Congenital Heart Defects

Everybody wants a perfect, healthy baby to bring home from the hospital! Some babies, however, are born with health problems such as birth defects. And one of the most common types of birth defect is a congenital heart defect. It is estimated that around 8 out of every 1,000 babies born in the United States has some form of this problem — and this comes out to around 35,000 babies annually.

Today, some 1 million Americans are living with congenital heart defects. Read on to find out more about this condition.

What is  Congenital Heart Defect?

When a baby is born with a congenital heart defect, this means that he or she was born with something wrong with how their heart is put together (the structure) or how the heart works (function). Some heart defects are very mild, while other are serious or even life-threatening.

How Do You Know if a Baby Has a Congenital Heart Defect?

The short answer is: sometimes you don’t know!  Babies whose heart defects are mild don’t have many signs and symptoms and doctors and grown-ups might not realize until later that anything is wrong.  On the other hand, if the defect is serious, so are the signs and symptoms and they will be evident as soon as the baby is born.

Signs and symptoms of a serious heart defect can include:

• Bluish or gray skin color (called cyanosis)
• Grunting sounds while breathing
• Fatigue and sleepiness
• Swelling in the legs, belly and around the eyes
• Rapid breathing
• Flared nostrils
• Poor circulation
• Shortness of breath while trying to feed
• Poor weight gain and development due to poor feeding

Signs and symptoms of a mild heart defect can include:

• Getting tired easily
• Find it hard to breathe when playing or being active
• Swollen feet, hands and ankles

What Causes a Congenital Heart Defect?

In many cases, doctors simply do not know what causes a congenital heart defect.  However, most of them believe that the problem starts very early in pregnancy — in the first 6 weeks, in fact.  It is during this time that the heart and the blood vessels around the heart begin to form and the heart begins to beat.  During this period, the heart is vulnerable to defects in the way it is put together or the way it works.

However, there are some factors that are known to cause heart defects. These include:

• Some conditions mothers may have during pregnancy.
• Certain medications that women take while pregnant.
• Use of tobacco, alcohol or illegal drugs while pregnant.
• Lack of important vitamins and minerals like folic acid while pregnant
• Getting infected with rubella or other viruses during pregnancy.

It is also believed that some heart defects can be caused by genes that a child inherits from their parents.  Some kinds of defects can run in families.

Are There Different Kinds of Heart Defects?

There are actually many different kinds of heart defects. These can include:

• Defects that block off blood flow. If the blood vessels or valves in the heart are too narrow — as is the case with pulmonary or aortic stenosis — this forces the heart to work harder and can lead to heart enlargement.
• Defects the cause holes in the wall of the heart. These holes can be in in the heart wall (called the septum) between the upper two chambers (atria) of the heart, which is known as a an atrial septal defect. They can also be between the lower two chambers (ventricles), which is known as a ventricular septal defect.
• Problems with the blood vessels. Blood vessels control how blood flows into and out of the heart. If there is a problem with how these blood vessels are positioned, however, this can have a negative impact on the blood flow. One example of this kind of defect is called the transposition of the great arteries, where the pulmonary artery and the aorta are both on the wrong sides of the heart.
• Problems with the heart valves. Heart valves are responsible for guiding the blood to flow along a certain route; problems can happen when these valves don’t open or close the way they should. One of the most common forms of this problem is called Ebstein’s anomaly, where the tricuspid valve is malformed and does not work properly.
• Heart underdevelopment. This happens when a whole section of the heart fails to form the way it should.  One example of this is called hypoplastic left heart syndrome, where the left side of the heart is has not developed enough to work the way it should.
• Combination of defects. Some babies are born with several different kinds of defects. One of the most common is called the Tetralogy of Fallot, where a baby is born with a hole in wall of the heart, restricted passages, the misplacement of the aorta and thickened muscles on the right side of the heart.

Complications from Heart Defects

Heart defects can lead to complications, long-term problems that can sometimes be as serious as the defect itself. These complications can include any of the following:

• Problems with growing and developing (a child with a heart defect, for example, can be underweight or short for his or her age)
• Infective endocarditis, a serious heart infection.
• Stroke, due to an increased risk for developing blood clots which can get stuck in the vessels that bring blood to the brain
• Emotional and psychological issues due to activity restrictions, worry about health and other issues.
• Heart failure, due to the fact that the heart must work harder due to its defect

How Does the Doctor Know if a Baby Has a Heart Defect?

Sometimes, babies can be diagnosed with a congenital heart defect at birth because of how severe their signs and symptoms are.

For other kids, a doctor might begin to suspect something if they hear a heart murmur, or whooshing sound, when they listen to a baby heart during an exam.

If a doctor suspects that a baby might have a defect, he or she will order further tests. These can include:

• Electrocardiogram, which help to form an image of the heart
• Pulse oximetry, to measure levels of oxygen in the baby’s blood
• A chest X-ray
• Cardiac catheter, which can both diagnose heart problems and to treat them.

How are Congenital Heart Defects Treated?

Sometimes heart defects are so mild that they will heal on their own (for example, an atrial septal defect which closes by itself) or just require regular monitoring to make sure they don’t get worse.

If a defect is more serious, however, more treatment will be necessary.  Because of advancements in modern medicine, there are a number of ways that heart defects can be treated. These include:

• Cardiac catheter procedures. For example, a cardiac catheter can be used to repair holes in the wall of the heart.
• Open heart surgery if a cardiac catheter cannot be used.
• A heart transplant if the defects are serious and cannot be repaired
• Medications to help with the strength and regularity of the heart
• Blood thinners to help prevent the formation of blood clots
• Heart-healthy diet low in sodium and saturated fat
• Possible exercise restrictions
• Regular medical check-ups and monitoring

Can Congenital Heart Defects be Prevented?

Some heart defects happen for no known reason and cannot, as far as we know, be prevented. However, there are some things that pregnant women can do to help reduce the chances of their baby being born with a heart condition. These include:

• Taking folic acid before and during pregnancy.
• Controlling medical conditions like diabetes while pregnant.
• Avoiding the use of alcohol, smoking and illegal drugs while pregnant.
• Reviewing medications with the doctor to make sure they are safe to take during pregnancy
• Getting the rubella vaccine to avoid a rubella infection during pregnancy.

Because some defects are believed to be inherited, genetic counselling is also recommended to help prevent passing this condition on.

So now you know a little bit more about congenital heart defects. While these can be very serious and require surgery to correct them, others are very mild and just need to be monitored or can be treated with things like medications and a healthy lifestyle. Most kids who are born with this condition go on to happy and fulfilled lives because of these advances in treatment.