Congenital Heart Diseases
Congenital heart disease refers to heart problems present at birth, affecting the heart's structure and function. These conditions typically develop during fetal development and may range from mild to severe. Considering that approximately 1,500,000 babies are born annually in our country, an estimated 12,000-15,000 newborns are diagnosed with congenital heart disease each year.
If a parent or sibling has congenital heart disease, the likelihood of a baby being born with the condition increases. Congenital heart disease is generally classified into two types. In one type, the baby relies on oxygen-rich blood provided by the mother via the umbilical vein, bypassing underdeveloped lungs, with circulation maintained through two natural openings in the heart and blood vessels.
Causes of Congenital Heart Diseases
Congenital heart diseases encompass structural abnormalities in the heart present at birth, potentially affecting the heart's chambers, valves, or arteries. While some cases resolve without intervention, others may require multiple surgeries over several years. Causes include genetic predispositions, medication use during pregnancy, maternal infections, radiation exposure, consanguineous marriages, maternal diabetes, and substance abuse.
Types and Symptoms of Congenital Heart Diseases
Congenital heart diseases manifest as structural abnormalities in the heart, which may affect its chambers, valves, or arteries. Common types include:
Heart Defects: Abnormal openings between heart chambers or major blood vessels may mix oxygen-rich and oxygen-poor blood, leading to cyanosis or bluish discoloration of the skin. Examples include ventricular septal defect (VSD) and atrial septal defect (ASD).
Reduced Blood Flow: Narrowed heart valves or arteries cause the heart to work harder to pump blood. Conditions such as pulmonary stenosis and aortic stenosis fall into this category.
Atrial Septal Defect (ASD)
Atrial septal defect (ASD) is a hole in the wall between the upper chambers (atria) of the heart, allowing oxygen-rich blood to leak into oxygen-poor blood. This can enlarge the right atrium. While small ASDs may resolve on their own, larger defects often require surgical intervention.
Ventricular Septal Defect (VSD) and Treatment
Ventricular septal defect (VSD) is a hole between the heart's lower chambers (ventricles), causing oxygenated and deoxygenated blood to mix. Treatment depends on the size and severity of the defect, with options including medication for heart failure symptoms or surgery to close the defect.
Patent Ductus Arteriosus (PDA)
Patent ductus arteriosus (PDA) occurs when the ductus arteriosus, a temporary fetal blood vessel, remains open after birth. Small PDAs may close with medication, while larger ones may require catheter-based or surgical closure.
Tetralogy of Fallot (TOF)
Tetralogy of Fallot (TOF) is a congenital condition involving four heart defects that reduce oxygen levels in the blood. Symptoms include cyanosis, difficulty breathing, and fatigue. Treatment typically involves corrective surgery during infancy.
Aortic Stenosis (AS)
Aortic stenosis is the narrowing of the aortic valve, restricting blood flow from the heart to the body. Risk factors include age, congenital defects, chronic kidney disease, and conditions such as diabetes and high blood pressure.
Transposition of the Great Arteries (TGA)
Transposition of the Great Arteries (TGA) is a congenital defect where the positions of the pulmonary artery and aorta are reversed, causing oxygen-poor blood to circulate in the body. Diagnosis is usually made with echocardiography, and treatment requires immediate surgical correction.
Congenital Heart Diseases and Genetic Links
Congenital heart diseases often result from genetic and environmental factors. Conditions like Down syndrome increase the risk of heart anomalies. Maternal health issues, such as diabetes, also contribute to the likelihood of congenital heart defects in offspring.
Congenital Heart Diseases and Pregnancy
Congenital heart diseases may arise from genetic and environmental factors during early pregnancy. Women with congenital heart defects have a higher likelihood of passing the condition to their children. Prenatal testing can help detect these conditions early.
Frequently Asked Questions
Treatment depends on the type and severity of the disease. Options include surgery, catheterization, medication, and lifestyle changes. Surgery is often used to correct structural defects, while catheter-based interventions address less severe problems. Medications help manage heart function, and regular medical follow-ups are critical.
Long-term outcomes depend on the type, severity, and treatment of the condition. Some patients fully recover and lead normal lives, while others may require ongoing care for complications like arrhythmias, heart failure, or pulmonary hypertension.
Although not entirely preventable, risks can be minimized by adopting a healthy lifestyle during pregnancy, including avoiding harmful substances and ensuring prenatal care. Genetic counseling can also help assess and manage risks in families with a history of heart defects.
