A congenital heart defect (CHD) is a defect in the structure of the heart and great vessels which is present at birth. Many types of heart defects exist, most of which either obstruct blood flow in the heart or vessels near it, or cause blood to flow through the heart in an abnormal pattern.
Other defects, such as long QT syndrome, affect the heart’s rhythm. Heart defects are among the most common birth defects and are the leading cause of birth defect-related deaths. Approximately 9 people in 1000 are born with a congenital heart defect. Many defects don’t need treatment, but some complex congenital heart defects require medication or surgery.
What are the Signs and Symptoms of CHD?
Many congenital heart defects have few or no symptoms. A doctor may not even detect signs of a heart defect during a physical exam.Some heart defects do have symptoms. These depend on the number and type of defects and how severe the defects are.
Severe defects can cause symptoms, usually in newborn babies. These symptoms can include:
Cyanosis (a bluish tint to the skin, lips, and fingernails)
Poor blood circulation
Congenital heart defects don’t cause chest pain or other painful symptoms. Abnormal blood flow through the heart caused by a heart defect will make a certain sound. Your doctor can hear this sound, called a heart murmur, with a stethoscope.
However, not all murmurs are a sign of a congenital heart defect. Many healthy children have heart murmurs. Normal growth and development depend on a normal workload for the heart and normal flow of oxygen-rich blood to all parts of the body.
Babies with congenital heart defects may have cyanosis or tire easily when feeding. Sometimes they have both problems. As a result, they may not gain weight or grow as they should. Older children may get tired easily or short of breath during exercise or activity.
Many types of congenital heart defects cause the heart to work harder than it should. In severe defects, this can lead to heart failure, a condition in which the heart can’t pump blood strongly throughout the body.
Symptoms of heart failure include:
Fatigue with exercise
Shortness of breath
A buildup of blood and fluid in the lungs
A buildup of fluid in the feet, ankles, and legs
Sometimes CHD improves without treatment. Other defects are so small that they do not require any treatment. Usually CHD is a serious affliction and requires surgery and/or medications.
Medications include diuretics, which aid the baby in eliminating water, salts, and digoxin for strengthening the contraction of the heart. This slows the heartbeat and removes some fluid from tissues.
Some defects require surgical procedures to restore circulation back to normal and in some cases, multiple surgeries are needed.Interventional cardiology now offers patients minimally invasive alternatives to surgery. Device closures can now be performed with a standard transcatheter procedure using a closure device mounted on a balloon catheter.
Most patients require life-long specialized cardiac care, first with a pediatic cardiologist and later with and adult congential cardiologist. There are more than 1.8 million adults living with congenital heart defects.
How are Congenital Heart Defects Diagnosed?
Serious congenital heart defects are generally identified during pregnancy or soon after birth. Less severe defects aren’t diagnosed until children are older. Minor defects often have no symptoms and are diagnosed based on results from a physical exam and special tests done for another reason.