What is Congenital heart disease on a baby?
Congenital heart disease affects about one baby in 120, so it is by no means rare. It is present from birth, although it might not make its presence felt until later on. Most forms cause no problem to the child, and the rest can often be treated successfully so that the child has a normal or near-normal life.
Congenital heart disease takes several forms. The commonest are:
- Openings in the internal wall of the heart (sometimes wrongly referred to as ‘hole in the heart’). These are called septal defects.
- Failure by a blood channel used only before the baby is born to close at the right time. This is called patent ductus arteriosus.
- Narrowing of the main heart valves. This is called aortic and pulmonary valve stenosis.
- Narrowing of the main artery of the body. This is called aortic stenosis.
Fallot’s tetralogy is a set of 4 congenital heart defects occurring together. These are:
- ventricular septal defect (a hole in the internal wall of the heart),
- pulmonary stenosis (narrowing of the main artery to the lungs),
- deposition of the aorta (the main artery to the body joins the heart at the wrong place),
- and right ventricular hypertrophy (thickening of the wall of one of the main heart chambers).
Symptoms of a congenital heart disease
Children affected by congenital heart disease usually show a bluish skin color, especially around the lips, and are breathless and easily tired. They often take up a characteristic squatting position after exercise. They may have spells in which they are very blue and floppy.
They usually have a heart murmur, which can be heard by your doctor between around 6 weeks and 1 year of age, depending on the nature of the problem.
Why Congenital heart disease occur?
There are many different causes of congenital heart disease. They include:
- Virus infections early in pregnancy, especially German measles (Rubella).
- Some medical drugs if taken in the early weeks of pregnancy (there are very few such drugs).
- Some poorly controlled medical conditions in the mother, such as diabetes or systemic lupus erythematosus (SLA).
- Down’s syndrome.
How to diagnose Congenital heart disease?
The first indication is often a bluish tinge in the skin and breathlessness. Babies may be ‘floppy’, which will alert their pediatrician (specialist in medicine in children) to do further tests.
- a chest X-ray,
- electrocardiograms (ECGs, which picks up electrical activity from the heart),
- echocardiography (ultrasound scanning to look at how the valves are working,
- and possibly the passage of fine tubes into the heart (cardiac catheterisation, to see how the blood is mixing).
Treatment of Congenital heart disease
Whenever a child’s future health is threatened by congenital heart disease, treatment is necessary. For these reasons, surgical correction of the congenital defect is often advised during infancy or childhood.
There have been great advances in the surgical treatment of congenital heart disease, and virtually all children can be cured.
At the very least, treatment can make their lives much better, even if it is not possible to completely solve the problem.
Because of the mixing of blood with oxygen (from one side of the heart) with blood coming from the body and containing little oxygen (in the other side of the heart), various complications may occur.
There may be skin blueness, poor growth, thickening (clubbing) of the tips of the fingers and toes, poor response to exercise, recurrent chest and possibly other infections, and a danger of the heart itself being infected.
Most, if not all, of these problems can be prevented by early surgery.