Structural Congenital Heart Disease
What is it?
Structural congenital heart disease is any structural
or functional abnormality or defect of the heart or its
major blood vessels present at birth. Most types of
congenital heart disease obstruct the flow of blood in the
heart or the vessels near it, or cause an abnormal flow of
blood through the heart. Rarer types of congenital heart
disease occur when the newborn has only one ventricle,
when the pulmonary artery and the aorta come out of the
same ventricle, or when one side of the heart is not
completely formed. Kinds of congenital heart disease
include atrial septal defect, coarctation of the aorta,
tetralogy of Fallot, transposition of the great vessels,
tricuspid atresia, and ventricular septal defect.
Who gets it?
Congenital heart disease is a major cause of neonatal
distress and is the most common cause of death in the
newborn other than problems related to prematurity. More
than 25,000 infants (one out of every 125 to 150) are born
with heart defects each year in the United States. The
likelihood of having a child with a congenital heart
disease increases if the mother or father, another child,
or another relative had congenital heart disease.
What causes it?
Causes of congenital heart disease include genetic and
environmental factors and lifestyle habits. Viral
infections, such as German measles, can produce congenital
heart disease. Other factors include a mother's excessive
use of alcohol or taking illegal drugs while pregnant and
exposure to certain anticonvulsant and dermatologic drugs
during pregnancy. There are some genetic conditions, such
as Down's syndrome, which affect multiple organs and can
cause congenital heart disease.
What are the symptoms?
Symptoms of congenital heart disease include shortness
of breath, cyanosis (bluish discoloration of the skin),
heart murmur, respiratory infections that recur
excessively, stunted growth, and limbs and muscles that
are underdeveloped.
How is it diagnosed?
Echocardiography and cardiac magnetic resonance imaging
are often used to diagnose congenital heart disease. An
echocardiograph can detects valve and other heart problems
by displaying an image of the heart formed by sound waves.
Fetal echocardiography is used to diagnose congenital
heart disease in utero. Cardiac magnetic resonance
imaging, a scanning method that uses magnetic fields and
radio waves, can also help physicians evaluate congenital
heart disease.
What is the treatment?
Congenital heart disease is treated with drugs and/or
surgery. Diuretics may be prescribed, which aid the baby
in excreting water and salts, as well as digoxin, which
strengthens the contraction of the heart, slows the
heartbeat, and removes fluid from tissues. Surgical
procedures seek to repair the defect as much as possible
and improve the flow of blood and oxygen to the body.
Smaller congenital heart defects can now be repaired in a
cardiac catheterization lab instead of an operating room.
Catheterization procedures include balloon atrial
septostomy and balloon valvuloplasty. Surgical procedures
include arterial switch, Damus-Kaye-Stansel procedure,
Fontan procedure, Ross procedure, shunt procedure, and
venous switch or intra-atrial baffle.
Self-care tips
Congenital heart disease cannot be predicted and many
types cannot be prevented. However, general measures
should be taken by the mother to ensure the birth of a
healthy baby, such as avoiding excess alcohol, not taking
drugs, and avoiding exposure to rubella and environmental
toxins. Many types of congenital heart disease that would
have been fatal can now be treated successfully, and
research on diagnosing heart defects while the fetus is in
the womb may lead to future treatment to correct defects
before the baby is born.
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
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