Defects With Increased Pulmonary Blood Flow

An infant can remain pink and still be developing cardiac failure. In an ASD, VSD, PDA, or AVSD, blood that has already received oxygen is redirected through the pulmonary circulation instead of moving only forward to the body. The lungs receive excess flow, and the heart must handle the additional volume with every breath and feed. At the bedside, the experienced clue is often a change in feeding rather than a change in colour: the infant breathes faster, sweats, tires, takes longer to feed, or produces fewer wet diapers. Those findings connect the anatomy to the immediate nursing priorities—work of breathing, feeding endurance, growth, hydration, and perfusion.