SARASOTA, Fla. (Sept. 26, 2016) – Small hearts sometimes conceal big challenges, especially when it comes to congenital heart defects.
Nicole and Mark Marquez, of Sarasota, found out firsthand the day they planned to take their newborn Nico home from Sarasota Memorial Hospital.
A nurse performing a routine health screening found his oxygen level a little low, which triggered further testing and revealed a critical heart defect that, left untreated, could have been deadly before his first birthday.
“We were all packed up and ready to go home … Nico was eating OK, his color was good. He wasn’t showing any signs of illness at all,” his mother Nicole recalled. “Then we had that screening and everything became a blur. That nurse and simple screening saved his life.”
Nico celebrated his first birthday on Saturday with delighted family and friends. His proud parents brought him back to the hospital on Monday to thank the nurses and doctors involved in his care and raise awareness about the benefits of the pulse oximetry screening.
The newborn assessment includes a physical examination, but does not always include the Critical Congenital Heart Disease Pulse Oximetry Screening, which involves placing a sensor on a thin part of a newborn’s right hand and foot. Despite recommendations from the Centers for Disease Control and Prevention for newborns to be screened at 24 hours of age, or prior to discharge from the hospital, many states, including Florida, balked at making the screening mandatory for all newborns. After several years of debate, Florida has finally joined the 45 other states requiring screenings starting in 2016.
Sarasota Memorial Hospital began universal cardiac screening of all newborns in April 2012, as part of its normal newborn screening program. Nico is actually the third baby whose screening revealed a life threatening heart defect before they left the hospital.
Judy Cavallaro, clinical manager of Sarasota Memorial’s mother-baby services, greets Mark and Nicole Marquez and their son 1-year-old Nico at the hospital on Monday. Nico Marquez, who turned 1 on Sept 24, was born with a potentially fatal heart defect discovered through a routine screening when he was just 2 days old. He showed no signs of the condition, which could have been fatal by his first birthday if not detected and surgically corrected. His proud parents brought him back to SMH on Monday to thank the nurses and doctors involved in his care and raise awareness about the benefits of the pulse oximetry screening. Nico’s September birthday is doubly significant, as it is Newborn Screening Awareness Month. The screening was performed by SMH Mother-Baby nurse Vilma Rodriguez (shown left, behind family).
“In the immediate newborn period, nothing may seem amiss because the baby's heart and lungs are transitioning from pre to post delivery circulation,” said Michelle Miller, MD, a pediatric cardiologist with Johns Hopkins All Children’s Hospital, which has an affiliation with Sarasota Memorial to provide specialty care to infants and older children in SMH’s Neonatal Intensive Care and Pediatric Units. “Prior to the newborn pulse oximetry screening, studies show that 20-25 percent of babies with critical heart defects were discharged home from our nation’s hospitals undiagnosed, only to return because of a life-threatening crisis. Detecting these cardiac abnormalities early is critical, and greatly improves survival and long-term outcomes in these infants.”
Congenital heart defects are the most common birth defects in infants, affecting about 1 percent of infants, about 40,000-50,000 each year. The painless, noninvasive, pulse oximetry screening measures the blood oxygen levels in the right hand and foot and screens for several critical congenital heart defects, including heart defects that do not allow adequate blood flow to the lungs or the body. Typically, these babies require a surgical or medical intervention in the first year of life.
Fortunately, Nico’s condition was detected before he left the hospital, at just 2 days old and before the defect caused his health to decline. He was born on Sept. 24, 2015 following an uncomplicated pregnancy. After the abnormal pulse ox screening results, an echocardiogram was performed and revealed that Nico transposition of the great arteries, also known as TGA. The two main arteries leaving his heart were reversed, which prevents oxygenated blood from reaching the body and could be life threatening without surgery.
After diagnosis, he was stabilized in Sarasota Memorial’s Neonatal Intensive Care Unit and then immediately transferred to Johns Hopkins All Children’s Hospital, where he underwent a complete surgical repair with excellent results. He was discharged on Oct. 7, at two weeks old, and has progressed normally, hitting all the usual milestones.
Nico’s September birthday is doubly significant, as it is Newborn Screening Awareness Month.
About Sarasota Memorial: Sarasota Memorial Health Care System is a regional medical center offering Southwest Florida’s greatest breadth and depth of care, with more than 900,000 patient visits a year. Sarasota Memorial’s flagship 819-bed acute care hospital has been recognized repeatedly as one of the nation’s largest, and best, with superior patient outcomes and a complete continuum of outpatient services– from urgent care clinics and physician groups, laboratory and diagnostic imaging centers, to home health and skilled nursing & rehabilitation.