Congenital heart disease is one of the commonest birth defect. It involves an abnormal development of heart structures when the fetus is in the womb. The structures that are involved in congenital heart disease can be the walls of the heart, its chambers, the valves or major vessels arising from the heart.
The overall incidence of congenital heart disease (CHD) is 1 per 100 live births. Its prevalence is high in a premature baby. Other factors that are known to increase the chances of congenital heart defect are; an infant born to a poorly controlled diabetic mother, mother having rubella infection during pregnancy.
The mortality rate is highest in first year of life as compared to several other birth defect conditions. There is 2% chance of recurrence in the next child if the first child is suffering from congenital heart disease. Most cases of congenital heart disease can be treated surgically with a good outcome. In few cases there is no need for any treatment and people with such anomaly may live a healthy life.
Symptoms Of Congenital Heart Disease
Congenital heart disease can be diagnosed at any stage of life. It can be diagnosed right after the birth, during childhood or during adulthood. In many cases the condition remains undetected since there are no presenting symptoms. Some of the common symptoms that can indicate congenital heart disease are:
Symptoms During Infancy
- Child breathing rapidly.
- Fast heart rate.
- Cyanosis. Bluish discoloration of lips, tongue, nails and in some cases the skin.
- Feeding difficulty.
- Failure to thrive.
- Excessive sweating.
- Repeated lower respiratory tract infections.
- Gets easily tired and breathless while playing games or doing mild exercise.
Symptoms During Adulthood
- If the obstruction is severe as seen in severe aortic stenosis or pulmonary stenosis during adulthood, where it affects the cardiac output, patient may experience breathlessness while doing slightest work.
- In some cases, the patient may have angina (heartache) on exertion or fainting spell. These patients are at a risk of sudden death.
- Congenital heart disease may occasionally present with arrhythmias (irregular rhythm of heart).
- Cerebral thrombosis or cerebral abscess is a common complication of congenital heart disease.
What Are The Causes Of Congenital Heart Defects?
The cause of congenital heart disease remains unknown in majority of cases. However, there are certain factors that are found to increase the risk of congenital disease. These include primary genetic factor (8%), environmental factors (2%).
1. Genetic factors:
- Trisomy 21 (Down’s syndrome).
- Trisomy 13 (Patau’s syndrome).
- Trisomy 18(Edward’s syndrome).
- Turner’s syndrome.
Single gene disorder:
- Noonan syndrome.
- Carpenter syndrome.
2. Environmental factors include:
- Infection in mother during pregnancy such as Rubella virus (German measles), Coxsackie virus, toxoplasmosis, etc.
- Uncontrolled diabetes in a pregnant mother.
- Abuse of alcohol and drugs during pregnancy.
- Taking certain medicines.
If one of the parents is suffering from congenital heart disease, the risk of their child suffering from congenital heart anomaly is high.
Most common congenital heart disease includes:
- Aortic stenosis (AS) it is a heart valve defect.
- Patent ductus arteriosus (PDA) accounts for 10% of congenital heart disease. It is slightly more common in female.
- Mitral valve stenosis (MS) is a heart valve defect.
- Atreoventricular canal defect (AVC).
- Coarctation of aorta (CoA) is a defect in the aorta, main vessel arising from the heart ventricale which carries pure oxygenated blood.
- Ventricular septal defect (VSD) is a defect in the wall between the atrium and ventricles.
- Pulmonic stenosis (PS).
Congenital Heart Disease Treatment
The treatment modality may depend on many factors. It depends on the type of congenital heart disease and how severe the symptoms are. If the symptoms are severe during the childhood, the anomaly has to be corrected with surgical procedure during childhood or infancy. However, if the symptoms of congenital heart disease are not severe during childhood, treatment can be postponed till the child becomes adult. However, regular checkup with cardiologist is always advisable.
To conclude, depending on the type of congenital heart disease, its severity of symptoms the cardiologists decides if the condition can be treated with medicines, cardiac catheterization or a corrective surgery.