Classification of Congenital heart diseases

1. Big picture

Congenital heart disease (CHD) means a structural heart or great-vessel abnormality present from birth. In pediatrics, classification is not just theoretical: it tells you why the child is cyanotic, why heart failure develops, whether the ductus arteriosus is life-saving, and how urgent the treatment is.

For the exam, think in this order:

Child/newborn with suspected congenital heart disease
↓
Is there central cyanosis?
↓
No cyanosis → acyanotic CHD
   - left-to-right shunt?
   - obstructive lesion?
↓
Cyanosis → cyanotic CHD
   - reduced pulmonary blood flow?
   - increased/mixed pulmonary blood flow?
   - parallel circulation?
↓
Is it duct-dependent?
↓
If yes: start prostaglandin E1 and transfer urgently

The safest oral-exam sentence:

“I classify congenital heart diseases first into acyanotic and cyanotic lesions; then by hemodynamics: left-to-right shunts, obstructive lesions, right-to-left shunts, mixing lesions, and duct-dependent lesions.”

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