<unk>  can sometimes be diagnosed in utero with an ultrasound after 18 weeks gestation. However, if it is not diagnosed in utero, cyanosis of the newborn (blue baby) should immediately indicate that there is a problem with the cardiovascular system. Normally, the lungs are examined first, then the heart is examined if there are no apparent problems with the lungs. These examinations are typically performed using ultrasound, known as an echocardiogram when performed on the heart. Chest x-rays and electrocardiograms may also be used in reaching or confirming a diagnosis; however, an x-ray may appear normal immediately following birth. If<unk>  is accompanied by both a VSD and pulmonary stenosis, a systolic murmur will be present. On the rare occasion (when there is a large VSD with no significant left ventricular outflow tract obstruction), initial symptoms may go unnoticed, resulting in the infant being discharged without<unk> ment in the event of a hospital or birthing center birth, or a delay in bringing the infant for diagnosis in the event of a home birth. On these occasions, a layperson is likely not to recognize symptoms until the infant is experiencing moderate to serious congestive heart failure (CHF) as a result of the heart working harder in a futile attempt to increase oxygen flow to the body; this overworking of the heart muscle eventually leads to hypertrophy and may result in cardiac arrest if left untreated. Normal heart anatomy compared to<unk>  Description In a normal heart, oxygen-depleted ("blue") blood is pumped from the right side of the heart, through the pulmonary artery, to the lungs where it is oxygenated. The oxygen-rich ("red") blood then returns to the left heart, via the pulmonary veins, and is pumped through the aorta to the rest of the body, including the heart muscle itself. With<unk> , deoxygenated blood from the right heart is pumped immediately through the aorta and circulated to the body and the heart itself, bypassing the lungs altogether, while the left heart pumps oxygenated blood continuously back into the lungs through the pulmonary artery. In effect, two separate "circular" (parallel) circulatory systems are<unk> ed, rather than the "figure 8" (in series) circulation of a normal cardio-pulmonary system. Variations and similar defects Arterial spatial relationships Differences in the shape of the atrial septum and/or ventricular outflow tracts affect the relative positions of the aorta and pulmonary artery. In the majority of<unk>  cases, the aorta is anterior and to the right of the pulmonary artery, but it can also be directly anterior or anterior and to the left. The aorta and pulmonary artery can also be side by side, with aorta on either side. This is a less common variant, and with this arrangement, an unusual coronary artery pattern is common. There are also some cases with aorta to the right and posterior to the pulmonary artery. Simple and complex<unk> <unk>  is often accompanied by other heart defects, the most common type being intracardiac shunts such as atrial septal defect (ASD) including patent foramen ovale (PFO), ventricular septal defect (VSD), and patent ductus arteriosus (PDA). Stenosis of valves or vessels may also be present. When no other heart defects are present it is called 'simple'<unk> ; when other defects are present it is called 'complex'<unk> . Although it may seem counterintuitive, complex<unk>  presents better chance of survival and less developmental risks than simple<unk> , as well as usually requiring fewer invasive palliative procedures. This is because the left-to-right and bidirectional shunting caused by the defects common to complex<unk>  allow a higher amount of oxygen-rich blood to enter the systemic circulation. However, complex<unk>  may cause a very slight increase to length and risk of the corrective surgery, as most or all other heart defects will normally be repaired at the same time, and the heart becomes "irritated" the more it is manipulated.
Dextro-Transposition of the great arteries
Double aortic arch
Levo-Transposition of the great arteries
Transposition of the great vessels
Double outlet right ventricle
Tetralogy of Fallot
Trilogy of Fallot
Interrupted aortic arch