Congenital Heart Defects or CHDs are issues with the structure of a heart, developed even before the baby is born. The severity of these defects may range from mild to complex. However, in any case, blood flow to the heart and other parts/organs of the body is obstructed from following its normal course. Depending on how serious the CHDs are, one may require no treatment at all or be set for a lifetime’s worth of surgeries/medications over the years.
What are Congenital Heart Defects?
A congenital heart defect affects the structure of a heart, either slowing down or disrupting the usual flow-cycle of blood. It may occur in the form of a hole in the heart, or problems with heart valves or blood vessels. Issues with the heart valves can include leaky valves or regurgitation; valves with no proper opening, a phenomenon known as atresia. In the case of blood vessels, their number may be too few or too many causing the flow of blood to take wrong routes or progress slowly.
Types of Congenital Heart Defects
The severity of congenital heart defects can fluctuate based on the type of issue with the heart. Here are the different types of CHDs that have been diagnosed to date:
Atrial Septal Defect (ASD)
ASD is a condition where the upper chambers of the heart have a hole. This increases the blood flow amount otherwise traced through one’s lungs.
Atrioventricular Canal Defect
Atrioventricular canal defect results when there is a hole in the wall that is present between heart chambers (ventricles). This triggers problems with the valves that control the flow of blood to the heart.
Bicuspid Aortic Valve
Issues with the aortic valve, like its narrowing or enlarged state, can negatively impact the flow of blood.
Coarctation of Aorta
This condition refers to the narrowing of the aorta, considered to be the main artery of the body. It triggers the heart to work harder to pump blood.
Congenital Mitral Valve Anomalies
Congenital mitral valve anomalies are defects in the valve present between two heart chambers.
Double-outlet Right Ventricle
Double outlet right ventricle is a heart defect resulting from the disconnected state of the aorta (main body's artery) and pulmonary artery (lung artery).
Ebstein Anomaly
Epstein anomaly is a rare condition where the tricuspid valve causes a disconnect between the top and bottom right chambers of a heart.
Eisenmenger Syndrome
Here, due to irregular blood flow in the heart and lungs, blood vessels in the lungs become narrow and stiff. Thus, there is an increase in blood pressure within the lungs’ arteries - resulting in long-term damage to the lungs' blood vessels.
Hypoplastic Left Heart Syndrome
Blood flow is impacted due to the incomplete development of the left side of the heart, it being too small. The right side, instead, overworks to keep the blood flowing.
Kawasaki
Kawasaki disease, also known as mucocutaneous lymph node syndrome, is a condition where walls of small to medium-sized blood vessels swell up.
Long QT Syndrome
This condition causes irregular patterns of heartbeat. Long QT syndrome can also develop later in life, due to intake of certain medicines or alterations in the body's mineral levels.
Partial Anomalous Pulmonary Venous Return
In this condition, the pulmonary veins end up attaching themselves to the wrong parts of the heart. Due to extra blood flowing into the right side of the heart, the chambers on the right may swell up.
Patent Ductus Arteriosus
If the ductus arteriosus of an unborn baby’s blood-flow system within the womb remains open after birth, it results in Patent Ductus Arteriosus.
Patent Foramen Ovale
Patent foramen ovale is a condition resulting from the non-closure of a hole in the heart after birth, present between the atria.
Pulmonary Atresia
This condition occurs when the pulmonary valve does not develop correctly.
Pulmonary Atresia with Intact Ventricular Septum
An individual is, first, diagnosed with pulmonary atresia. However, the natural course of blood flow remains intact, through an opening situated between the aorta.
Pulmonary Atresia Ventricular Septal Defect
In this case, an individual is diagnosed with pulmonary atresia too. Additionally, there is a hole present between the two heart chambers responsible for pumping blood.
Pulmonary Valve Stenosis
Pulmonary valve stenosis is a condition where the valve between lung arteries and the heart chambers narrows down.
Tetralogy of Fallot
The tetralogy of Fallot in babies consists of four different types of heart problems occurring at once, resulting in the disruption of usual blood flow.
Transposition of the Great Arteries
In the transportation of the great arteries, the two arteries coming out of the heart are reversed in position. Its subtypes include complete transposition of the great arteries and congenitally corrected transposition.
Tricuspid Atresia
Tricuspid atresia develops when the valve between the two right heart chambers is not formed, instead, a layer of tissues blocks the flow of blood between them.
Truncus Atresia
Instead of two blood vessels leaving the heart, truncus atresia causes only one to do so.
Vascular Rings
In this condition, the aorta or its parts form a ring-like structure around the food pipe, windpipe or both.
Ventricular Septal Defect
A ventricular septal defect is more of a commonly occurring congenital heart defect. In this condition, there is a hole in the wall that distinguishes between two ventricles.
Wolff-Parkinson-White Syndrome (WPW)
The WPW syndrome is one where there is an extra, unaccounted path running between the heart’s lower and upper chambers. This causes the heart to beat faster, and work harder.
Symptoms of Congenital Heart Defects
Congenital heart defects pose issues with blood flow to different parts of the body and also cause the heart muscle to grow larger in some cases. Owing to it, the heart works harder to pump blood. Some measurable symptoms experienced by affected individuals include fatigue, murmurs/whooshing sounds accompanied by irregular heartbeats (arrhythmias), edema, shortness of breath, a pounding heart, rapid breathing, poor blood circulation, and weakened pulse, among others. Blue to greyish tone of the affected baby's skin/lips (cyanosis) is also a tell/tale sign of CHDs.
Causes of Congenital Heart Defects
While no specific causes of congenital heart defects have been pinpointed, researchers and healthcare professionals around the world have short-listed some possible sources. They include gene alterations, poor lifestyle choices like indulgence in smoking, and compromised environmental conditions. Intake of certain medications may also cause congenital heart defects, including isotretinoin for acne or lithium for bipolar disorder.
Risk Factors of Congenital Heart Defects
Genetics poses a risk factor when it comes to congenital heart defects. While usually not passed over to a child from a parent, there still remains a fighting chance for it to be the case. Smoking by the mother at the time of pregnancy or passive smoking also increases the risks of congenital heart defects. Finally, medication taken during the first trimester of pregnancy can put the baby at risk of developing CHD. Such medications include ones for regulating high blood pressure and the appearance of acne.
Diagnosis of Congenital Heart Defects
Foetal ultrasound can reveal the occurrence of congenital heart defects, thus making it possible for health professionals to detect them during pregnancy. Post-birth, delay in growth or changes in the colour of a baby's lips or skin can indicate heart defects. Certain tests shall be conducted to diagnose CHDs, including pulse oximetry, ECG, echocardiogram, chest X-ray, heart MRI and cardiac catheterisation.
Treatment of Congenital Heart Defects
Congenital heart defect treatment depends on the severity of the condition and its type. For example, a small hole in a child’s heart may close up as they grow up. On the other hand, certain defects will require surgery or medication. Water pills may be prescribed, also known as diuretics. They will drain the body of extra fluid, lessening the pressure on the heart. Heart rhythm drugs or blood pressure drugs may also be prescribed. In case of a serious congenital heart defect, heart surgery or even a heart transplant may be necessary.
Preventive Measures for Congenital Heart Defects
Congenital heart defect prevention measures are tough to isolate as the causes are, in most cases, unknown. However, there are certain healthy guidelines one can follow during pregnancy. Avoiding the use of recreational drugs, staying away from active/passive smoking and keeping underlying health conditions regulated, shall help. It is also safer to undergo recommended screening tests to detect any CHD-related problem as early as possible.
Myths and Facts Related to Congenital Heart Defects
Here are some myths associated with congenital heart defects, subsequently busted by relevant facts:
Myth 1: A Child with Congenital Heart Defects Cannot Lead an Active Life Fact: A child with congenital heart defects should be encouraged to lead an active life, as it automatically means keeping the heart healthy. Surgical corrections may help too. By consulting the respective health professional, a child can safely participate in physical activities in moderation.
Myth 2: People with Congenital Heart Defects Always Die Early Fact: People affected by congenital heart defects require ongoing care and surveillance, often requiring medication and surgeries. However, with the right resources, affected individuals can live a long life.
Myth 3: Holes in the Heart will Go Away with Age Fact: A hole in the heart is a congenital heart defect. While it’s possible for it to close up as a child grows up, it’s not a guaranteed outcome. It may require professional intervention at some point.
FAQs
Are congenital heart defects life-long?
Congenital heart defects typically require lifelong care and healthcare expertise on call. Symptoms may also worsen with time. So, it is important to have the right group of doctors on the affected individual's side.
How can I live a fruitful life with CHD?
What is congenital heart defects recovery time?
What types of foods can I have with a CHD?
What foods should I avoid if I have congenital heart defects?