About the disease
Congenital heart defects are the congenital anomalies of the heart. They can also be called inborn heart defects. Usually it means that there is some problem with the heart structure, which developed during pregnancy. Frequency of congenital heart defects is as high as 1% in all newborns.
Most common congenital heart defects are:
- Septal valve defect
- Narrowing of the aortic isthmus
- Atrial septal defect
- Stenosis of the pulmonary artery valve
- Aortic valve stenosis
- Ebstein`s anomaly
- Dextocardia
Inborn heart defects are the most common and they have the highest occurrence rate. Other types of congenital heart defects may develop if there is some problem between connection of the heart and major blood vessels. For example, such broken connection may occur between aorta and pulmonary artery. In this regard, blood in the body gets extremely low level of oxygen, which may be life-threatening. Stenosis of pulmonary valve also happens frequently. The more heart defect is complex, more likely heart surgery is the only method of treatment.
Congenital heart defects are rarely diagnosed right after birth. Usually symptoms manifest themselves during the lifetime. It was noted that only those congenital heart defects which are associated with the disruption of pulmonary artery can be diagnosed during the first weeks of child`s life. If a child has a valve stenosis of the pulmonary artery, he has the narrowing of the valve, which means that he does not have enough oxygen. This type of congenital heart defect may also be diagnosed early.
As child gets older, new heart defects, a combination of congenital and newly emerged defects, are appeared. In such case, child who already had correctional heart surgery, may later need another surgery as well. Most common inborn heart defect if the aortic stenosis, which is narrowing (stenosis) of the aorta.
There are many causes known to modern medicine, which can provoke the development of heart disease. Most common causes include genetic predisposition. Inborn heart defects may appear as a result of such infection as rubella, which usually develops during the pregnancy. If patients are closely related, for instance, if they are cousins or have the same gene pool, there is a high risk of heart disease development. Also bad habits of both parents may influence baby`s health. For instance, if a pregnant woman drinks alcohol or smokes tobacco, it can provoke abnormalities in baby`s heart and lungs development. If there is at least one relative with history of heart defect, a woman is examined more often, because a child can also have it. Also if a child has Down syndrome and it was diagnosed during the pregnancy, there is a high risk factor of having heart defect.
Symptoms
Variety of symptoms may indicate an inborn heart defect. Main symptom of heart defect is the lack of oxygen. It may be manifested through the blue, pale color of the skin, lips and nails. Along with this, a person may experience sudden palpitations and swelling of feet, phalanges, ankles or abdomen. Because there is not enough oxygen in person`s body, he can also feel dizzy and faint. Even simple exercises can result in breathlessness.
Diagnosis
Today it is possible to detect inborn heart defects and vascular malformation during the prenatal diagnosis. However, prenatal diagnosis does not serve as a basis for termination of pregnancy. Rather it is designed to provide optimal medical care to the baby after birth, because it is much more difficult to diagnose the defect after child was born than during the development in mother’s womb.
Many inborn heart defects cause loud heart murmurs which may be heard through a stethoscope, which is the most widespread diagnosis device for the detection of heart problems. Depending on the nature of the noise in the heart specialists can detect the cause of murmurs.
With the help of ECG doctors can also detect disturbance in the heart rhythm and determine size and location of heart`s upper chambers. Today the most important method of diagnostic evaluation is echocardiography. This ultrasound accurately reflects heart`s structure and gives doctors an opportunity to see all valves, arteries and upper chambers of the heart. Echocardiography is absolutely painless and it does not pose any risk as cardiac catheterization diagnosis does.
Holter monitoring is device which records the heartbeat for 24 hours to determine if there is anomaly.
Treatment
All interventional heart surgeries present the same goal – correction of heart defect. Surgery mostly aims to normalize blood supply and blood pumping to the whole body and lungs. During such surgery blood with low oxygen level is immediately sent to the arteries, where it is enriched with oxygen. Such operation also has healing effect on the heart rhythm and thus it extends patient’s life.
A particular challenge among severe heart disease treatment is a transposition of the great vessels. This operation is usually done right after the birth of child. In the absence of a transposition, newborns with heart disease die within few days after the birth. During the surgery, surgeons disconnect the aorta and pulmonary artery and rearrange them to the right place.
Surgical treatment is usually performed with the help of heart-lung machine, which allows the patient to breathe and pump blood, while surgeon conducts operation.
Authors: Dr. Nadezhda Ivanisova, Dr. Farrukh Ahmed
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