ABSTRACT
The presentation of congenital heart disease can vary, from the asymptomatic child presenting with a murmur, to the infant or child who presents acutely unwell with cyanosis or heart failure. The majority of cases are multifactorial, with genetic and environmental factors having a role to play. Symptoms of heart failure in early infancy include poor feeding, recurrent infections, shortness of breath, sweating, easy fatigability, failure to thrive and irritability. Older children may present with dyspnoea on exertion, decreased exercise tolerance, poor weight gain, oedema, palpitations and chest pain. The commonest murmur heard in children is the functional, innocent or physiological heart murmur. Newborns who have severe left-to-right shunts never present with heart failure in the first few days of life. The ductus arteriosis connects the descending aorta to the left pulmonary artery. In the foetus, the duct allows blood to flow from the pulmonary artery into the aorta, thereby bypassing the lungs and allowing oxygenation in the placenta.
