythmias are discussed in Chapters 9 and 10, respectively; and heart failure is discussed in Chapter 11.