Understanding Congenital Heart Disease

A congenital heart disease or defect (CHD), also known as congenital heart anomaly, is a problem with the structure of the heart present at birth. Congenital heart defects are the most common type of birth defects.

Though there are many different types of congenital heart defects, they can be divided into three main categories:

  • In-Heart Valve Defects : Here, the valves inside the heart that direct blood flow may close up or leak. This interferes with the heart’s ability to pump blood correctly.
  • In-Heart Wall Defects : Here the natural walls that exist between the left and right sides and the upper and lower chambers of the heart may not develop correctly, causing blood to back up into the heart or to build up in places where it doesn’t belong. The defect puts pressure on the heart to work harder, which may result in high blood pressure.
  • In-Blood Vessels Defects : In this type, the arteries and veins that carry blood to the heart and back out to the body may not function correctly. This can reduce or block blood flow, leading to various health complications.


Here are the names of examples of congenital heart defect :

  • Atrial septal defect (ASD)
  • Atrioventricular canal defect
  • Bicuspid aortic valve
  • Coarctation of the aorta
  • Congenital mitral valve anomalies
  • Double-outlet right ventricle
  • Ebstein anomaly
  • Eisenmenger syndrome
  • Hypoplastic left heart syndrome
  • Kawasaki disease
  • Long QT syndrome
  • Partial anomalous pulmonary venous return
  • Patent ductus arteriosus (PDA)
  • Patent foramen ovale
  • Pulmonary atresia
  • Pulmonary atresia with intact ventricular septum
  • Pulmonary atresia with ventricular septum defect
  • Pulmonary valve stenosis
  • Tetralogy of Fallot
  • Total anomalous pulmonary venous return
  • Transposition of the great arteries
  • Tricuspid atresia
  • Truncus arteriosus
  • Vascular rings
  • Ventricular septal defect (VSD)
  • Wolff-Parkinson-White (WPW) syndrome




Symptoms of Congenital Heart Diseases

Congenital heart diseases or defects (CHD) usually become evident soon after birth or during the first few months of life. Signs and symptoms could include:

  • Bluish lips, skin, fingers, and toes.
  • Breathlessness or trouble breathing.
  • Feeding difficulties.
  • Low birth weight.
  • Chest pain delayed growth.


Also in other cases, the symptoms of a congenital heart disease/defect may not appear until many years after birth. Once symptoms do develop, they may include:

  • Abnormal heart rhythms.
  • Dizziness.
  • Trouble breathing.
  • Fainting.
  • Swelling.
  • Fatigue.


Diagnosing Congenital Heart Diseases

In many cases, congenital heart diseases are diagnosed during pregnancy. However, a diagnosis may sometimes only be confirmed after the birth. Congenital heart disease may initially be suspected during a routine ultrasound scan of the baby in the womb. Specialist ultrasound, called foetal echocardiography, will then be carried out at around 18 to 22 weeks of the pregnancy to try to confirm the exact diagnosis. This may also be undertaken if there’s a family history of congenital heart disease or where there’s an increased risk.

It’s sometimes possible to diagnose a baby with congenital heart disease shortly after birth if some of the characteristic signs or symptoms of congenital heart disease, such as a blue tinge to the skin (cyanosis), are present. You should see your GP if you or your child shows signs of the condition.

Further testing can usually help to confirm or rule out a diagnosis. Further tests may be used to diagnose congenital heart diseases which includes:

  • Echocardiography : This is often used to check the inside of the heart. Heart problems that were missed during foetal echocardiography can sometimes be detected as a child develops.
  • Electrocardiogram (ECG) : This is a test that measures the heart’s electrical activity. Electrodes are placed on the skin around the heart and are connected to a computer. The computer analyses the electrical signals produced by the heart to assess how well it’s beating.
  • Chest X-ray : A chest X-ray of the heart and lungs can be used to check whether there’s an excess amount of blood in the lungs, or whether the heart is larger than normal. Both may be signs of heart disease.
  • Pulse oximetry : This is a test that measures the amount of oxygen present in the blood. The test involves placing a special sensor on the fingertip, ear or toe that sends out light waves. A computer is connected to the sensor and measures how the light waves are absorbed. Oxygen can affect how the light waves are absorbed, so by analysing the results, the computer can quickly determine how much oxygen is present in the blood.
  • Cardiac catheterisation : This is a useful way of obtaining more information about exactly how the blood is being pumped through the heart. During the procedure, a small, flexible tube called a catheter is inserted into a blood vessel, usually through an artery and/or vein in the groin, neck or arm. The catheter is moved into the heart, guided by X-rays or sometimes an MRI scanner, and allows pressure measurements in different parts of the heart or lungs to be taken.




Treatment of Congenital Heart Diseases

Treatment for congenital heart disease depends on the specific defect you or your child has. You might not need any treatment. Or you may need medications, surgery, or other procedures. If you have congenital heart disease, you’ll need to see a heart specialist on a regular basis.

People with congenital heart defects are more likely to have inflammation of the inner layer of their heart (a condition doctors call endocarditis), especially if their heart was repaired or replaced through surgery.

In some cases, medications may be used to relieve symptoms or stabilise the condition before and/or after surgery or intervention. These may include diuretics (water tablets) to remove fluid from the body and make breathing easier, and other medication, such as digoxin to slow down the heartbeat and increase the strength of the heart’s pumping function.



How To Prevent Congenital Heart diseases

Since we know little about the causes of congenital heart disease, there’s no guaranteed way of avoiding having a baby with the condition.

However, if you’re pregnant, the following advice can help reduce the risk:

  • Ensure you are vaccinated against rubellaand flu (Influenza).
  • Avoid drinking alcohol or taking medication.
  • Take 400 micrograms of folic acid supplement a day during the first trimester (first 12 weeks) of your pregnancy – this lowers your risk of giving birth to a child with congenital heart disease, as well as several other types of birth defect.
  • Check with your GP or pharmacist before you take any medication during pregnancy, including herbal remedies and medication that’s available over the counter.
  • Avoid contact with people who are known to have an infection.
  • If you have diabetes, make sure it’s controlled.
  • Avoid exposure to organic solvents, such as those used in dry cleaning, paint thinners and nail polish remover.







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