Congenital heart diseases: types, subtypes, symptoms, causes

CONGENITAL HEART DISEASES:

Table of content:

• Definition
• Introduction
• Major types
• Minor types
• medications 
• Symptoms 
• Causes
• procedure
• Diagnosis
• Treatment 
• Conclusion  

Definition

Congenital heart diseases are a group of conditions that affect the structure and function of the heart and blood vessels, which are present from birth. These abnormalities can range from simple defects that may not require any treatment, to complex ones that may require surgery or other interventions. 

Introduction

Congenital heart diseases refer to a group of conditions that affect the heart and blood vessels and are present from birth. These conditions can vary widely in terms of severity and can impact the structure and function of the heart, making it difficult for the heart to pump blood effectively. While some congenital heart diseases may cause no symptoms or mild symptoms, others can cause serious health problems that require treatment.

The causes of congenital heart diseases are not always clear, but they can be related to genetic factors, environmental factors, or a combination of both. Many congenital heart diseases can be diagnosed before birth, while others may not be discovered until later in life. Early diagnosis and appropriate treatment are crucial in managing congenital heart diseases and minimizing the risk of complications.

While living with congenital heart disease can present challenges, many people with these conditions are able to lead full and active lives with appropriate medical care and management. With ongoing medical monitoring and treatment, it is often possible to successfully manage symptoms, prevent complications, and maintain heart health.

1.CONGENITAL HEART DISEASES:

Congenital heart disease (CHD) is a defect in the heart’s structure that’s present at birth. It can be detected before birth, soon after birth, or anytime throughout life. There are many kinds of CHD. Symptoms and treatment depend on the type of defect and its severity. A person with CHD should see a cardiologist regularly throughout life. Congenital heart disease (CHD) is a defect or problem with the heart’s structure that’s present at birth, such as:

·        A hole in the heart wall.

·        Issues with the blood vessels (too many or too few, blood flowing too slowly, to the wrong place, or in the wrong direction).

·        Problems with the heart valves.

·        Some cases of CHD are simple and may not cause any symptoms, but others can be life-threatening and require treatment.

Heart defects may be detected early (before a baby is born or shortly afterward). But sometimes, CHD isn’t diagnosed until childhood, adolescence, or adulthood. CHD is the most common type of birth defect, affecting 8 to 9 per 1,000 live births.

MAJOR TYPES:

There are two main groups of CHDs: cyanotic congenital heart disease and acyanotic congenital heart disease.

1.1   CYANOTIC (LOW OXYGEN IN THE BLOOD) CONGENITAL HEART DISEASE:

Cyanotic congenital heart disease involves heart defects that reduce the amount of oxygen delivered to the rest of the body. This is sometimes called a critical congenital heart defect. Babies born with cyanotic congenital heart disease usually have low levels of oxygen and need surgery. Examples include:

Left heart obstructive lesions:

This type of defect reduces blood flow between the heart and the rest of the body (systemic blood flow). Examples include hypoplastic left heart syndrome (when the heart is too small on the left side) and interrupted aortic arch (the aorta is incomplete).

Right heart obstructive lesions:

 This type of defect reduces blood flow between the heart and lungs (pulmonary blood flow). Examples include tetralogy of Fallot (a group of four defects), pulmonary atresia and tricuspid atresia (valves don’t develop correctly).

Mixing lesions:

With this type of defect, the body mixes systemic and pulmonary blood flow. One example is a transposition of the great arteries when the two main arteries leaving the heart are reversed. Another is truncus arteriosus, when the heart has only one main artery, instead of two, to carry blood to the body.

1.2  ACYANOTIC (BLOOD OXYGEN LEVEL IS ACCEPTABLE) CONGENITAL HEART DISEASE:

Acyanotic congenital heart disease involves a defect that causes blood to pump through the body abnormally. For example:

Hole in the heart:

One of the heart’s walls can have an abnormal opening. Depending on the location of the hole, this may be called an atrial septal defect, atrioventricular canal, patent ductus arteriosus, or ventricular septal defect.

Problem with the aorta:

 The aorta is the main artery that carries blood away from your heart to the rest of the body. It can be too narrow (aortic coarctation). Or the aortic valve (which opens and closes to regulate blood flow) may be restricted in opening and or a more common defect with only two flaps instead of three (called bicuspid aortic valve).

Problem with the pulmonary artery:

The pulmonary artery carries blood from the right side of the heart to the lungs to get oxygen. If this artery is too narrow, it’s called pulmonary artery stenosis.

MINOR TYPES:

1)      Atrial septal defect (ASD)

2)      Atrioventricular canal defect

3)     Coarctation of the aorta

4)     Congenital mitral valve anomalies

5)     Double-outlet right ventricle

6)     Ebstein anomaly

7)     Eisenmenger syndrome

8)     Hypoplastic left heart syndrome

9)     Long QT syndrome

      Partial anomalous pulmonary venous return

      Patent ductus arteriosus (PDA)

1    Patent foramen ovale

       Pulmonary atresia

      Pulmonary atresia with intact ventricular septum

      Pulmonary atresia with a ventricular septal defect

        Pulmonary valve stenosis

1      Tetralogy of Fallot

        Total anomalous pulmonary venous return (TAPVR)

       Transposition of the great arteries

2      Tricuspid atresia

       Truncus arteriosus

2      Vascular rings

       Ventricular septal defect (VSD)

2      Wolff-Parkinson-White (WPW) syndrome

1)   ATRIAL SEPTAL DEFECT:

An atrial septal defect (ASD) is a hole in the heart between the upper chambers (atria). The hole increases the amount of blood that flows through the lungs. The condition is present at birth (congenital heart defect).

Small atrial septal defects might be found by chance and never cause concern. Others close during infancy or early childhood.

A large, long-term atrial septal defect can damage the heart and lungs. Surgery may be needed to repair an atrial septal defect and to prevent complications.

1.1)    TYPES:

Types of atrial septal defects include:

1.1.1)  SECUNDUM:

This is the most common type of ASD. It occurs in the middle of the wall between the upper heart chambers (atrial septum).

1.1.2)  PRIMUM:

This type of ASD affects the lower part of the atrial septum and might occur with other congenital heart defects.

1.1.3)  SINUS VENOSUS:

This rare type of ASD usually occurs in the upper part of the wall separating the heart chambers. It's also associated with other heart structure changes present at birth.

1.1.4)  CORONARY SINUS:

In this rare type of ASD, part of the wall between the coronary sinus — which is part of the vein system of the heart — and the left upper heart chamber (left atrium) is missing.

2) ATRIOVENTRICULAR CANAL DEFECT:

Atrioventricular canal defect is a mix of problems affecting the center of the heart. The heart condition is present at birth. That means it's a congenital heart defect. Children born with this condition have a hole in the wall between the heart's chambers. They also have problems with the valves that control blood flow in the heart. Atrioventricular canal defect allows extra blood to flow to the lungs. The extra blood forces the heart to work too hard, causing the heart muscle to grow larger. Untreated, atrioventricular canal defects can cause heart failure and high blood pressure in the lungs. Treatment usually involves surgery during the first year of life to close the hole in the heart and repair the valves.

 

3)   COARCTATION OF THE AORTA:

The aorta is the largest artery in the body. It moves oxygen-rich blood from the heart to the rest of the body. Aortic coarctation is a narrowing of the aorta. It forces the heart to pump harder to move blood through the aorta. Coarctation of the aorta is generally present at birth (congenital heart defect). Symptoms can range from mild to severe. The condition might not be detected until adulthood. Coarctation of the aorta often occurs along with other congenital heart defects. Treatment is usually successful, but the condition requires careful lifelong follow-up.

 

4)   CONGENITAL MITRAL VALVE ANOMALIES:

Congenital mitral valve anomalies are problems with the valve between the heart's two left chambers. That valve is called the mitral valve. Congenital means it is present at birth.

Mitral valve anomalies include:

·        Thick or stiff valve flaps, also called leaflets.

·        Deformed leaflets or leaflets that join together. Your provider may say they are fused.

·        Problems with the cords that support the valve. They might include missing cords, short and thick cords, or cords attaching to the heart muscle near the mitral valve.

·        Heart tissue or heart muscle problems near the mitral valve.

·        More than one opening in the area of the mitral valve. This is called a double-orifice valve.

Types of heart valve disease caused by mitral valve anomalies include:

4.1) NARROWING OF THE MITRAL VALVE, ALSO CALLED MITRAL VALVE STENOSIS

The valve flaps are stiff and the valve opening may be narrowed. This condition reduces blood flow from the left atrium to the left ventricle.

4.2) LEAKY MITRAL VALVE, ALSO CALLED MITRAL VALVE REGURGITATION

The valve flaps don't close tightly. Sometimes they push back into the left upper heart chamber as the heart squeezes. As a result, the mitral valve leaks blood.

 

5)   DOUBLE-OUTLET RIGHT VENTRICLE:

The double-outlet right ventricle is a heart condition present at birth. That means it's a congenital heart defect. In this condition, the body's main artery and the lung artery do not connect to the usual areas in the heart. The body's main artery is called the aorta. The lung artery is called the pulmonary artery.

Sometimes these blood vessels also are reversed from their usual positions. In a typical heart, the aorta connects to the left lower heart chamber. The pulmonary artery connects to the right lower heart chamber. In babies with the double-outlet right ventricle, both the aorta and the pulmonary artery connect partially or completely to the right lower heart chamber.

Babies with double-outlet right ventricles also have a hole between the lower heart chambers. The lower heart chambers are called the ventricles. The hole is called a ventricular septal defect. The hole causes oxygen-rich blood to mix with oxygen-poor blood. Babies with this condition may not get enough oxygen in the bloodstream. Their skin may appear gray or blue. Double-outlet right ventricle may occur with other heart problems present at birth. These problems may include other holes in the heart, heart valve problems, or blood vessel problems.

 

6) EBSTEIN ANOMALY:

Ebstein anomaly is a rare heart defect that's present at birth (congenital). In this condition, your tricuspid valve is in the wrong position and the valve's flaps (leaflets) are malformed. As a result, the valve does not work properly.

Blood might leak back through the valve, making your heart work less efficiently. The Ebstein anomaly can also lead to enlargement of the heart and heart failure. If you have no signs or symptoms associated with the Ebstein anomaly, regular monitoring of your heart might be all you need. You might need treatment if signs and symptoms bother you or if your heart is enlarging or weakening. Treatment options include medications and surgery.

 

7)   EISENMENGER SYNDROME:

 Eisenmenger syndrome is a long-term complication of an unrepaired heart problem present at birth (congenital heart defect). Eisenmenger syndrome is life-threatening. In Eisenmenger syndrome, there is irregular blood flow in the heart and lungs. This causes the blood vessels in the lungs to become stiff and narrow. Blood pressure rises in the lungs' arteries (pulmonary arterial hypertension). Eisenmenger syndrome permanently damages the blood vessels in the lungs.

 

8)   HYPOPLASTIC LEFT HEART SYNDROME:

Hypoplastic left heart syndrome is a rare heart defect present at birth (congenital). In this condition, the left side of the heart is extremely underdeveloped. If a baby is born with hypoplastic left heart syndrome, the left side of the heart can't pump blood well. Instead, the right side of the heart must pump blood to the lungs and to the rest of the body. Treatment of hypoplastic left heart syndrome requires medication to prevent the closure of the connection (ductus arteriosus) between the right and left sides of the heart. Plus, either surgery or a heart transplant is necessary. Advances in care have improved the outlook for babies born with this condition.

 

9) LONG QT SYNDROME:

Long QT syndrome (LQTS) is a heart-signaling disorder that can cause fast, chaotic heartbeats (arrhythmias). A heart signaling disorder is also called a heart conduction disorder. Some people are born with altered DNA that causes long QT syndrome (congenital long QT syndrome). Long QT syndrome may also occur later in life (acquired long QT syndrome) as the result of some medical conditions, certain drugs, or mineral imbalances.

Long QT syndrome can cause sudden fainting and seizures. Young people with LQTS syndrome have an increased risk of sudden death. Treatment for long QT syndrome includes lifestyle changes and medications to prevent dangerous heartbeats. Sometimes surgery is needed to implant a device to control the heart's rhythm.

 

10)   PARTIAL ANOMALOUS PULMONARY VENOUS RETURN:

In this condition, some of the blood vessels of the lungs attach to the wrong place in the heart. These blood vessels are called the pulmonary veins. In a typical heart, oxygen-rich blood goes from the lungs to the upper left heart chamber, called the left atrium. Then the blood flows through the body.

 

11)  PATENT DUCTUS ARTERIOSUS (PDA):

Patent ductus arteriosus (PDA) is a persistent opening between the two major blood vessels leading from the heart. The heart problem is present from birth. That means it is a congenital heart defect.

An opening called the ductus arteriosus is part of a baby's blood flow system in the womb. It usually closes shortly after birth. If it remains open, it's called a patent ductus arteriosus.

A small patent ductus arteriosus often doesn't cause problems and might never need treatment. However, a large, untreated patent ductus arteriosus can let oxygen-poor blood move the wrong way. This can weaken the heart muscle, causing heart failure and other complications.

 

12) PATENT FORAMEN OVALE:

 A patent foramen ovale (PFO) is a hole in the heart that didn't close the way it should after birth. The hole is a small flaplike opening between the upper heart chambers. The upper chambers of the heart are called the atria. As a baby grows in the womb, an opening called the foramen ovale sits between the upper heart chambers. It typically closes during infancy. When the foramen ovale doesn't close, it's called a patent foramen ovale.

13)     PULMONARY ATRESIA:

 Pulmonary atresia is a heart defect present at birth (congenital) that's usually diagnosed soon after birth. In pulmonary atresia, the valve that lets blood out of the heart to go to the lungs (pulmonary valve) doesn't form correctly. Instead of opening and closing to allow blood to travel from the heart to the lungs, a solid sheet of tissue forms. So, blood can't travel its usual route to pick up oxygen from the lungs. Instead, some blood travels to the lungs through other natural passages within the heart and its arteries.

 

14)   PULMONARY ATRESIA WITH INTACT VENTRICULAR SEPTUM:

 In pulmonary atresia, the valve between the heart and lungs (pulmonary valve) isn't fully developed. Blood can't flow from the right lower heart chamber (right ventricle) to the lungs.

Some blood may move through a natural opening between the artery carrying oxygen-rich blood out of the heart (aorta) and the pulmonary artery. This opening called the ductus arteriosus typically closes soon after birth, but it can be kept open with medications.In pulmonary atresia with the intact ventricular septum (PA/IVS), there isn't a hole between the two pumping chambers of the heart. If there is a hole, the condition is called pulmonary atresia with ventricular septal defect (VSD).

A baby with pulmonary atresia doesn't get enough oxygen in the blood. Urgent treatment is needed. Treatment for pulmonary atresia with intact ventricular septum may include a combination of medication, procedures, or surgery to correct the congenital heart defect.

 

15)  PULMONARY ATRESIA WITH VENTRICULAR SEPTAL DEFECT:

Pulmonary atresia with ventricular septal defect (VSD) is a heart problem present at birth (congenital heart defect). In this pulmonary atresia, the valve between the heart and lungs (pulmonary valve) is not fully developed. Blood can't flow from the right lower heart chamber (right ventricle) to the lungs. In pulmonary atresia with ventricular septal defect (VSD), there's also a hole between the two pumping chambers of the heart.

The VSD allows blood to flow into and out of the baby's right ventricle. Some blood may also flow through a natural opening called ductus arteriosis. The ductus arteriosus typically closes soon after birth, but it can be kept open with medications. The lung artery and its branches can be very small or nonexistent in babies with pulmonary atresia. If these blood vessels are missing, other arteries form on the body's main artery (aorta) to provide blood flow to the lungs. These arteries are called major aortopulmonary collateral arteries (MAPCAs).

 

16)  PULMONARY VALVE STENOSIS:

Pulmonary valve stenosis is a narrowing of the valve between the lower right heart chamber and the lung arteries. In a narrowed heart valve, the valve flaps may become thick or stiff. This reduces blood flow through the valve.

Usually, pulmonary valve disease is caused by a heart problem that develops before birth. A heart problem present at birth is called a congenital heart defect. In adults, pulmonary valve stenosis may be a complication of another illness. Pulmonary valve stenosis ranges from mild to severe. Some people with mild pulmonary valve stenosis do not have symptoms. They may need only occasional health checkups. Moderate and severe pulmonary valve stenosis may need a procedure to repair or replace the valve.

 

17)  TETRALOGY OF FALLOT:

 These defects, which affect the structure of the heart, cause oxygen-poor blood to flow out of the heart and to the rest of the body. Infants and children with tetralogy of Fallot usually have blue-tinged skin because their blood doesn't carry enough oxygen.

Tetralogy of Fallot is often diagnosed while the baby is an infant or soon after. Sometimes, depending on the severity of the defects and symptoms, tetralogy of Fallot is not detected until adulthood. All babies who have tetralogy of Fallot need corrective surgery. People with tetralogy of Fallot need regular doctor's checkups for the rest of their life and may have activity restrictions.

 

18) TOTAL ANOMALOUS PULMONARY VENOUS RETURN (TAPVR):

 In this heart condition, the lung blood vessels called the pulmonary veins, attach to the wrong place in the heart. In a typical heart, oxygen-rich blood flows from the lungs to the upper left heart chamber, called the left atrium. The blood then flows through the body.

In TAPVR, the connection of veins is changed. Blood flows through the upper right heart chamber, called the right atrium. This change in blood flow causes oxygen-poor blood to mix with oxygen-rich blood. As a result, blood flowing to the body doesn't have enough oxygen. The specific type of TAPVR depends on where the veins connect. Most children born with TAPVR have no family history of congenital heart disease.

 

19)     TRANSPOSITION OF THE GREAT ARTERIES:

 Transposition of the great arteries (TGA) is a serious, rare heart problem in which the two main arteries leaving the heart are reversed. The condition is present at birth, which means it's a congenital heart defect.

19.1) TYPES

There are two types of transposition of the great arteries:

·        Complete transposition of the great arteries, also called dextro-transposition of the great arteries (D-TGA). This type reduces the amount of oxygen-rich blood to the body. Symptoms are usually noticed during pregnancy, immediately after birth or within a few weeks of birth. Without treatment, serious complications or death can occur.

·        Congenitally corrected transposition, also called levo-transposition of the great arteries (L-TGA). This is a less common type. Symptoms may not be noticed right away. Treatment depends on the specific heart problems.

 

20) TRICUSPID ATRESIA:

 Tricuspid atresia is a heart problem present at birth, known as a congenital heart defect. The valve isn't formed between the two right heart chambers. Instead, a solid sheet of tissue blocks the blood flow between the right heart chambers. The condition limits blood flow through the heart. Tricuspid atresia causes the right lower heart to be underdeveloped.

People with tricuspid atresia can't get enough oxygen through the body. So they tire easily and they are often short of breath. Their skin and lips may look blue or gray.

 

21) TRUNCUS ARTERIOSUS:

Truncus arteriosus is a rare heart problem present at birth. That means it's a congenital heart defect. In this condition, one large blood vessel leads out of the heart, instead of two.

Having only one large blood vessel means that oxygen-poor and oxygen-rich blood mix. This mixing reduces the amount of oxygen delivered to the body. It usually increases the amount of blood flow into the lungs too. The heart has to work harder to adjust to the changes in blood flow.

22) VASCULAR RINGS:

A vascular ring is a heart problem present at birth. That means it's a congenital heart defect. In this condition, part of the body's main artery or its branches forms a ring around the windpipe, the food-swallowing tube, or both.

 

23) VENTRICULAR SEPTAL DEFECT (VSD):

ventricular septal defect (VSD) is a hole in the heart. It's a common heart problem present at birth (congenital heart defect). The hole occurs in the wall that separates the heart's lower chambers (ventricles).

A VSD changes how blood flows through the heart and lungs. Oxygen-rich blood gets pumped back to the lungs instead of out to the body. The oxygen-rich blood mixes with oxygen-poor blood. These changes may increase blood pressure in the lungs and require the heart to work harder to pump blood. A small ventricular septal defect may cause no problems. Many small VSDs close on their own. Babies with medium or larger VSDs may need surgery early in life to prevent complications.

 

24)   WOLFF-PARKINSON-WHITE (WPW) SYNDROME:

  In Wolff-Parkinson-White (WPW) syndrome, an extra signaling pathway between the heart's upper and lower chambers causes a fast heartbeat (tachycardia). WPW syndrome is a heart condition present at birth (congenital heart defect). It is fairly rare.

The episodes of fast heartbeats seen in WPW syndrome usually aren't life-threatening, but serious heart problems can occur. Rarely, WPW syndrome may lead to sudden cardiac death in children and young adults. Treatment of WPW syndrome may include special actions, medications, a shock to the heart (cardioversion), or a catheter procedure to stop the irregular heart rhythm (arrhythmia).

GENETICS:

Congenital heart disease appears to run in families (inherited). It's associated with many genetic syndromes. For instance, children with Down syndrome often have congenital heart defects. Genetic testing can detect Down syndrome and some other genetic conditions while a baby is still in the mother's womb.

GERMAN MEASLES (RUBELLA):

Having rubella during pregnancy may affect how the baby's heart develops while in the womb.

DIABETES:

Having type 1 or type 2 diabetes during pregnancy also may affect a baby's heart development. Gestational diabetes generally doesn't increase the risk of congenital heart disease.

MEDICATIONS:

Taking certain medications while pregnant can cause congenital heart disease and other birth defects. Medications linked to heart defects include lithium for bipolar disorder and isotretinoin (Claravis, Myorisan, others), which is used to treat acne. There are several medicines linked to an increased risk of a baby being born with congenital heart disease. These include:

·        certain anti-seizure medicines – such as benzodiazepines (for example diazepam)

· Certain acne medicines – such as isotretinoin and topical retinoids (see treating acne for more information)

·        ibuprofen – women who take the painkiller ibuprofen when they are 30 or more weeks pregnant have an increased risk of having a baby with a heart problem

·        Paracetamol is a safer alternative to ibuprofen during pregnancy, although ideally, you should avoid taking any medicines while you're pregnant, particularly during the first 3 months of pregnancy.

ARBS AND ACE INHIBITORS:

These are two widely used types of medicines that lower blood pressure. They relax blood vessels, which makes it easier for your heart to pump blood.

BETA-BLOCKERS:

These medicines slow your heart rate and help widen arteries. Some examples of beta blockers that your doctor might prescribe are atenolol (Tenormin), carvedilol (Coreg CR), and metoprolol (Lopressor).

DIURETICS:

 Also called water pills, these medications lower fluid levels. Less blood volume can lower your blood pressure.

Medications may be enough to help treat mild cases or be used when surgery isn’t a good option. Other times, doctors will need to do more.

SYMPTOMS OF CONGENITAL HEART DISEASE:

Symptoms may start as soon as a baby is born or may not appear until later in life. They can include:

• Cyanosis (blueish skin, lips, or nails).
•  Excessive sleepiness.
•  Fast breathing or trouble breathing.
•  Fatigue (extreme tiredness).
•  Getting unusually tired or out of breath during exercise.
•  Heart murmur (a swishing sound made by the heart that may indicate abnormal blood flow).
•  Poor blood circulation.
•  Weak pulse or pounding heartbeat.

       The signs and symptoms vary widely, depending on:

·        Age.

·        The number of heart defects (a person can be born with more than one defect).

·        The severity of the condition.

·        Type of defect.

CAUSES:

CHD happens when the fetal heart doesn’t develop correctly in the uterus. Scientists don’t fully understand why that happens, but it may be related to:

·        Abnormal chromosomes or genetics.

·        Drinking or smoking during pregnancy (or significant environmental exposures such as secondhand smoke).

·        Illnesses in the mother during pregnancy (diabetes, drug use, phenylketonuria, or viral infection).

PROCEDURES:

Thanks to new technology, doctors have easier and better ways to fix these defects. Depending on the problem, your baby may get surgery or catheterization within hours of being born. Other times, it may happen days or months later.

Sometimes, infants need several procedures as they grow up. As their heart gets bigger, replacement valves, for example, will need to be changed. Your doctor will tell you what they’ll need, and when.

There are two main options for procedures for congenital heart defects. One uses a catheter, which doesn’t require opening the chest. The other is open-heart surgery.

CARDIAC CATHETERIZATION:

More and more, doctors are able to repair hearts using catheters. These procedures, known as cardiac catheterizations, are used for two main heart repairs: closing a hole or opening a narrowed valve or artery.

Doctors can, for example, repair holes in the wall that separates the heart’s left and right sides. This is a common congenital heart defect called an atrial septal defect (ASD). Using a catheter, the doctor can place a tiny umbrella-shaped patch over the hole. The tissue will form over the covering and keep the wall together.

Doctors can also widen a narrowed artery or stiff valve. And they can use one to close off a vessel if it’s carrying blood in the wrong direction or place a patch over a hole.

They can also fit a catheter with a tiny balloon and direct it toward a valve or artery that isn’t working right.

The doctor can inflate the balloon to widen the valve or artery. This allows the blood to flow better. When it is done for a valve, it’s called a valvuloplasty. When it’s done in an artery, it’s called an angioplasty.

Catheter procedures alone might not fix every issue. Some people need medicine, and children might need surgery when they are a little older. But these procedures can make blood flow better and keep your baby healthy while care continues in the months and years ahead.

OPEN-HEART SURGERY:

In some cases, your doctor will tell you that you or your baby needs open heart surgery. With this surgery, a doctor has to cut through the breastbone to operate on the heart directly. Defects that might be treated with open-heart surgery include holes in the heart, valve problems, and narrow arteries.

Because a heart grows in size along with its owner, some people may need more surgeries or other procedures years later. If you need open-heart surgery, you’ll get general anesthesia, so you won’t be awake or feel pain during the procedure.

DIAGNOSIS:

Sometimes a heart defect is found before a baby is born. If your healthcare provider finds anything unusual during a routine prenatal ultrasound, you and the fetus may need further testing. For example, a fetal echocardiogram uses sound waves to create pictures of the fetal heart.

Other heart defects are found soon after a baby is born. For example, cyanotic CHD is often detected by pulse oximetry. The simple, painless test uses sensors on the fingers or toes to find out if oxygen levels are too low. Sometimes, congenital heart disease isn’t diagnosed until later in life.

Tests that can help diagnose CHD in newborns, children, or adults include:

Physical exam:

 During an exam, a healthcare provider will listen to the heart for any abnormal sounds.

 Chest X-ray:

 A chest X-ray takes pictures of the inside of your chest to reveal any structural abnormalities.

Electrocardiogram:

 Electrocardiogram (EKG or ECG) measures the electrical activity of your heart.

Echocardiogram:

 An echocardiogram (echo) uses ultrasound to create images of the heart’s valves and chambers.

Heart catheterization:

 A healthcare provider can tell how well your heart is pumping and circulating blood by performing a heart catheterization. It’s also called cardiac catheterization or coronary angiography.

Magnetic resonance imaging (MRI):

MRI for heart disease can create detailed pictures of your heart.

TREATMENT:

Some cases of CHD may heal themselves. Others may remain but don’t require any treatment while others must be treated soon after birth.

Anyone with a heart defect should see a heart specialist (cardiologist) regularly throughout their life. Be sure the cardiologist has training and expertise in congenital heart defects.

Treatment for CHD may involve:

·        Catheter procedure to place a plug into the defect.

·        Medications to help your heart work more efficiently or to manage blood pressure.

·        Nonsurgical procedure to close a defect using a closing device.

·        Oxygen therapy, which provides higher levels of oxygen than normal room air would.

·        Prostaglandin E1, which relaxes smooth heart muscle and can keep opening the ductus arteriosus (a blood vessel normally closed after birth) helping provide needed circulation.

·        Surgery to repair a defect, open up blood flow or redirect blood. In severe cases, a heart transplant may be necessary.

 

 PROBLEMS IN ADULTHOOD DUE TO CHD:

Adults with congenital heart disease may develop certain health problems later in life. They can limit your ability to perform everyday tasks and shorten your life span. Examples include:

Arrhythmia:

 Arrhythmia is an abnormal heart rhythm. It can occur when there is a problem with the heart’s structure or scar tissue from an earlier surgery.

Endocarditis:

 Endocarditis is an infection in the heart. Taking antibiotics if indicated for a specific defect before dental and surgical procedures can help prevent heart infections.

Heart failure:

In heart failure, the heart can no longer pump adequately for proper blood circulation to fulfill the body’s needs. It’s sometimes called congestive heart failure.

Hypertension:

 Hypertension (high blood pressure) occurs when pumping blood puts too much pressure on blood vessel walls.

Pregnancy complications:

 Women with ACHD may have an increased risk of pregnancy complications, including arrhythmia, heart failure, and stroke.

Pulmonary hypertension:

 Pulmonary hypertension is high blood pressure in the lung’s arteries. It can lead to heart failure.

Stroke:

 A stroke occurs when a blood vessel in the brain becomes blocked or bursts. This blockage or rupture cuts off the blood supply to the brain.

Sudden cardiac death:

Sudden cardiac death is a sudden loss of heart function. It’s caused by sudden cardiac arrest. This life-threatening condition occurs when the heart’s electrical system malfunctions, most commonly causing a dangerously fast heartbeat.

Valve dysfunction:

 If the heart’s valves aren’t working correctly, blood may be restricted or back up into the heart chambers causing overload or the heart to work harder than it should.

HOW TO MINIMIZE THE RISK OF ALL THE ABOVE DISEASES:

To keep your heart as healthy as possible and prevent complications of ACHD:

·        Eat a well-balanced, nutritious diet of heart-healthy foods.

·        Exercise regularly (but only with your cardiologist’s approval).

·        Maintain a healthy weight.

·        See a cardiologist regularly throughout your life to monitor and manage ACHD and detect any complications.

·        Tell all of your healthcare providers about the heart defect, all medications you take, and what surgeries you’ve had.

·        Understand the specific type of heart defect you have and what the possible complications are.

·        If you plan to become pregnant, talk to your cardiologist, obstetrician, and primary care doctor well in advance. They will help you understand and manage the risks throughout your pregnancy.

   Conclusion:

Congenital heart disease (CHD) is a broad term used to describe a range of structural defects in the heart that are present at birth. There are numerous types and subtypes of CHD, each with its own set of symptoms, causes, and treatments.

The most common types of CHD include atrial septal defects, ventricular septal defects, patent ductus arteriosus, Tetralogy of Fallot, and coarctation of the aorta. The symptoms of CHD can vary widely depending on the type and severity of the defect but may include fatigue, shortness of breath, chest pain, and difficulty feeding or gaining weight.

The exact causes of CHD are not yet fully understood, but some risk factors have been identified, including genetic factors, maternal illness or medication use during pregnancy, and environmental factors such as exposure to certain chemicals.

Diagnosis of CHD usually involves a physical exam, medical history, and imaging tests such as echocardiography or cardiac catheterization. Treatment options for CHD depend on the type and severity of the defect but may include medication, surgical repair, or other interventions such as catheter-based procedures.

Overall, early detection and treatment are crucial in managing CHD and improving outcomes for affected individuals. Ongoing research is also needed to better understand the causes of CHD and develop new and more effective treatments.

    frequently asked questions?

    What Are The 4 Types Of Congenital Heart Disease?

     There are many types of congenital heart disease, but the following four are among the most common:

1. Atrial Septal Defect (ASD): This is a defect in the wall between the two upper chambers of the heart, called the atria. An ASD allows oxygen-rich blood to mix with oxygen-poor blood, which can cause the heart to work harder than it should.

2. Ventricular Septal Defect (VSD): This is a hole in the wall between the two lower chambers of the heart, called the ventricles. A VSD can allow oxygen-rich blood to mix with oxygen-poor blood, which can also cause the heart to work harder than it should.

3. Tetralogy of Fallot (ToF): This is a combination of four heart defects that affect the structure of the heart and the way blood flows through it. ToF usually causes a low oxygen level in the blood, which can cause blue-tinged skin and shortness of breath.

4. Patent Ductus Arteriosus (PDA): This is a condition where a blood vessel called the ductus arteriosus, which normally closes shortly after birth, remains open. This can cause extra blood to flow to the lungs, which can put a strain on the heart and lead to heart failure over time.

What Are The 5 Main Types Of Congenital Heart Disease?

There are many types of congenital heart disease (CHD), but the following five are among the most common:

1. Atrial Septal Defect (ASD): This is a hole in the wall (septum) between the two upper chambers (atria) of the heart.

2. Ventricular Septal Defect (VSD): This is a hole in the wall (septum) between the two lower chambers (ventricles) of the heart.

3. Patent Ductus Arteriosus (PDA): This is a condition where a blood vessel called the ductus arteriosus, which normally closes shortly after birth, remains open.

4. Tetralogy of Fallot (ToF): This is a combination of four heart defects that affect the structure of the heart and the way blood flows through it.

5. Transposition of the Great Arteries (TGA): This is a condition where the two main arteries leaving the heart are switched (transposed), so that the oxygen-poor blood is pumped to the body instead of the lungs.

It's important to note that there are many other types of congenital heart disease, and each case is unique. Treatment and management will depend on the specific type and severity of the defect.

What Are The 7 Heart Diseases?

There are many types of heart disease, but the following are among the most common:

1. Coronary artery disease (CAD): This is a condition in which the arteries that supply blood to the heart become narrowed or blocked, which can lead to chest pain or a heart attack.

2. Heart failure: This is a condition in which the heart is unable to pump enough blood to meet the body's needs, which can cause shortness of breath, fatigue, and fluid buildup in the lungs or other organs.

3. Arrhythmias: This is an abnormal heart rhythm, which can cause the heart to beat too fast, too slow, or irregularly. This can lead to symptoms such as dizziness, fainting, or chest pain.

4. Valvular heart disease: This is a condition in which one or more of the heart valves do not work properly, which can cause symptoms such as fatigue, shortness of breath, or swelling in the legs.

5. Aortic aneurysm: This is a condition in which the aorta, the main artery that carries blood from the heart to the body, becomes enlarged and weakened. This can lead to a rupture, which can be life-threatening.

6. Cardiomyopathy: This is a disease of the heart muscle, which can cause the heart to become enlarged, thickened, or rigid. This can lead to symptoms such as shortness of breath, fatigue, and swelling in the legs.

7. Congenital heart disease: This is a condition in which there is a structural defect in the heart that is present at birth. There are many types of congenital heart disease, each with its own set of symptoms and treatments.

What Are 6 Types Of Heart Disease?

There are many types of heart disease, but the following six are among the most common:

1. Coronary artery disease (CAD): This is a condition in which the arteries that supply blood to the heart become narrowed or blocked, which can lead to chest pain or a heart attack.

2. Heart failure: This is a condition in which the heart is unable to pump enough blood to meet the body's needs, which can cause shortness of breath, fatigue, and fluid buildup in the lungs or other organs.

3. Arrhythmias: This is an abnormal heart rhythm, which can cause the heart to beat too fast, too slow, or irregularly. This can lead to symptoms such as dizziness, fainting, or chest pain.

4. Valvular heart disease: This is a condition in which one or more of the heart valves do not work properly, which can cause symptoms such as fatigue, shortness of breath, or swelling in the legs.

5. Aortic aneurysm: This is a condition in which the aorta, the main artery that carries blood from the heart to the body, becomes enlarged and weakened. This can lead to a rupture, which can be life-threatening.

6. Cardiomyopathy: This is a disease of the heart muscle, which can cause the heart to become enlarged, thickened, or rigid. This can lead to symptoms such as shortness of breath, fatigue, and swelling in the legs.

What Are The 7 Critical Congenital Heart Defects?

The American Academy of Pediatrics (AAP) has identified seven critical congenital heart defects (CCHDs) that are present at birth and require prompt medical intervention:

1. Hypoplastic left heart syndrome (HLHS): This is a condition where the left side of the heart is underdeveloped, leading to a range of complications.

2. Pulmonary atresia: This is a condition where the pulmonary valve is completely closed or missing, preventing blood flow to the lungs.

3. Tetralogy of Fallot: This is a combination of four heart defects that affect the structure of the heart and the way blood flows through it.

4. Total anomalous pulmonary venous return (TAPVR): This is a condition where the pulmonary veins, which normally carry oxygen-rich blood from the lungs to the heart, are not connected properly to the heart.

5. Transposition of the great arteries (TGA): This is a condition where the two main arteries leaving the heart are switched (transposed) so that the oxygen-poor blood is pumped to the body instead of the lungs.

6. Tricuspid atresia: This is a condition where the tricuspid valve, which controls blood flow between the right atrium and right ventricle, is missing or does not function properly.

7. Interrupted aortic arch: This is a condition where the aorta, the main artery that carries blood from the heart to the body, is not connected properly.

What Are The Most Common Types Of Congenital Heart Disease?

The most common types of congenital heart disease (CHD) are:

1. Atrial septal defect (ASD): This is a hole in the wall (septum) between the two upper chambers (atria) of the heart.

2. Ventricular septal defect (VSD): This is a hole in the wall (septum) between the two lower chambers (ventricles) of the heart.

3. Patent ductus arteriosus (PDA): This is a condition where a blood vessel called the ductus arteriosus, which normally closes shortly after birth, remains open.

4. Tetralogy of Fallot (ToF): This is a combination of four heart defects that affect the structure of the heart and the way blood flows through it.

5. Pulmonary valve stenosis: This is a narrowing of the valve that controls blood flow from the right ventricle to the lungs.

6. Coarctation of the aorta: This is a narrowing of the aorta, the main artery that carries blood from the heart to the body.

7. Transposition of the great arteries: This is a condition where the two main arteries leaving the heart are switched (transposed), so that the oxygen-poor blood is pumped to the body instead of the lungs.

How Many Types Of Congenital Heart Disease Are There?

There are many different types of congenital heart disease (CHD), which are classified based on the specific defect or abnormality in the structure or function of the heart. The number of types of CHD can vary depending on how the classification is made, but there are typically dozens of different types.

Some examples of CHD include atrial septal defects, ventricular septal defects, patent ductus arteriosus, tetralogy of Fallot, coarctation of the aorta, transposition of the great arteries, pulmonary valve stenosis, Ebstein's anomaly, among many others. Each type of CHD can have different symptoms, causes, and treatments, and the severity can also vary greatly from case to case.

Who Diagnoses Congenital Heart Disease?

Congenital heart disease (CHD) is typically diagnosed by a pediatric cardiologist, who is a medical doctor specializing in diagnosing and treating heart conditions in children.

In many cases, CHD is detected during routine prenatal ultrasounds or physical examinations of newborns, and the diagnosis is confirmed with additional testing, such as echocardiography, which uses sound waves to create images of the heart. Other diagnostic tests that may be used include electrocardiography (ECG), cardiac catheterization, and magnetic resonance imaging (MRI), among others.

If CHD is suspected, it's important to seek medical attention from a healthcare professional as soon as possible. Early diagnosis and treatment can help improve outcomes and prevent complications associated with CHD.