Table 2

Case-by-case summary of diagnoses, complications result in readmission and symptoms

Identifier1DiagnosisComplicationSymptoms
FR01Single-ventricle disease (not HLHS)Right diaphragm palsy with plication
  • Respiratory distress

FR02HLHSWound infection (emergency sternal wound debridement)
  • Reduced feeding

  • ++vomiting

  • Abdomen ‘not quite right’ (respiratory distress)

FB03†Transposition of the great arteries (plus or minus other features)Out-of-hospital cardiac arrest (cause unknown)
  • Collapsed at home after a feed

  • No other symptoms

FB04†HLHSSudden collapse at home. Died in A&E
  • Excessive crying and screaming

  • Collapsed at home

FB05†HLHSAspirated at home
  • Reduced feeding

  • ++vomiting

  • Dry nappy

FB06†Ventricular septal defect plus significant medical comorbiditySudden collapse at home
  • Slight cough

FR07Single-ventricle disease (not HLHS)Blocked left shunt (urgent redo)
  • Respiratory distress

  • Recessing chest,

  • Purple fingertips and lips

  • Did not notice first time but symptoms pointed out at routine scan at local hospital

FR08Tetralogy of FallotBlocked shunt (urgent central shunt)
  • No obvious symptoms

  • Low sats detected during home visit

FR09Transposition of the great arteries (plus or minus other features)Resection of aortic aneurysm
  • No obvious symptoms

  • Mother felt something was wrong but did not know what it was ‘mother's instinct’

FB10†Single-ventricle disease (not HLHS) and significant medical co morbidityAspirated at home
  • Breathing

  • Pale colouring

  • ++vomiting

  • Crying

  • Found in the night in respiratory distress

FB11†HLHSSudden collapse at home. Died in A&E
  • Excessive crying

  • Unable to settle

FB12†Single-ventricle disease (not HLHS)Blocked shunt
  • Breathlessness noted by paediatrician 2 days before, appeared ‘normal’ to parents

  • Sleepier after feeds

  • Screaming and unable to comfort

  • Collapsed at home

FB13†HLHSBlocked shunt
  • No obvious symptoms

  • Routine vaccinations day before and following this:

  • More lethargic than usual

  • Diarrhoea in night

  • Deteriorated over the course of the day

  • Respiratory distress ->collapsed at home

FB14†Anomalous coronary artery from pulmonary arterySudden collapse at home. Died in A&E
  • Sweating++ and vomiting after feeds,

  • ‘Spelling’ intermittently (pale/blue/grey lips)

  • Quiet and weak in the AM

  • Grunting/straining sounds

  • Started screaming during feed and collapsed

FR15Single-ventricle disease (not HLHS)Severe mitral regurgitation and left ventricular failure
  • Reduced appetite

  • Lethargic

  • Vomiting

  • Cough

  • ‘Grunting’ breath sounds

FR16†Single-ventricle disease (not HLHS)Pacemaker pocket infection and dehydration
  • ++crying and restless at night

  • Rapid breathing

  • Blue face/hands/lips

  • Recessing under ribs

FB17†Single-ventricle disease (not HLHS)Sudden collapse at home. Died in A&E
  • Appeared ‘agitated’ and generally less settled

  • Taking less feed in one go

  • Slight cough

  • Routine vaccinations week prior to death.

  • Collapsed during feed

FB18†Single ventricle disease (not HLHS) Sudden collapse at home. Died in A&E
  • More ‘emotional’ and ‘moody’

  • More difficult to comfort

  • Easily tired

  • Breathless on activity

  • Napping more during daytime

  • More unsettled at night

  • Blue hands and feet at times

  • Vomiting in hot weather

  • Sweating

  • Woke in night crying, vomiting and short of breath, then screamed and collapsed

FR19Transposition of the great arteries (plus or minus other features)Readmitted for coarctation repair
  • High blood pressure picked up at local review resulting in readmission to tertiary centre

  • No clinical signs observed

FR20Total anomalous pulmonary venous drainageIncreasing left upper pulmonary vein stenosis, ongoing tachypnoea and hepatomegaly with increased right heart pressures secondary to increased pulmonary venous pressures
  • General ‘grumpiness’

  • Mother feeling that something was not right

  • High rate of breathing

  • Vomiting

  • Broad diagnostic grouping have been used to preserve the anonymity of patients with rare conditions.

  • †Indicates that the child is deceased.

  • HLHS, hypoplastic left heart syndrome.