# Congenital anomaly of the circulatory system - Category: chronic - Review status: reviewed (every claim checked against a document named on this page) - 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 date: 2026-08 ## Verified against - 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) ## Treatment metadata - No drug therapy in primary care (Referral & Advice) ## Complete treatment card ```text CONGENITAL ANOMALY OF THE CIRCULATORY SYSTEM 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/ Review status: REVIEWED against 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) (2026-08) 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 Source StatPearls "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 Status traced to the source above 1. NO DRUG THERAPY IN PRIMARY CARE (REFERRAL & ADVICE) [1st line] Adult 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 Peds Children follow the same pathway: recognise and refer. No primary-care medicine is implied. 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. Caution 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. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. [Privacy policy](/privacy)