What is congenital heart disease?

As the term implies “congenital”, these heart diseases present in an individual since their birth. Congenital heart disease comprises structural abnormalities of the heart that develop before birth. While the foetus is growing in the uterus during pregnancy, several abnormalities can appear. One in every 100 kids suffers heart problems brought on by chromosomal or genetic disorders like Down syndrome.

The fetal heart is developed and begins to beat throughout the first six weeks of pregnancy. During this crucial period, the main blood arteries that travel to and from the heart also start to be formed. Congenital cardiac abnormalities may start to manifest at this stage of fetal development.

The risk of congenital heart disease in children increases if a parent or sibling also has a congenital heart defect. Other risk factors for congenital heart disease in children include maternal viral infections such as the Rubella virus and measles (German measles) in the first trimester of pregnancy

Clinical features and diagnosis of Congenital heart disease

Congenital heart disease doesn’t have any specific symptoms, although it can cause weariness, shortness of breath, and murmurs in the heart, which can be detected by using a stethoscope. During a prenatal ultrasound scan, congenital cardiac disease is frequently identified before a baby is born. However, congenital cardiac problems can’t always be found in this method. After birth, congenital heart disease can be found using echocardiography or transesophageal echocardiogram, EKG, chest X-ray, cardiac catheterization, and MRI procedures

Types of congenital heart disease

Congenital heart disease comprises several categories, namely follows altered connections in the heart or blood vessels, congenital heart valve problems, and a combination of congenital heart defects.

The following are examples of different heart or blood vascular connection changes. A hole between the atria is known as an Atrial Septal Defect (ASD). A hole in the wall between the right and left ventricles is known as a Ventricular Septal Defect (VSD). Check out the articles on ASD and VSD on the Valve Clinic web page for more details. The body’s main artery, the aorta and the pulmonary arteries are connected by a structure called the Patent Ductus Arteriosus (PDA). It is wide open during a foetus’ development in the womb and usually shuts shortly after delivery. However, in a few infants, it remains open, resulting in improper blood flow between the two arteries. When all or portion of the blood vessels from the lungs (pulmonary veins) join to the incorrect location or parts of the heart, this condition is known as a total or partial anomalous pulmonary venous connection.

Problems with the heart valves can include those that are narrower and those that do not open fully (stenosis) or those that do not close fully (regurgitation). The following are a few examples of congenital heart valve issues. A baby may be born with an aortic valve that has one or two valve flaps (cusps) rather than three if they have aortic stenosis. As a result, there is a tiny, constricted aperture for blood to travel through. In this case, for the blood to flow past the valve, the heart must work harder. This eventually causes the heart to become larger and the heart muscle to thicken. The pulmonary valve opening is restricted and the blood flow is slowed by pulmonary stenosis, a lesion on or near the pulmonary valve. The tricuspid valve, which is related to the Ebstein anomaly, is deformed and frequently leaks between the right atrium and the right ventricle.

Besides, a combination of congenital heart defects can also occur which is called complex congenital heart disease.

How to treat congenital heart disease?

Depending on the patient’s particular defect, congenital heart disease is treated differently. Most congenital heart disease issues are minor cardiac anomalies that do not often require treatment, though patients are likely to get routine checkups to monitor their health in an outpatient setting throughout their lives. More serious heart defects typically require long-term monitoring of the heart throughout adulthood by a congenital heart disease expert. This category of patients can also undergo surgery or catheter intervention where a tiny hollow tube is introduced into the heart via an artery.

Before, during, or after surgery or other interventions, drugs may be utilised in some circumstances to reduce symptoms or stabilise the condition. Diuretics, which help the body expel fluid and improve breathing, as well as other drugs like digoxin, which decrease the heartbeat and strengthen the heart’s pumping action, may be among them.

Conclusion

Congenital heart disease can be very simple and treated easily or it can be more complex and requires more expertise and technological support to treat. Even though there are several congenital heart diseases, most of them can be successfully treated using different modern treatment modalities.

References

1. Congenital heart disease – NHS. Accessed August 5, 2022. https://www.nhs.uk/conditions/congenital-heart-disease/
2. Sun RR, Liu M, Lu L, Zheng Y, Zhang P. Congenital Heart Disease: Causes, Diagnosis, Symptoms, and Treatments. Cell Biochem Biophys 2015 723. 2015;72(3):857-860. doi:10.1007/S12013-015-0551-6