Congenital Heart Disease

Congenital heart disease is a category of heart disease that includes abnormalities in cardiovascular structures that occur before birth.

These defects occur while the fetus is developing in the uterus and may affect approximately 1 in 100 children.

Congenital heart defects may produce symptoms at birth, during childhood, or not until adulthood.  Other congenital defects may cause no symptoms.

About 500,000 adults in the U.S. have congenital heart disease.

What Causes Congenital Heart Disease?

In the majority of people, the cause of congenital heart disease is unknown. However, there are some factors that are associated with an increased chance of having congenital heart disease. These risk factors include:

• Genetic or chromosomal abnormalities in the child, such as Down syndrome
• Taking certain medications or alcohol or drug abuse during pregnancy
• Maternal viral infection, such as rubella (German measles) in the first trimester ofpregnancy

The risk of having a child with congenital heart disease may double if a parent or a sibling has a congenital heart defect.

What Types of Congenital Heart Problems Are There?

The most common congenital heart problems include:

• Heart valve defects. These can result in a narrowing or stenosis of the valves, or a complete closure that impedes or obstructs forward blood flow. Other valve defects include leaky valves that don't close properly, thereby allowing blood to leak backwards.
• Defects in the walls between the atria and ventricles of the heart (atrial and ventricular septal defects). Holes or passageways between the heart’s different chambers may allow abnormal mixing of oxygenated and unoxygenated blood between the right and left sides of the heart.
• Heart muscle abnormalities that can lead to heart failure.

What Are the Symptoms of Congenital Heart Disease in Adults?

Congenital heart disease may be diagnosed before birth, right after birth, during childhood, or not until adulthood. It is possible to have a defect and no symptoms at all. In adults, if symptoms are present, they may include:

• Shortness of breath
• Limited ability to exercise

How Is Congenital Heart Disease Diagnosed?

Congenital heart disease is often first detected when your doctor hears an abnormal heart sound or heart murmur when listening to your heart.

Depending on the type of murmur your doctor hears, he or she may order further testing such as:

• Echocardiogram or transesophageal echocardiogram (TEE)
• Cardiac catheterization
• Chest X-ray
• Electrocardiogram (ECG or EKG)
• MRI

How Is Congenital Heart Disease Treated?

Treatment is based on the severity of the congenital heart disease. Some mild heart defects do not require any treatment. Others can be treated with medications, procedures, or surgery. Most adults with congenital heart disease should be monitored by a heart specialist throughout their lifetime.

How Can I Prevent Endocarditis?

Some people with congenital heart disease are at risk for getting endocarditis, especially if the heart was repaired or replaced through surgery. To protect yourself:

• Tell all doctors and dentists you have congenital heart disease. You may want to carry a card with this information.
• Call your doctor if you have symptoms of an infection (sore throat, general body aches, fever).
• Take good care of your teeth and gums to prevent infections. See your dentist for regular visits.
• Take antibiotics according to the American Heart Association guidelines before you undergo a procedure that may cause bleeding, such as: dental work, invasive tests (any test that may involve blood or bleeding), and most major or minor surgeries. Check with your doctor about the type and amount of antibiotics that you
•  should take.

• Congenital Heart Defects in Children

  There are several congenital heart defects that are detected and treated early in infancy. Most of them are abnormal connections among the blood vessels, as well as other vessels of the heart (aorta and pulmonary artery). These abnormal connections can allow unoxygenated blood to flow to the body instead of to thelungs, or allow oxygenated blood to flow to the lungs instead of to the body. They may also cause heart failure. Some examples of congenital heart disease in infants and children include:
  • Patent ductus arteriosus (when blood bypasses the lungs, preventing oxygen from circulating throughout the body)
  • Tetralogy of Fallot (four different heart defects that occur together)
  • Transposition of the great vessels (blood from the left side of the heart and right side of the heart intermix because the large artery connections are reversed)
  • Coarctation of the aorta (a pinched aorta)
  • Heart valve problems
  
  

  What Are the Symptoms of Congenital Heart Disease in Infants and Children?

  The symptoms of congenital heart disease in infants and children may include:
  • Cyanosis (a bluish tint to the skin, fingernails, and lips)
  • Fast breathing and poor feeding
  • Poor weight gain
  • Recurrent lung infections
  • Inability to exercise
  
  

  How Are Congenital Heart Defects in Children Treated?

  Some congenital heart defects will require surgery or an interventional procedure to repair the problem. Children with congenital heart disease may also need treatment with medication to improve heart function.
  Children and adults with congenital heart disease should be treated by a cardiologist who specializes in congenital heart disease. Some types of disease may require a team approach as the child grows into an adult. 
  It is important to continue to see a cardiologist as an adult.