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Congenital Heart Disease

Overview

Congenital heart disease (congenital heart defect) is an abnormality in the structure of the heart that one is born with. Congenital heart disease used to be fatal, but now with advancement in technology and medicine it is far more treatable. Children born with this disease undergo surgical treatment and survive well into adulthood.

While medical advances have improved and surgeries are conducted on babies, follow-up care as adults is also critical.

Symptoms

Symptoms of congenital heart disease sometimes do not show up until later in life. This disease recurs years after one has had treatment for congenital heart disease. Some typical congenital heart disease symptoms seen in adults include:

  • Arrhythmias (abnormal heart rhythms)
  • Cyanosis (bluish tint to the skin)
  • Shortness of breath
  • Tiredness upon exertion
  • Dizziness or fainting
  • Edema (swelling of body tissue or organs)

In the event that one has any of the signs or symptoms of congenital heart disease, a visit to the doctor is necessary. If chest pain or severe shortness of breath is experienced, immediate medical attention is necessary.

Causes

It is not clear as to what exactly causes defects to begin, but research indicates that some medical conditions, medications and genetics may play a role.

Patients who are treated for congenital heart disease as infants have a recurrence as adults. In some cases, the treatment received in childhood may have been successful, but the problem recurs and worsens later in life.

Risk factors

Congenital heart disease often results from problems early in the development of the foetus. Certain environmental and genetic factors affect the development of congenital heart disease. Which includes

  • Rubella (German measles) : If the mother has rubella during pregnancy, it can affect the heart development of the foetus.
  • Diabetes : If the mother has type 1 or type 2 diabetes, it can interfere with the development of the heart of the foetus. Although, gestational diabetes generally does not increase the risk of developing a heart defect.
  • Medications : Taking certain medications during pregnancy is known to cause birth defects, including congenital heart defects. Some medications that increase risks include the drug is otretinoin (Amnesteem, Claravis, Sotret).
  • Heredity : Congenital heart disease appears to run in families and is associated with many genetic syndromes. Half the children with Down syndrome have heart defects. Genetic testing can detect such disorders during the development of the foetus.

Complications

Complication of congenital heart disease may not develop until many years after initial treatment. Since the severity of congenital heart disease varies widely, the possible complications vary too. Some common complications that can develop in adulthood include:

  • Arrhythmias (abnormal heart rhythms) : Heart rhythm problems (arrhythmias) occur when the electrical impulses in the heart that coordinates the heartbeats do leading to increased, decreased or irregular heartbeats. Heart rhythm problems are generally seen in people who have congenital heart disease. This is because the heart defect itself interferes with the normal electrical impulses, or because previous corrective surgery has left scar tissue that can cause arrhythmias. In some patients, these arrhythmias can become severe leading to sudden cardiac death.
  • Endocarditis (heart infection) : Endocarditis is an infection of the inner lining of the heart. Some heart defects interrupt the smooth flow of blood inside the heart, thus making it easier for bacteria to collect. Endocarditis typically occurs when bacteria or other germs from another part of the body, especially the mouth, enter the bloodstream and lodge themselves in the heart. If left untreated, endocarditis can damage or destroy the heart valves and trigger a stroke.
  • Stroke : A stroke occurs when the blood supply to a part of the brain is interrupted, thus depriving the brain tissue of oxygen and nutrients. When this happens, within a few minutes the brain cells begin to die.
  • Heart failure : Heart failure is known as congestive heart failure. Some types of congenital heart disease lead to heart failure. Conditions such as coronary artery disease or high blood pressure gradually sap the heart of its strength, leaving it too weak to fill and pump efficiently. Lifestyle changes, such as exercising, eating food with less salt (sodium), stress management, treating depression, managing hypertension, and weight loss can help prevent fluid buildup and improve the quality of life.
  • Pulmonary hypertension : In this case high blood pressure affects only the arteries in the lungs. Due to some congenital heart defects more blood flows to the lungs thus increasing pressure. As the pressure increases, the heart must work harder to pump blood through the lungs. This causes the heart muscles to weaken and sometimes leads to heart failure. If not detected early, permanent lung artery damage can occur.
  • Heart valve problems : The heart valves are abnormal in some types of congenital heart disease. In some cases, a valve that has been repaired or replaced during infancy may require further surgery as an adult. Surgical or catheter-based treatments performed during infancy may also require repeat procedures later in the life of the patient.