Congenital Heart Disease
This is an abbreviated version of the complete article.*
||Congenital heart disease is a heart defect that is present from birth.
||Congenital heart disease includes malformations of blood vessels in the heart, problems with heart valves, structural defects of the heart muscle walls, and abnormal connections between the heart and the blood vessels that carry blood to and from the heart.
||Congenital heart disease can cause problems in children immediately after they are born, although other defects heal in childhood. Still other defects can become more abnormal with age and can cause symptoms and problems in adulthood.
Congenital heart disease refers to heart defects that have been present since birth, which include:
Congenital heart defects include:
- Abnormally shaped blood vessels;
- Missing or defective valves;
- Abnormal connections between the heart and the main arteries and veins; and/or
- Defects of the walls that separate the chambers of the heart.
WHAT ARE THE SYMPTOMS?
- Atrial and ventricular septal defects;
- Coarctation of the aorta;
- Aortic, mitral, pulmonic, and tricuspid valve defects; and
- Tetralogy of Fallot.
Symptoms vary, depending on the defect.
In childhood, there may be few, if any, symptoms. Teens and adults may experience the following:
Coarctation of the aorta
- Shortness of breath; and
- Heart murmur.
Symptoms may include:
Aortic valve defects
- Cold feet or legs;
- Leg cramps while exercising;
- Localized hypertension; and
- Low stamina.
People with aortic stenosis, or narrowing, may not experience any symptoms until they develop congestive heart failure. Those with aortic regurgitation, a type of valve defect, may experience the following:
Mitral valve defects
- Chest pain; and
- Night sweats.
People with mitral valve defects may not display symptoms until their 30s, when they may experience:
Pulmonic valve defects
- Ankle swelling;
- Shortness of breath while lying down or after exercise;
- Chest discomfort;
- Loss of consciousness; and
- Symptoms of heart failure.
When pulmonic stenosis is severe, people may experience:
Tricuspid valve defects
- Shortness of breath while exercising;
- Swelling in the arms, legs, and abdomen;
- Audible heart murmur; and
The symptoms of tricuspid stenosis include:
Those with tricuspid regurgitation may also have an enlarged liver.
- Upper right abdomen discomfort;
- Shortness of breath;
- Fluid retention;
- Vomiting; and
Tetralogy of Fallot
Symptoms that may indicate tetralogy of Fallot include:
CAUSES AND RISK FACTORS
- Breathing difficulties;
- Loss of consciousness after activity;
- Bulging nail beds; and
- Symptoms of congestive heart failure.
The exact cause of congenital heart defects is largely unknown, but many experts believe that genetic and environmental factors play a role.
Risk factors that can increase the chances that an infant will be born with congenital heart disease include:
- Excessive alcohol consumption by a pregnant woman;
- Certain infections occurring during pregnancy, such as rubella.
A physician diagnoses congenital heart disease by evaluating the person's medical history and symptoms, and by using a variety of tests, which include:
- Blood count and hematocrit;
- Cardiac catheterization;
- Chest x ray;
- Computed Tomography (CT) scan;
- Duplex ultrasound;
- Electrocardiography; and
- Magnetic resonance imaging (MRI).
Many people are treated with medications. Some of the most commonly prescribed medication groups are:
- Digitalis drugs;
- Anticoagulants; and
- Angiotensin converting enzyme (ACE) inhibitors.
Surgery can correct most congenital heart defects. A procedure is performed while the patient is under general anesthesia and usually lasts 2 to 5 hours. Most procedures require open-heart surgery, although some repairs can be made with a catheter.
If the hole in the septum is small, it can be closed using a special thread made of a polymer material. For larger defects, the surgeon will use a synthetic fabric patch or the patient's own pericardium, or pericardium from a cow or other animal.
Some atrial septal defects can be corrected using a synthetic patch.
Coarctation of the aorta
Surgical correction includes removing the narrowed segment of the aorta and connecting the two ends or by placing a synthetic graft.
Heart valves can either be repaired or replaced with a tissue or mechanical valve.
Tetralogy of Fallot
Surgery to widen the pulmonary valve and correct ventricular septal defect is usually recommended to treat tetralogy of Fallot.
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