Congenital heart disease can
last into adulthood, but it’s always present at birth. Caused by an early
developmental problem with the heart’s structure and function, it typically
interferes with proper blood flow through the heart and may affect breathing.
With today’s more advanced treatments and proper follow-up care, many infants
who once would have died of congenital heart disease are able to survive well
Congenital heart disease is
caused by a congenital heart defect. Often, the two terms are used
interchangeably. According to the March of Dimes, one in 125 babies born in the
United States has a congenital heart defect. In fact, these are the most common
type of all birth defects. Although doctors sometimes don’t know the cause of
the heart defect, suspected causes include:
- genetics: the defect may run in
- medications: some drugs taken during
pregnancy can increase the risk, such as anti-seizure medications
- alcohol or drug abuse during pregnancy
- infections: if the mother had a viral
infection in the first trimester, it may increase the risk of giving birth to a
child with a heart defect
- diabetes: may affect childhood
development. Gestational diabetes so far hasn’t been linked to congenital heart
there are many different types of congenital heart defects, they can be
condensed into three main categories:
- Heart valve defects. The valves inside the heart
that direct blood flow may close up or leak so that the heart can’t pump blood
- Heart wall defects. The natural walls that exist
between the left and right side and the upper and lower chambers of the heart may
not develop correctly, allowing blood to back up into the heart or pool where
it doesn’t belong. The defect puts pressure on the heart to work harder and may
result in high blood pressure.
- Blood vessel defects. The arteries and veins that
carry blood to the heart and back out to the body may not function correctly,
blocking or slowing blood flow.
doctors classify congenital heart defects into two types: those that result in
low oxygen levels and those that don’t. Babies who suffer from breathlessness
or whose skin turns a bluish tint aren’t getting enough blood because the heart
isn’t pumping as it should. This is called “cyanotic heart disease.” Babies who
have enough oxygen but later suffer from high blood pressure or other signs of
a heart working too hard have “acyanotic heart disease.”
Symptoms and Risk Factors
A congenital heart defect may
often be detected by an ultrasound during pregnancy. When a doctor hears a
heart murmur, for instance, they may further investigate with tests like an
echocardiogram, chest X-ray, or MRI. If a diagnosis is made, the doctor will
have the appropriate specialists on hand during delivery. Early symptoms of a
congenital heart defect include:
lips, skin, fingers, and toes
or trouble breathing
difficulties (baby seems uninterested in nursing)
oxygen levels or fainting
acyanotic heart disease where the baby is getting enough oxygen—symptoms won’t
show up until many years later. In this case, symptoms may include:
of the organs or body tissues
a congenital heart defect depends on the type and severity of the defect. Some
babies have mild heart defects that heal on their own with time. Some may need
to be treated with medications. Others may require one or more heart surgeries.
These may include: catheter procedures, open-heart surgeries or—in the most
severe cases—a heart transplant.
Congenital Heart Disease in Adults
the defect, diagnosis and treatment may proceed shortly after birth, during
childhood, or not until adulthood. Some defects present no symptoms until the
person becomes an adult, and therefore aren’t treated until then. In these
cases, symptoms of a newly discovered congenital heart defect may include:
- shortness of breath
- chest pain
- reduced ability to exercise (early fatigue)
treatment in children, adult treatment varies from watchful waiting to
medications and surgeries. Defects that may have been treated in childhood may
present problems again in adulthood. The original repair may no longer be effective
or the initial defect may become worse with time. Scar tissue that developed
around the original repair may end up causing problems like arrhythmias.
Sometimes a defect that was “mild” in childhood and required no treatment may
of the situation, everyone with congenital disease should continue to go to
their cardiologist for follow-up care. Treatments for congenital heart disease
aren’t cures. They’re merely repairs to help the patient live a normal life. The
risk for complications like high blood pressure in the lungs, heart infections,
stroke, heart failure, is higher in those with congenital heart defects, so it’s
best to maintain regular visits with a doctor who has experience in this type
of heart disease.
are 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 become pregnant, talk to your doctor about
any medications you’re taking.
- Avoid alcohol and illegal drugs during pregnancy.
- If you have diabetes, make sure your blood sugar levels are under
control before becoming pregnant and work with your doctor to manage the
disease while pregnant.
- If you weren’t vaccinated against rubella (German measles), avoid
exposure to the disease and talk to your doctor about prevention options.