A baby’s heart begins to beat as early as 22 days into the pregnancy. But it doesn’t always progress properly.
Complex folding and development of the heart before a baby is born results in distinct chambers, separated by walls and valves. Important large blood vessels enter and leave the heart. The arrangements change again around the time of birth, when oxygen begins to arrive through the lungs instead of the umbilical cord.
Problems in early development, or in adjusting from fetal circulation to life in the outside world, can result in congenital heart disease (CHD).
There are many types of congenital heart disease. They can be very mild, or they can be quite serious. Some require surgical treatment.
The eight most common types are listed below:
About one in 200 children are born with congenital heart disease of some form. It is more common in babies born early, but it can happen to anyone.
Many factors can lead to congenital heart disease, but it sometimes runs in families. There is a new and rapidly growing field of genetics, human cardiovascular genetics, that seeks to discover the genes involved in heart development and heart disease.
A variety of pediatric conditions are sometimes associated with specific types of heart defects, for example ASD, VSD, or other heart defects in children with Down syndrome.
Conditions in pregnant women (such as diabetes or rubella) can also lead to congenital heart disease. Some medications, such as those used to treat seizures, can lead to CHD in children. Drinking alcohol during pregnancy is another cause of CHD.
Some forms of congenital heart disease may have no symptoms. They might be suspected by hearing a murmur on a routine physical examination. Sometimes symptoms such as poor feeding, shortness of breath, poor growth, frequent pneumonias, sweating, or dusky coloring lead to the diagnosis.
Some forms of congenital heart defects show up as medical emergencies, perhaps with respiratory distress, cardiac distress, or blue coloring.
No, although infectious diseases such as rubella can lead to CHD.
This varies with the type and extent of the defect. Some will last until they are corrected surgically–sometimes requiring a series of operations. Some forms of CHD, however, do heal spontaneously. Many VSDs, for instance, close during infancy or toddlerhood with no treatment.
The diagnosis is suspected based on the history and physical exam. Further workup may include studies such as EKGs, chest x-rays, and echocardiograms.
The treatment depends on the type and the extent of the defect. It might involve medications, operations, or sometimes no treatment at all other than just watching and waiting for it to heal on its own.
Congenital heart disease is often impossible to prevent. Avoiding toxic exposures, such as drinking alcohol during pregnancy, prevents some CHD. Similarly, avoiding certain infections during pregnancy, such as rubella (preventable by immunization), can prevent some CHD.
AS, ASD, Aortic Valve Stenosis, Atrial Septal Defects, CHD, Coarctation of the Aorta, Hypoplastic Left Ventricle, Patent Ductus Arteriosus, PDA, PS, Pulmonary Valve Stenosis, Tetralogy of Fallot, TGA, TOF, Total Anomalous Pulmonary Venous Return, Transposition of the Great Arteries, Tricuspid Atresia, Truncus