Heart defects, types and causes

A congenital heart defect (CHD) is the most common form of congenital heart disease. It is also one of the most common and potentially serious birth defects.

Coronary artery disease is a difference in the structure of the heart or a major artery. A person is born with it, and in the United States, almost 1% babies are born with coronary artery disease every year.

This type of abnormality can obstruct blood flow to the heart or nearby vessels, or cause irregular blood flow in the heart.

In the past, it was common for coronary heart disease to cause life-threatening health problems, but advances in medicine and technology mean that most people with these differences survive into adulthood. Each person’s outlook depends on the severity of their coronary heart disease.

Children undergoing treatment for coronary heart disease should continue to receive follow-up care throughout adulthood. People with complex health needs may need specialized care throughout their lives.

Doctors classify coronary heart disease based on which part of the heart is most affected. the The most common type is ventricular septal defect. This implies that the wall between the two ventricles of the heart never fully develops in utero, leaving a void.

There are also different types of congenital heart disease. It may be ‘cyanotic’, in which case an abnormality results in low blood oxygen levels.

Infants with cyanotic congenital heart disease experience shortness of breath, fainting, and fatigue, and they may have bluish toes, fingers, and lips.

Alternatively, the disease may be “acyanotic”. In this case, there is enough oxygen in the blood, but the heart does not pump blood efficiently throughout the body.

Certain types of coronary heart disease can cause blood pressure to be higher than usual. This is because the heart has to work harder to pump blood, which can weaken it.

Specifically, there may be high blood pressure in the arteries of the lungs, a condition called pulmonary hypertension, which can cause shortness of breath, fatigue, dizziness, and fainting.

Cyanotic heart disease can cause:

Acyanotic heart disease can cause:

  • shortness of breath, especially during physical activity
  • sweating, especially during feedings
  • slow growth rate and low body weight
  • difficulty feeding and lack of appetite, in infants
  • Extreme tiredness
  • chest pain

There may be no symptoms soon after birth – these may only appear as the child grows and may need treatment.

Coronary artery disease usually develops during the early stages of development.

There is a higher risk if the pregnant person:

  • has rubella or German measles
  • has diabetes, including gestational diabetes, that is not well managed
  • takes certain medications, such as isotretinoin (Accutane), a medication primarily for severe acne
  • consumes large amounts of alcohol

Genetics can also play a role. At least 15% of people with coronary artery disease also have a genetic condition. Certain genetic conditions can increase the risk of having coronary heart disease.

Tests can show heart problems such as coronary artery disease before and after birth.

before birth

Routine ultrasounds during pregnancy can provide information about the structure of the fetal heart.

If the scan indicates a problem, fetal echocardiography can help show a CHD. It’s like an ultrasound, but it can collect more detailed information about the chambers of the heart.

after birth

A newborn with cyanotic congenital heart disease tends to have recognizable symptoms, but those of acyanotic congenital heart disease may not appear until the child is 3 or older.

See a doctor if a child of any age has symptoms of congenital heart disease, including shortness of breath or difficulty feeding.

A doctor usually assesses heart activity using an electrocardiogram, echocardiogram, or both.

Echocardiography is an imaging technique that usessound waves to create an animated image of the heart. It shows the size and shape of the heart and the proper functioning of the chambers and valves.

This technique can show areas of low blood flow and any part of the muscle that is not contracting effectively. It can also show if the heart muscle has suffered damage due to low blood flow.

An electrocardiogram, or ECG, provides information about the electrical activity of the heart, including rhythms and the size of the chambers.

An X-ray can show any enlargement of the heart and if there is too much blood in the lungs.

Pulse oximetry, on the other hand, measures oxygen levels in the blood of the arteries using a sensor placed on the fingertip, ear or toe.

Both children and adults can take these tests.

Adults may also need to do a stress test. This involves exercising on a treadmill while a healthcare professional measures blood pressure and heart activity.

According to the Centers for Disease Control and Prevention (CDC), about 1 of 4 infants with coronary artery disease have a critical abnormality that requires surgery in their first year of life.

In other cases, the symptoms improve without treatment or the abnormality is small and does not require treatment. The doctor may recommend watchful waiting to determine if medication or surgery is needed.

A person with coronary heart disease may need treatment, such as medication to lower blood pressure, at any age.

Operation

A surgeon can correct CHD through a catheter or an open-heart procedure.

The specific approach depends on the CHD. Options include:

Specifically, the surgeon may use balloon valvuloplasty to repair a valve. This involves passing a small balloon through a catheter and inflating it to expand the valve. A stent or metal coil can then prevent the valve from narrowing again.

Adulthood

After surgery, the heart usually functions as it should, but some people develop related problems as they age.

And if there is scar tissue on the heart, as a result of surgery, it can increase the risk of problems.

The person may feel:

  • an irregular heartbeat or arrhythmia
  • cyanosis
  • dizziness and fainting
  • swelling of organs or body tissues, called edema
  • shortness of breath
  • fatigue, especially after exertion

Also, mild symptoms of coronary heart disease that do not warrant surgery in childhood may worsen over time and require treatment in adulthood.

Coronary artery disease can lead to complications, such as:

Development issues

A child with coronary artery disease may start walking and talking later than their peers, and they may have learning difficulties. They may also be smaller than others of the same age.

Arrhythmias

An irregular heartbeat, or arrhythmia, can be a complication of coronary artery disease. The name for a fast heartbeat is tachycardia, and a slow heartbeat is called bradycardia.

If the heart cannot efficiently pump blood throughout the body, heart failure can result.

It can affect one or both sides of the heart, and the symptoms vary accordingly. Heart failure can be fatal and requires immediate attention.

Pulmonary hypertension

Uncontrolled high blood pressure in the arteries of the lungs, known as pulmonary hypertension, can lead to irreversible lung damage.

Endocarditis

Inflammation of the lining, valves or muscles of the heart – called endocarditis – can spread from the skin, gums or elsewhere in the body. Having a CHD increases the risk of this problem.

A cerebral vascular accident

If there is an obstruction in the flow of blood to any part of the brain, a stroke can result.

Blood carries oxygen and glucose to the brain, and without it brain cells die. The effects of a stroke can include problems with speech, movement and memory.

To reduce the risk of complications, the CDC recommend:

  • have a healthy diet to ensure growth and good health
  • exercise regularly, as it helps strengthen the heart
  • take all necessary medications
  • follow doctor’s advice carefully
  • discuss any precautions that may be needed during pregnancy
  • know the signs of related health problems, such as cardiovascular problems, liver disease, and diabetes

It’s also important to recognize the warning signs of a heart attack, including:

  • pain in the chest, back, arm, neck, or jaw
  • shortness of breath
  • nausea, vomiting and dizziness

If anyone is experiencing these symptoms, it is crucial to call 911 immediately or seek emergency medical attention.

Living with coronary heart disease can cause anxiety and depression. A doctor should be able to provide details of local support groups.

In the past, coronary artery disease was usually fatal, but advances in medicine in recent a few decades significantly increased survival rates.

The outlook depends on:

  • the severity of the anomaly
  • speed of diagnosis
  • treatment provided

Doctors now expect about 96% of people who are diagnosed with coronary artery disease and treated in hospital survive. Meanwhile, the search for new advances continues.

In the future, treatment could involve using bio-engineered tissue rather than prosthetics and fixing any problems in the developing heart before birth.

Read this article in Spanish.