Congenital Heart Disease in Babies

A doctor checking an infant with a stethoscope

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There are many medical conditions that a baby can be born with and one such medical condition is a congenital heart defect or a congenital heart disease. The severity of this defect can range from minor abnormalities to major life-threatening complications. Here’s all that you need to know about this medical condition and how you may effectively manage this condition in your new born baby.





What are Congenital Heart Defects?

A congenital heart disease is an abnormality that can be present in a baby at the time of birth. The defect can be present in the walls, valves or vessels of the heart. Such cardiac birth defects can disrupt the normal flow of blood. The real cause of congenital heart defect has not been established but it may run in the genes. Most congenital heart problems in newborn babies are generally fixed with minimal or no medical intervention. However, the severe cases require immediate medical attention after birth. In some cases, special care and precaution may be required throughout the life.

Types of Congenital Heart Defects

There are many types of congenital and newborn heart defects. However, congenital heart defects can be broadly classified into three major categories:




1. Heart Valve Defects 

These types of heart defects occur when the valves inside the heart leak or close-up. Such defects in the valve hampers with its ability to pump blood.





2. Heart Wall Defects 

These kinds of defects occur when the walls inside the heart do not develop properly. Such defects can disrupt the flow of blood and the blood may reach places where it does not belong. The heart works more than usual in such conditions and the blood pressure may elevate too.




3. Blood Vessel Defects 

These types of defects occur in the arteries and veins of the heart. The blood flow reduces or gets blocked in the vessels. Such defects may lead to fatal medical conditions.





What are the Other Names for Congenital Heart Defects?

Congenital heart defects can also be classified as Cyanotic and Acyanotic congenital heart defects. Both these defects occur due to heart’s inability to pump blood properly. Cyanotic heart defect occurs because of the decreased levels of oxygen in the blood. Babies with this kind of heart defects may experience breathlessness and may also have bluish tint to their skin. However, there are no decreased levels of oxygen in babies with Acyanotic heart defects, but they may experience complications later in life (for example- high blood pressure).

Causes of Congenital Heart Defects

The causes of congenital heart defects in babies can be because of genetic or prenatal environmental factors.




1. Environmental Factors

The environmental factors include:





Use Of Certain Medication

The use of certain medication in pregnancy increases the risk of heart defects in babies. Some of these medicines include Accutane (medicine for acne), Lithium (used for bipolar disorders), seizure medicines etc.




Smoking 

Smoking in pregnancy can increases your risk of having a baby with congenital heart defects.





Having Alcohol 

Consuming alcohol in pregnancy can be detrimental for your baby’s heart and there are high chances that your baby is born with heart defects. Alcohol also puts your baby under risk of catching FAS or fetal alcohol syndrome, which may also lead to heart problems in babies.




Mother’s With Viral Infection 

If you fall sick with certain viral infections, such as rubella in your pregnancy (in first trimester), then your baby is at great risk of having congenital heart defects.


Mother’s Chronic Illness 

If a mother has any kind of chronic illness (phenylketonuria, diabetes or vitamin deficiency) then there is likelihood that the baby may develop congenital heart disease.

2. Genetic factors 

The genetic factors include:


Mutation 

There are many genetic mutations that may result in congenital heart defects in babies, such as atrial septic defect.

Hereditary 

If there is a family history of congenital heart defects (the parents or the sibling have it) then there is a high possibility that it is passed on to the offspring.


Other Birth Defects 

Congenital heart defects may occur due to other medical conditions as well. Babies who are born with Turner or Down syndrome are at risk of having congenital heart defects too.

Symptoms of Congenital Heart Problems

A doctor checking an infant sitting on the father's lap

Some congenital heart defects are asymptomatic or have negligible symptoms, whereas some heart defects have notable symptoms, such as:

  • The baby may have difficulty in feeding.
  • The baby may have bluish tint to the skin (lips, fingers, toes or skin).
  • The baby may have trouble in breathing or experience breathlessness.
  • The baby may feel chest discomfort or pain.
  • The baby may not gain weight properly.

Apart from these above-mentioned symptoms that are evident soon after birth, there may be some symptoms that may appear later in life, such as:


  • Dizziness
  • Fainting
  • Irregular heart beats
  • Tiredness or fatigue
  • Swelling

Most cases of congenital heart defects are established during the pregnancy ultrasounds. You may have to undergo further tests if your doctor suspects any kind of abnormality in the fetal heartbeat.

How Congenital Heart Defects are Diagnosed?

Most severe cases of congenital heart defects are established during pregnancy ultrasounds. However, there are many defects that may be diagnosed later by your doctor while examining your child. Once the doctor suspects the possibility, the following techniques of newborn congenital heart disease screening may be recommended:

Chest x-ray 

The chest x-ray will reveal the abnormalities in the heart.

Echocardiogram 

This is like an ultrasound and involves taking images of the heart.

Electrocardiogram 

This helps establish the electrical activity of the heart.

MRI 

This aids the complete scan of the heart.

Pulse Oximetry 

This helps establish the amount of oxygen in the blood.

Is It Possible to Detect Heart Problems before Birth?

Yes, it is possible to detect heart problems before birth. If your doctor suspects any abnormality in the fetal heart-beat, you may be recommended to go for fetal echocardiography. This sonogram involves the use of special sound waves to get information about the baby’s heart. Based on the sonogram images, your doctor may make a treatment plan for the baby. The doctor may start the treatment while you are pregnant or soon after birth, based on the severity of the heart condition.

Treatment

After diagnosing the severity of the defect, your doctor may recommend the best suitable treatment option for your baby. Here are some steps that may be recommended for congenital heart defects:

Medication 

The milder cases of heart disease can be treated with medicines. The prescribed medicines help in preventing blood clotting and irregular heartbeats.

Catheter procedure 

This procedure helps to repair certain heart conditions without any surgical intervention.

Implants 

ICDs or implantable cardioverter defibrillators, pacemakers etc are some of the implantable devices that help cure certain congenital heart defects (abnormal or irregular heartbeats).

Open Heart Surgery 

The procedure involves surgically opening the heart and repair the defects (widen blood vessels, close holes or repair heart valves)

Heart Transplant 

This is a complex congenital heart disease surgery that involves replacing the child’s heart with the donor’s healthy heart.

Prevention

Some measures that you may adopt during pregnancy to lower the risk of congenital heart defects in your baby include:

  • If you are suffering from some medical condition, such as diabetes, get in touch with your doctor to know more about how to effectively manage your medical condition in pregnancy.
  • If you are taking some prescribed medicines, talk to your doctor about it before or soon after you get pregnant.
  • If you have family history of congenital heart disorders, get help with genetic counselling.
  • Refrain from smoking or consuming alcohol.
  • If you have not received vaccination against viral infections (German measles or rubella), ask your doctor about the preventive options.

Can Congenital Heart Defects be Treated Effectively?

Most cases of congenital heart defects can be treated or repaired. Generally, the congenital defects do not have major ill-effects on the child’s overall growth and development. Also, there are certain defects that are not diagnosed till the child reaches adolescence. At the same time there are some congenital heart defects that require ongoing treatment and care.
With the constant advancement in medical technology, most cases of congenital heart diseases are effectively diagnosed and treated on time.

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