Congenital heart disease: symptoms, types and treatment

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Definition of congenital heart disease

What is congenital heart disease (CHD)?

Congenital heart disease (CHD) is an abnormality in the structure of the heart that generally occurs from birth. This heart defect can change the structure, arrangement of the arteries, blood vessels, heart walls, heart valves, and other things related to heart function.

The presence of these disorders can cause changes in normal blood flow through the heart. Blood flow can slow down, flow in the wrong direction or place, or become completely blocked.

If the condition is severe and life-threatening, treatment will be taken as early as possible to prevent life-threatening complications.

This heart defect has several types. Starting from simple conditions that do not require surgical procedures, to complex and critical.

Broadly speaking, congenital heart disease is divided into 2 types, namely:

Cyanotic congenital heart disease

Cyanotic congenital heart disease is a heart defect that can decrease the amount of oxygen in the body. This condition occurs because oxygen-rich blood mixes with blood that is less oxygenated. As a result, only a small amount of oxygen-rich blood reaches the body's tissues.

This condition causes a bluish discoloration of the skin, aunts, and the coating of the nails (cyanosis). Cyanotic congenital heart disease in infants and children is divided into several types, namely:

• Tetralogy of Fallot (a combination of four disorders, namely pulmonary stenosis, ventricular septal defect, right ventricular hypertrophy and aortic overriding).
• Pulmonary atresia (a pulmonary disorder that results in blood from the heart returning to the lungs).
• Truncus arteriosus (one large artery leaving the heart which is supposed to be two arteries).
• Hypoplastic left heart syndrome (left side of the heart that is not completely inflated).
• Tricuspid valve abnormalities (tricuspid valve that doesn't form properly or doesn't form at all).

Asianotic congenital heart disease

Asianotic congenital heart disease is a heart defect that usually doesn't affect the amount of oxygen or blood reaching the body's tissues.

Therefore, the baby or child's skin color will not be bluish. The appearance of bluish signs, often occurs when the baby is crying or breastfeeding.

This asianotic congenital heart disease is further divided into several types that may occur in infants and children, namely:

• Ventricular septal defect or ventricular septal defect (a hole in the wall between the ventricles).
• Atrial septal defect or atrial septal defect (a hole in the wall between the atria).
• Patent ductus arteriosus (the two main arteries of the heart don't close properly after birth).
• Pulmonary valve stenosis (narrowing of the valve through which blood passes from the heart to the lungs).
• Aortic valve stenosis (the opening between the four chambers of the heart at birth).
• Coarctation of the aorta (narrowing of the portion of the large blood vessel that carries blood from the heart to the rest of the body).

How common is this disease?

Congenital heart disease is a common heart disease, especially in infants and children. Heart defects often co-occur with Down syndrome and German measles.

Mothers who have diabetes before pregnancy, are accustomed to drinking alcohol and smoking are at risk of giving birth to children with this heart defect.

Signs & symptoms of congenital heart disease

In most cases, the symptoms of congenital heart disease are not always immediately detectable. Some can be detected early on via pregnancy ultrasound, but some babies may not show any abnormalities at all during the womb.

Signs and symptoms do not appear until birth. Symptoms of congenital heart disease that exist in infants or children are not always the same.

Reporting from the Mayo Clinic page, symptoms of congenital heart disease in babies and children that appear after birth, include:

• The baby's lips, skin, fingers, and toes appear bluish or grayish in color.
• Babies experience shortness of breath or breathe faster than usual.
• Babies have difficulty eating.
• Babies experience swelling in the legs, stomach, or the area around the eyes.
• Stunted growth and development of the baby and low body weight.

The symptoms, mentioned above, are serious signs. So, when you find your baby experiencing these symptoms, immediately go to the doctor or hospital.

Sometimes, congenital heart disease is not diagnosed right away because the first symptoms appear within a few years of birth.

The doctor will usually advise your child to do an echocardiogram, chest x-ray, or an MRI examination (magnetic resonance imaging) .

When the child starts to grow up, congenital heart disease can develop with symptoms such as:

• Easy shortness of breath when exercising or doing activities.
• Get tired quickly while doing activities, even fainting.
• Fainting while exercising or doing activities.
• Swelling in several parts of the body.

When to see a doctor?

Severe congenital heart disease conditions are usually diagnosed before or after the baby is born. Immediately take your baby and get it checked by the doctor if you see the signs and symptoms mentioned above.

Your doctor will tell you if your little one's symptoms are caused by a heart defect or other medical condition.

But don't worry, you can reduce your risk of developing this disease by reducing the existing risk factors. Consult your doctor for more information.

Causes of congenital heart disease

The main cause of congenital heart disease is that the heart does not develop normally while the baby is still in the womb. In some cases, the cause is not known with certainty.

According to the National Heart, Lung, and Blood, genetic problems can also be a cause of congenital heart disease. More specifically, this may be due to changes in DNA, genes, or chromosomes that may or may not come from the parent. That is why, this condition is passed down from the family.

Meanwhile, based on the type of congenital heart disease, some of the causes of this condition include:

A hole forms in the heart

A hole that forms in the wall between the atria, blood vessels, and chambers of the heart can cause congenital heart defects.

The hole causes oxygen-rich blood to mix with low-oxygen blood so that the body's tissues get less oxygen.

Abnormal structure of the heart and its supporting organs

Congenital heart defects can be caused by the left side of the heart that is not developing normally.

It can also occur due to abnormal heart blood vessels. This can indicate an improper location of the blood vessels, the presence of narrowing of the blood vessels, or the direction of circulation of blood that is not appropriate.

Apart from blood vessels, heart valves can also be disabled. This is characterized by the heart valve not opening or closing properly, resulting in blood not flowing smoothly. It could also be due to a damaged or leaky heart valve.

Risk factors for congenital heart disease

Although sometimes the cause of congenital heart disease is not known with certainty, there are various things that trigger it, including:

Genetic factors

Heart defects in babies are more likely to occur in families with a history of the same heart defects. Both husband and wife's genetic factors can increase the risk of abnormal heart disease in babies.

Risk factors related to pregnant women

Congenital heart defects that occur during pregnancy lead health professionals to believe it has something to do with pregnancy which may be caused by:

• Blood relationship between mother and father (kosanguinitas). Marriage with too close kinship can increase the risk of various congenital disorders, one of which is congenital heart defects.
• History of metabolic syndrome in pregnant women. Uncontrolled blood sugar conditions, obesity before and during pregnancy, can interfere with fetal development, thereby increasing congenital heart defects in babies.
• German measles (rubella) infection. Rubella infection can inhibit heart development in the fetus.
• Take certain medications while pregnant. Some drugs can increase the risk of developing an incomplete fetus, such as anti-seizure drugs, ibuprofen, acne medication with isotretinoin, topical drugs with retinoids, and anti-depressants lithium.
• Phenylketonuria (PKU) condition. Uncontrolled history of PKU conditions in pregnant women can cause the baby they are carrying to experience congenital heart defects.
• Cigarette and drug use.The use of illegal drugs and cigarettes during pregnancy can increase the risk of heart defects in the fetus by twofold.
• Chemical exposure.Chemicals such as pesticides, monoxide, herbicides, and thinner fluids can interfere with fetal heart development.

Risk factors related to children's health

Apart from the mother, the disrupted development of the baby's heart can also be triggered by health problems that the child does, such as:

• Gene mutation disorders.Problematic genes can interfere with the development of the baby's organs. These disorders include Marfan syndrome, Smith-Lemli-Opitz syndrome, Alagille syndrome, and other rare conditions.
• Chromosomal abnormalities. Chromosome errors can cause organs to form imperfectly. Chromosomal abnormalities are common in children with conditions such as Down syndrome, Turner's syndrome, William's syndrome, and DiGeorge syndrome.

Diagnosis and treatment of congenital heart disease

The information provided is not a substitute for medical advice. ALWAYS consult your doctor.

There are two forms of examinations that doctors usually do to diagnose congenital heart disease in babies, namely:

Prenatal checkup

Congenital heart disease detection can be done before the baby is born. This includes imaging tests, in the form of ultrasound (ultrasound). With this test, the doctor can see an image of the fetal heart structure.

The next test that can be done to detect congenital heart disease is a fetal echocardiogram or fetal echocardiogram.

This test is similar to an ultrasound, only the information about the condition of the baby's heart will be obtained in more detail. Usually this test is done in the 18th to 24th week of pregnancy.

Examination after birth

Congenital heart defects may not be detected during pregnancy. If this happens, the doctor will recommend other tests that the baby can do directly, including:

• Echocardiogram

An echocardiogram test is performed to determine heart activity, including heart rhythm and condition. Using sound waves, this test will display the size, shape, and how well the baby's heart is functioning.

• Imaging test

This chest X-ray will show the size of the heart as well as the amount of blood in the lungs.

• Cardiac catheterization

Cardiac catheterization may be necessary in children with congenital heart disease. In this test, a thin, flexible catheter is inserted into the blood vessel. This test is much more detailed than an echocardiogram.

• Cardiovascular magnetic resonance imaging (MRI)

Imaging tests that are done to evaluate congenital heart defects in adolescents in more detail.

What are the treatment options for congenital heart disease?

Treatment for congenital heart disease will be determined based on the type and severity of the disease.

Some babies have mild heart defects that can heal on their own. One example is an atrial septal defect with a small opening.

Over time, the holes in the walls between these atria will close on their own. However, parents and doctors need to monitor the child's heart health.

However, some other babies may have a more severe condition that requires serious treatment.

In worrisome or severe cases, the baby or child needs immediate medical attention and care, including:

1. Take drugs

The doctor can give several types of drugs that will help the heart work. The goal, to prevent the formation of blood clots or to help control an irregular heartbeat.

Prescription medications are beta blockers or arrhythmia drugs. In infants, the drug may be given is acetaminophen or paracetamol.

2. Cardiac catheterization procedure

Apart from being performed as a test, this procedure can also be performed as a treatment for congenital heart defects. Usually this is done for fairly simple conditions, such as an atrial septal defect and a patent ductus arteriosus that doesn't improve on its own.

3. The surgical process

A surgeon will perform direct surgery on the heart. This treatment is performed to treat complex heart defects that have not been treated effectively with previous treatments.

These surgical procedures include heart transplantation (replacing a damaged heart with a healthy heart), palliative surgery (inserting a tube as an additional route for blood), and inserting special instruments to help the ventricles of the heart.

4. Other supportive care

Congenital heart disease in infants or children may make them need special treatment. This is because they may be late in growth or have difficulty controlling their emotions.

Apart from doctors and health professionals, the role of parents and the people around them is needed to support children to have a better quality of life.

Prevention of congenital heart disease

Although the cause is not known with certainty, congenital heart disease in infants and children can be prevented. This is done by reducing the various risks, such as:

• Joined the German measles vaccine

Before trying to get pregnant, you need to get this vaccine so that the baby is not infected and the development of his organs is not problematic.

• Always check your health

During pregnancy, you must regularly check the development of the fetus. Moreover, if you have health problems, such as diabetes.

• Be careful in using certain drugs

During pregnancy, consult your doctor about the safety of the drugs you intend to use. Make sure you take the medicine according to the rules.

• Apply a healthy lifestyle

Pregnant women are required to adopt a healthy lifestyle so that the fetus can develop properly. This includes maintaining nutritional intake of food and supplements, quitting smoking and staying away from secondhand smoke, and reducing exposure to chemicals.

If you have any questions, consult your doctor for the best solution to your problem.