Congenital Heart Disease - Symptom, Causes, Treatment of Congenital Heart Disease

Congenital heart disease is the defects in the development of the heart and major blood vessels (aorta, pulmonary artery) before birth. About 1 in 120 babies is born with congenital heart disease (CHD), but many defects are minor and do not cause health problems. Some infants are born with mild types of congenital heart disease, but most need surgery in order to survive. Patients who have had surgery are likely to experience other cardiac problems later in life. CHD occurs when the heart or blood vessels near the heart does not develop properly before birth. Therefore, the heart does not pump because it is not completely developed. Also the blood flow is obstructed in the heart of the vessels nearby, causing an abnormal flow of blood through the heart.

Severe defects are usually detected at birth, less severe defects may not show symptoms until later in childhood. Congenital heart disease is the most frequent form of major birth defects in newborns affecting close to 1% of newborn babies (8 per 1,000). This figure is an underestimate since it does not include some common problems, namely:

• Patent ductus arteriosus in preterm babies (a temporary condition)
• Bicuspid (two cusps) aortic valve (the aortic valve usually has three cusps or flaps)
• Mitral valve prolapse (drooping of a heart valve)
• Peripheral pulmonary stenosis (narrowing of the lung vessels well away from the heart)

Cause of Congenital Heart Disease

In most cases the cause is unknown. Some congenital heart disease may be traced to chromosomal defects, maternal illness, or exposure during pregnancy to certain drugs or viral infections such as RUBELLA (German measles). Congenital heart disease can have diverse causes. The causes include environmental factors (such as chemicals, drugs or infections), certain maternal diseases, chromosome abnormalities, genetic diseases, and unknown (idiopathic) factors.

Symptoms of Congenital Heart Disease

Symptoms of congenital heart disease in general include: shortness of breath, difficulty feeding in infancy, sweating, cyanosis (bluish discoloration of the skin), heart murmur, respiratory infections that recur excessively, stunted growth, and limbs and muscles that are underdeveloped. In general, any baby suffering from breathing difficulties or blueness of the skin, or failing to grow properly should be checked for CHD. Some children have no signs while others may exhibit shortness of breath, cyanosis, chest pain, syncope, sweating, heart murmur, respiratory infections, underdeveloping of limbs and muscles, poor feeding, or poor growth. Most defects cause a whispering sound, or murmur, as blood moves through the heart causing some of these symptoms.

Diagnosis and treatment of Congenital Heart Disease

If suspicious heart murmurs are found by listening to the chest through a stethoscope, the defect can usually be located by an echocardiogram (ultrasound of the heart in action) and special chest X-rays. Several tests can show what kind of heart disease your baby has. They can also check on your baby's condition, to see how the heart is working. Here are some tests your baby might have:

• ECG (short for "electrocardiogram")--An ECG is a drawing of the baby's heart beat. It shows how well the heart is working.
• Pulse oximetry--This test shows how much oxygen is in the baby's blood.
• Echocardiogram--This test gives the doctor an ultrasound "picture" of the baby's heart.
• Chest x-ray--This can show how well the heart is growing and if your baby's lungs have fluid in them.
• Cardiac catheterization--This test uses dye in the heart to give the doctor a clear picture of the heart problem.

Most Congenital Heart Disease can be corrected by surgery, and some defects must be repaired soon after birth for the child to survive. Congenital heart disease is treated with drugs and/or surgery. Drugs used include diuretics, which aid the baby in excreting water and salts, and digoxin, which strengthens the contraction of the heart, slows the heartbeat, and removes fluid from tissues. One particular type (patent ductus arteriosus - a persistent opening between the aorta and the pulmonary artery) may be treated by medi-cation. In other cases heart function can be con-trolled with medication until surgical correction later in infancy or childhood.

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