North American Registry of Midwives (NARM) Practice Exam

What are the two primary signs of heart disease in a newborn?

1. Cyanosis and Hypotension

2. Cyanosis and Tachypnea

3. Palpitations and Tachycardia

4. Bradycardia and Cyanosis

The correct answer is: Cyanosis and Tachypnea

Cyanosis and tachypnea are fundamental signs that may indicate heart disease in a newborn. Cyanosis refers to a bluish discoloration of the skin and mucous membranes, typically resulting from inadequate oxygenation of the blood. When a newborn demonstrates cyanosis, especially if it's persistent or occurs during feeding or crying, it raises concerns regarding potential congenital heart defects or other cardiac issues that impair oxygen delivery. Tachypnea, or rapid breathing, can also signify cardiovascular problems. This may occur as the newborn's body attempts to compensate for low oxygen levels by increasing the respiratory rate. In cases of heart disease, the heart may not effectively pump blood, resulting in reduced oxygen perfusion and triggering a compensatory response of increased respiration. Together, these two signs are critical indicators that warrant further evaluation to determine the underlying cause and ensure appropriate management. While other combinations of symptoms may also suggest heart issues, such as bradycardia (slow heart rate) or hypotension (low blood pressure), cyanosis and tachypnea are more common and directly related to the body’s acute response to inadequate oxygenation. Understanding these primary signs allows healthcare providers to promptly recognize potential neonatal heart conditions and take necessary actions.