Episode Details
Back to Episodes#461 - [🫀 From The Heart] - Blue Baby, Gray Baby: Severe LV Dysfunction Masquerading as PPHN
Description
A term newborn looks fine on mom's chest, then crashes within minutes. By the time transport arrives, there's a pH of 6.9, a lactate over 10, and a baby already intubated and on surfactant. Is this pulmonary hypertension, congenital heart disease, or something else entirely? In this episode of From the Heart, It's Complicated, Dr. Adrianne Bischoff and Dr. Nim Goldshtrom work through a real, complex neonatal cardiac case in real time — the kind of case that keeps neonatologists up at night. They break down how to clinically differentiate PPHN from congenital heart disease with limited data, why epinephrine's response mattered more than the blood pressure number, how therapeutic hypothermia can unmask cardiac dysfunction, and why "blue is always better than gray" when managing a shunt-dependent circulation. Along the way: real literature, real physiology, and the reasoning behind decisions made under pressure, with a surprise diagnosis at the end.
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Enjoy!