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Congenital Heart Defects in Children – an Overview | Cardiology

What are congenital heart defects in children?

Congenital heart defects in children (CHDs) are the most well-known sort of birth deformity. With advances in medical care and treatment, children with CHD live longer and healthier lives. Find out more facts about coronary heart disease below.

What are congenital heart defects (CHDs)?

Coronary artery disease is present at birth and can affect the structure and functioning of a baby’s heart. It can affect how blood flows through the heart and out to the rest of the body. Coronary artery disease can vary from mild (such as a small hole in the heart) to severe (such as missing or poorly formed parts of the heart).

About 1 in 4 babies born with a heart defect suffer from critical coronary heart disease (also known as a serious congenital heart defect). Babies with critical coronary heart disease need surgery or other procedures in the first year of life.

Types of congenital heart defects in children

Babies and children with all types of congenital heart defects receive expert diagnosis and treatment from specialists at the Pediatric Congenital Heart Program. Congenital heart defects in children occur at birth and affect the heart or blood vessels. Hundreds of heart defects can arise as a baby develops in the womb, and some infants may have more than one. Some defects cause no health challenges for years; in fact, some may never pose a health risk.

However, many infants require treatment with surgery or catheter procedures to repair congenital heart defects in children immediately or in the first few months of life. Others may need medication as a bridge to surgery or other procedures, or as the only therapy to manage symptoms.

Our experts treat babies and children with all types of congenital heart defects in children, including:

  • Aortic valve stenosis
  • Atrial septal defect
  • Ebstein’s anomaly
  • Hypoplastic left heart syndrome
  • Interrupted aortic arch
  • Coarctation of the aorta
  • Complete atrioventricular canal defect
  • Patent ductus arteriosus
  • Total anomalous pulmonary venous return
  • Transposition of the great arteries
  • Tricuspid atresia
  • Pulmonary valve stenosis
  • Tetralogy of Fallot
  • Truncus arteriosus
  • Ventricular septal defect

Symptoms of congenital heart defects in children

Serious congenital heart defects in children usually appear soon after birth or within the first few months of life. They can include signs and symptoms:

  • Pale gray or blue skin color (cyanosis)
  • Rapid breathing
  • Swelling in the legs, abdomen, or areas around the eyes
  • Shortness of breath during feeding, resulting in poor weight

Less serious congenital heart defects in children may not be diagnosed until later in childhood, because your child may not show any noticeable signs of a problem. If signs and symptoms occur in older children, they may include:

  • Feeling short of breath easily during exercise or activity
  • Fatigue easily during exercise or activity
  • Fainting during exercise or activity
  • Swelling in the hands, ankles, or feet

Causes of congenital heart defects in children

Doctors don’t always know why a child has a congenital heart defect. It tends to run in families. Things that make congenital heart defects in children more likely include:

  • Genetic or chromosomal problems in a child, such as Down syndrome
  • Taking certain medications or alcohol or drug abuse during pregnancy
  • A viral infection, such as rubella (rubella) in the mother in the first trimester of pregnancy

How are heart defects treated?

Youngsters with minor heart deformities may not require any treatment. However, some children suffer from severe symptoms that require medical or surgical treatment during the first year of life. They will be taken care of:

  • Pediatric cardiologists: Doctors who specialize in treating children’s heart problems
    or
  • Pediatric heart surgeons: Specialists in pediatric heart surgery

Procedures performed through cardiac catheterization – such as balloon angioplasty or valvuloplasty – can dilate blood vessels or a blocked valve. Another procedure, blockage of the catheter device, can close abnormal openings or holes in the heart or blood vessels without surgery.

Some problems, such as small or medium-sized ventricular septal defects, may close or get smaller as the child grows. While waiting for the hole to close, the child may have to take medications. Complex Congenital heart defects in children detected early may need a series of processes ending when the child is approximately 3 years old.

Testing and diagnosis of congenital heart disease

Several serious congenital heart diseases are detected during pregnancy, during a routine ultrasound examination. Other conditions may be diagnosed soon after birth. Less serious heart conditions may not be diagnosed until children get older and begin to show certain signs or symptoms of congenital heart disease.

During pregnancy, if your doctor thinks your baby may have CHD, you will likely be referred to a pediatric cardiologist for further testing. The type of diagnostic tests performed will depend on the form of coronary heart disease your child may have. Examples of tests used include a fetal echocardiogram, electrocardiogram (EKG), magnetic resonance imaging of the heart (MRI), and cardiac catheterization. If you are referred to the Children’s Hospital of Philadelphia, you will be seen through the Heart Center’s Fetal Heart Program.

Risk factors for congenital heart defects in children

Most Congenital heart defects in children are caused by problems early in the development of your baby’s heart, and the cause is unknown. However, some environmental and genetic risk factors may play a role. They include:

  • Rubella (German measles): German measles infection during pregnancy can cause problems with the development of your baby’s heart. Your doctor can test for immunity to this viral disease before pregnancy and vaccinate you against it if you are not immune.
  • You can reduce the risk of Congenital heart defects in children by carefully controlling diabetes before trying to conceive and during pregnancy. Gestational diabetes generally does not increase your baby’s risk of developing a heart defect.
  • Some medications taken during pregnancy may cause birth defects, including congenital heart defects. Provide your doctor with a complete list of all medications you take before trying to conceive.
  • Medicines known to increase the risk of congenital heart defects include thalidomide (Thalomide), angiotensin-converting enzyme (ACE) inhibitors (ACE), statins, acne medication isotretinoin (Absorica, Amnstim, and Claravis), and lithium.
  • Drinking alcohol during pregnancy: Avoid drinking alcohol during pregnancy because it increases the risk of Congenital heart defects in children.
  • Smoking during pregnancy increases the likelihood of a congenital heart defect in the baby.
  • Congenital heart defects in children sometimes run in families and may be associated with an inherited syndrome. Many children with Down syndrome – which is caused by an extra chromosome 21 (trisomy 21) – have heart defects. A missing (deleted) piece of genetic material on chromosome 22 also causes heart defects.
  • Genetic testing can detect such disturbances during fetal development. If you already have a baby with a congenital heart defect, a genetic counselor can estimate the odds that your next child will have it.

Complications of congenital heart defects in children

Complications depend on the type of congenital heart defect you have. Include some potential complications:

  • Arrhythmia
  • Blood clots
  • Developmental disorders and delays: Children with congenital heart defects are more likely to have behavior problems. They are also more likely to have speech and attention-deficit / hyperactivity disorder.
  • Emotional health issues: Depression, anxiety, and PTSD are common among people with congenital heart defects.
  • Endocarditis: A type of heart inflammation
  • Endocrine disorders: Include thyroid problems, bone health problems, and diabetes. Problems with the hormones that deal with calcium can cause bone problems.
  • Heart failure: Heart failure is the leading cause of death in adults with congenital heart defects. Some children with congenital heart defects develop heart failure.
  • Kidney disease
  • Liver disease
  • Pneumonia: Pneumonia is a leading cause of death in adults with congenital heart disease.
  • Pregnancy complications: Women with congenital heart defects are at increased risk of developing complications during pregnancy and childbirth. Read more in the Living With section.
  • Pulmonary hypertension
  • Stroke

Outlook and follow-up care for congenital heart disease

Children with congenital heart disease are monitored by specialists called pediatric cardiologists. These doctors diagnose heart disease and help manage children’s health before and after surgical repair of a heart problem. The specialists who correct heart problems in the operating room are known as pediatric cardiovascular surgeons or cardiothoracic surgeons.

It is imperative that individuals born with congenital heart disease who have reached adulthood transition to the appropriate type of heart care. The type of care required depends on the type of CHD the person has. Generally, people with mild types of Congenital heart defects in children can be cared for by a community adult cardiologist. People with more complex types of coronary heart disease will need care at a center that specializes in adult congenital heart disease, such as the Philadelphia Adult Congenital Heart Center.

How can congenital heart disease be prevented?

Women who are pregnant or planning to become pregnant can take certain precautions to reduce the risk of having a baby with a congenital heart defect:

  • If you are planning to become pregnant, talk to your doctor about any prescription or over-the-counter medicines you are taking.
  • If you have diabetes, make sure your blood sugar levels are controlled before pregnancy. It is also important to work with your doctor to manage illness during pregnancy.
  • If you have not been vaccinated against rubella or rubella, avoid exposure to the disease and talk to your doctor about prevention options.
  • If you have a family history of congenital heart defects, ask your doctor about genetic testing. Certain genes may contribute to abnormal heart development.
  • Avoid drinking alcohol and using drugs during pregnancy.
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Disease

Types of Congenital Heart Disease | Cardiology

What is congenital heart disease?

Congenital heart disease is a problem with the structure of the heart. It is at birth. Defects include the walls of the heart, the heart valves, and the arteries and veins near the heart. These interrupt the normal flow of blood through the heart. Blood flow may slow down, go in the wrong direction or the wrong place, or be completely blocked.

Is congenital heart disease an elective or an emergency procedure?

Congenital heart disease (CHD) is the most common birth defect, affecting approximately 125 live births. Advances in medical care have enabled 90% of these children to live to adulthood. Children with coronary heart disease are more prone to childhood illnesses than healthy children and therefore require selective and emergency surgery at their local hospital. In general, children with coronary artery disease who undergo non-cardiac surgery have an increased risk of disease, perioperative cardiac arrest, and 30-day mortality.

However, it is impossible to generalize the complexity of heart defects and the different types of heart surgery. A 9-year-old child with a repaired atrial septal defect (ASD) has a lower risk of requiring an emergency appendectomy; However, a 12-year-old boy with failed mono ventricular conduction for the same operation presents a significant challenge to even the most experienced pediatric cardiac anesthetist.

Types of congenital heart disease

Although there are many types of congenital heart defects, they can be divided into three main categories:

  • In heart valve defects, direct blood flow can cause the valves within the heart to close or leak. It interferes with the heart’s ability to pump blood properly.
  • In heart wall defects, the natural walls on the left and right sides and between the upper and lower chambers of the heart may not develop properly, causing blood to flow back to the heart or pool where it is not. Deficiency puts pressure on the heart to work harder, leading to high blood pressure.
  • In vascular disorders, the arteries and veins that carry blood to the heart and the body may not work properly. It can reduce or block blood flow, which can lead to various health problems.

Causes of congenital heart disease

Congenital heart disease occurs as a result of an early developmental problem in the structure of the heart. The deficiency generally interferes with the normal flow of blood through the heart, affecting breathing.

Risk factors for congenital heart disease

Congenital heart defects are the most common birth defect, occurring in about one percent of live births in the united states. If your baby has a congenital heart defect, you may think you did something wrong during your pregnancy.

However, doctors often do not know why congenital heart defects occur. Researchers know that the risk of having a baby with congenital heart defects is influenced by family history and genetics, maternal health, gender, and exposure to environmental factors such as smoke or certain drugs during pregnancy. Other medical conditions can also increase your risk of having a baby with congenital heart defects.

Signs and symptoms of congenital heart disease

The signs and symptoms are related to the type and severity of the heart defect. Symptoms often appear early in life, but some coronary heart disease goes undiagnosed throughout life. Some children have no symptoms, while others have shortness of breath, cyanosis, epilepsy, a heart murmur, organ and muscle development, poor nutrition or growth, or respiratory infections.

Congenital heart defects cause abnormal heart formation, causing certain sounds called heart murmurs to be produced. These can sometimes be detected by oscillation. However, not all heart murmurs are caused by congenital heart defects.

Diagnosis of congenital heart disease

Some coronary heart diseases can be diagnosed during pregnancy using a specialized ultrasound called a fetal echocardiogram, which creates ultrasound images of the developing baby’s heart. However, some heart conditions are not detected after birth or later in life, until childhood or adolescence. If the doctor suspects coronary heart disease, the baby may receive various tests (such as an echocardiogram) to confirm the diagnosis.

Treatment for congenital heart disease

You may not need treatment. Or you may need medicine, surgery, or other procedures. If you have congenital heart disease, you should see a cardiologist every day.

People with congenital heart defects are more likely to have inflammation of the lining of the heart (condition doctors call endocarditis), especially if their heart has been repaired or replaced by surgery. 

Prevention

  • Avoid drinking alcohol or using drugs.
  • Check with your GP or pharmacist before taking any medications during pregnancy, as they include herbal and over-the-counter medications.
  • Take 400 micrograms of the folic acid supplement per day during the first trimester (first 12 weeks) of your pregnancy – this will reduce the risk of giving birth to a baby with congenital heart disease, as well as many other types of birth defects.
  • Make sure you are vaccinated against rubella and the flu (influenza).
  • Avoid exposure to organic solvents such as dry cleaning, paint thinner, and nail polish remover.

Complications

Complications of congenital heart disease occurring a few years after treatment:

  • Irregular heartbeat (arrhythmia): An arrhythmia occurs when the electrical signals that coordinate your heartbeat don’t work properly. Your heart may beat too fast, too slow, or irregular. In some people, severe arrhythmia can lead to stroke or sudden cardiac death if left untreated. Scar tissue in your heart from previous surgeries can contribute to this problem.
  • Pulmonary hypertension: This is high blood pressure that affects the arteries in your lungs. Some congenital heart defects send more blood to the lungs, causing increased pressure. This can eventually weaken your heart muscle and sometimes fail.
  • Heart failure: Heart failure (circulatory heart failure) means that your heart cannot pump enough blood to meet the needs of your body. Some types of congenital heart disease can lead to heart failure.

Department to consult for this condition

  • Department of Cardiology