Congenital heart disease, or a congenital heart defect, is a heart abnormality present at birth. The issue can affect:
• the heart walls
• the heart valves
• the blood vessels
There are numerous kinds of congenital heart defects. They can range from simple conditions that don’t cause symptoms to complex issues that cause severe, life-threatening symptoms.
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According to the Centers for Disease Control and Prevention, there are currently 1 million adults and 1 million children in the United States present with congenital heart defects. Treatments and follow-up care for defects have improved drastically over the past few decades, so nearly all children with heart defects survive into adulthood. Some require continuous care for their heart defect throughout their lives. However, many go on to have active and productive lives despite their condition.
Types of Congenital Heart Disease
Though there are many different kinds of congenital heart defects, they can be divided into three main categories:
• In heart valve defects, the valves inside the heart that direct blood flow may close up or leak. This interferes with the heart’s ability to pump blood correctly.
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• In heart wall defects, the natural walls that exist between the left and right sides and the upper and lower chambers of the heart may not develop correctly, causing blood to back up into the heart or to build up in areas where it doesn’t belong. The defect puts pressure on the heart to work harder, which may lead to high blood pressure.
• In blood vessel defects, the arteries and veins that convey blood to the heart and back out to the body may not operate correctly. This can reduce or block blood flow, resulting in various health complications.
Cyanotic and Acyanotic Congenital Heart Disease
Many doctors classify congenital heart disease as either cyanotic congenital heart disease or acyanotic congenital heart disease. In both situations, the heart isn’t pumping blood as efficiently as it should. The main difference is that cyanotic congenital heart disease creates low levels of oxygen in the blood, and acyanotic congenital heart disease doesn’t. Babies with reduced oxygen levels may notice breathlessness and a bluish tint to their skin. Babies who have enough oxygen in their blood don’t show these symptoms, but they may still develop complications later in life, such as high blood pressure.
What Are the Symptoms of Congenital Heart Disease?
A congenital heart defect is often observed during a pregnancy ultrasound. If your doctor notices an abnormal heartbeat, for example, they may further investigate the issue by carrying out certain tests. These may include an echocardiogram, a chest X-ray, or an MRI scan. If a diagnosis is made, your doctor will make sure the appropriate specialists are available during delivery.
In some situations, the symptoms of a congenital heart defect may not appear until shortly after birth. Newborns with heart defects may experience:
• bluish lips, skin, fingers, and toes
• breathlessness or trouble breathing
• feeding difficulties
• low birth weight
• chest pain
• delayed growth
In other situations, the symptoms of a congenital heart defect may not appear until many years after birth. Once signs do develop, they may include:
• abnormal heart rhythms
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• trouble breathing
What Causes Congenital Heart Disease?
Congenital heart disease happens as a result of an early developmental problem in the heart’s structure. The defect typically interferes with the normal flow of blood through the heart, which may affect breathing. Although researchers aren’t precisely sure why the heart fails to develop correctly, suspected causes include the following:
• The heart defect may run in families.
• Taking certain prescription drugs during pregnancy puts a child at a higher risk for a heart defect.
• Using alcohol or illegal drugs during pregnancy can increase a child’s risk of having a heart defect.
• Mothers who had a viral infection during the first trimester of pregnancy are more likely to give birth to a child with a heart defect.
• Increased blood sugar levels, such as happens with diabetes, may affect childhood development.
How Is Congenital Heart Disease Treated?
The treatment for a congenital heart defect depends on the type and severity of the sitaution. Some babies have mild heart defects that heal on their own with time. Others may have severe defects that need extensive treatment. In these cases, treatment may include the following:
There are various medications that can assist the heart work more efficiently. Some can also be used to keep blood clots from forming or to control an irregular heartbeat.
Implantable Heart Devices
Some of the complications linked with congenital heart defects can be stopped with the use of certain devices, including pacemakers and implantable cardioverter defibrillators (ICDs). A pacemaker can help regulate an abnormal heart rate, and an ICD may correct life-threatening irregular heartbeats.
Catheterization techniques lets doctors to repair certain congenital heart defects without surgically opening the chest and heart. During these procedures, the doctor will put a thin tube into a vein in the leg and guide it up to the heart. Once the catheter is in the correct place, the doctor will use small tools threaded through the catheter to correct the defect.
This type of surgery may be required if catheter procedures aren’t enough to repair a congenital heart defect. A surgeon may carry out an open-heart surgery to close holes in the heart, repair heart valves, or widen blood vessels.
In the rare situations in which a congenital heart defect is too complex to fix, a heart transplant may be required. During this procedure, the child’s heart is replaced with a healthy heart from a donor.
Congenital Heart Disease in Adults
Depending on the defect, diagnosis and treatment may start shortly after birth, during childhood, or in adulthood. Some defects don’t cause any signs until the child becomes an adult, so diagnosis and treatment may be delayed. In this situation, the symptoms of a newly discovered congenital heart defect may include:
• shortness of breath
• chest pain
• a reduced ability to exercise
• being easily fatigued
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The treatment for congenital heart disease in adults can also differ depending on the severity of the heart defect. Some people may only have to monitor their condition closely, and others may need medications and surgeries.
In some cases, defects that may have been treated in childhood can pose problems again in adulthood. The original repair may no longer be effective or the initial defect may have become worse over time. Scar tissue that started around the original repair may also end up causing problems, such as heart arrhythmias.
Irrespective of your situation, it’s vital to continue seeing your doctor for follow-up care. Treatment may not cure your condition, but it can help you maintain an active, productive life. It will also reduce your risk for serious complications, such as heart infections, heart failure, and stroke.
How Can Congenital Heart Disease Be Prevented?
Women who are pregnant or plan on becoming pregnant can take certain precautions to lower their risk of giving birth to a baby with a congenital heart defect:
• If you’re planning on getting pregnant, talk to your doctor about any prescription or over-the-counter medications you’re taking.
• If you have diabetes, ensure your blood sugar levels are under control before becoming pregnant. It’s also vital to work with your doctor to manage the disease while pregnant.
• If you weren’t vaccinated against rubella, or German measles, 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 screening. Certain genes may add to abnormal heart development.
• Avoid drinking alcohol and using illegal drugs during pregnancy.