Congenital Heart Disease: Types, Causes, Symptoms & Treatment

Congenital heart diseases, often known as defects, are structural issues with the heart that are present from birth. They might alter the normal blood flow through the heart.

There are several types of congenital heart diseases. The most common defects involve the valves of the heart, inside walls of the heart, or the large blood vessels that carry blood to and from the heart. Certain defects are minor and require no treatment, while others are critical and require treatment soon after birth. 

While the exact cause of congenital cardiac problems is frequently unknown, a number of variables might increase a baby's chance of being born with a heart defect. Among the risks are a family history of congenital heart defects, smoking, and using specific medications while pregnant.

Symptoms or examinations of newborns or pregnant women can typically lead a physician to discover congenital heart diseases. If you or your child is diagnosed with a congenital heart defect, a doctor may occasionally need to perform cardiac testing. 

Identifying and managing congenital heart diseases has advanced within the past few years. Better medical options, such as medications and treatments, are available. Congenital heart diseases are now common in many children and adults, either fully recovered or still present. You can lower complications and enhance your quality of life by managing your disease through regular follow-up care, mental health support, and condition monitoring.

What Are The Different Types Of Congenital Heart Diseases?

The following are the main types of congenital heart diseases:

• Cyanotic congenital heart diseases
• Acyanotic congenital heart diseases 

Cyanotic congenital heart disease:

Cyanotic heart disease is a condition in which the heart does not function normally due to reduced oxygen levels in the blood and it reduces the amount of oxygen your heart can deliver to the rest of your body. Babies born with cyanotic congenital heart disease generally have low levels of oxygen and need surgery. Examples include:

Left heart obstructive lesions: These decrease blood flow between the heart and the rest of your body (systemic blood flow). Examples are hypoplastic left heart syndrome (when your heart is too small on the left side) and interrupted aortic arch (incomplete aorta).

Right heart obstructive lesions: These limit the blood flow between your heart and lungs (pulmonary blood flow). Tetralogy of Fallot (a group of four anomalies), Ebstein’s anomaly, pulmonary atresia and tricuspid atresia (valves don’t develop correctly) are a few examples.  

Mixing lesions: Systemic and pulmonary blood flow are combined by the body. An example is the transposition of the great arteries, which denotes an incorrect location for the two major arteries that leave your heart. Another is truncus arteriosus, which is a condition in which your heart only has one major artery rather than two to supply blood to your body.

Acyanotic congenital heart disease:

Acyanotic heart disease is a type of congenital heart defect which causes irregular blood flow. These defects do not affect the amount of oxygen or blood given to the rest of the body. It can range from mild to severe. Babies suffering from this illness may appear fatigued and breathless.  The acyanotic congenital heart disease involves a hole in the heart, problems associated with the pulmonary artery, and problems in the aorta.  The examples include:

• Aortic stenosis
• Pulmonic stenosis
• Coarctation of the aorta
• Bicuspid aortic valve
• Atrial septal defect (ASD)
• Ventricular septal defect (VSD)
• Atrioventricular canal (endocardial cushion defect)
• Patent ductus arteriosus (PDA)

Congenital heart disease results When the fetal heart fails to develop correctly in the uterus.   Most of the time, congenital heart disease has no known cause. Nonetheless, there are a few identified factors that raise the condition's risk, such as:

• Mother is having certain types of infections like Rubella during pregnancy
• Excessive smoking and alcohol consumption during pregnancy
• Mother is taking certain medications like statins, and acne medicines during pregnancy
• Uncontrolled diabetes during pregnancy
• Genetic or chromosomal defects which happen randomly or are inherited from parents 
• Down’s syndrome

What Are The Symptoms Of Congenital Heart Diseases?

Each patient experiences different signs and symptoms based on their age, the number of cardiac problems they have, the severity of their disease, and the type of congenital condition they have. The general signs and symptoms of congenital cardiac disease are as follows:

• Extreme tiredness
• Bluish discolouration of the skin and nails (cyanosis)
• Rapid breathing or trouble breathing
• More sleepiness
• Difficulty to breath or getting severe after exercise
• Heart murmur
• Poor blood circulation
• Pounding heartbeat
• Swelling in tummy, legs, or around the eyes

How Congenital Heart Diseases Are Diagnosed?

During a regular prenatal ultrasound screening, medical professionals can identify congenital cardiac disease before the baby is born. If anomalies are discovered, they can recommend that you have a fetal echogram to create images of the developing heart. Using pulse oximetry after birth, medical professionals can identify the cardiac condition. Cyanotic heart disease is suspected when pulse oximetry readings show low oxygen levels.

The diagnostic procedures carried out to detect congenital heart diseases include:

• Detailed physical examination: In this, doctors utilize a stethoscope to check for abnormal heartbeats, heart murmur, pounding heartbeat etc
• Chest X-ray: Doctors utilize the X-rays to visualize the internal structures and to rule out abnormalities
• Electrocardiogram: It helps to detect the electrical activity of the heart
• Echocardiogram: During this procedure, the images of heart valves and chambers are obtained using an ultrasound
• Heart catheterisation or coronary angiography: It helps doctors to visualize the blood flow; how the heart is pumping and circulating
• Magnetic resonance imaging: Doctors utilize the MRI for detailed visualization of structures of the heart

How Is Congenital Heart Diseases Treated?

Certain types of congenital heart diseases do not require any treatment while others are life-threatening and need immediate treatment after delivery. The treatment options for congenital heart diseases include:

• Medications to improve heart functioning and to control blood pressure
• Catheter procedure to insert a plug into the defect
• A non-surgical procedure to correct the issue using a closing device
• Oxygen therapy which helps to provide more oxygen than normal air would
• Prostaglandin E1,which helps to provide needed circulation by relaxing the smooth heart muscles and it can keep open a closed blood vessel
• Surgery to repair the defect, open up blood vessels and to redirect blood flow
• Heart transplant (needed in severe cases)

Conclusion

Congenital heart disease, or a congenital heart defect, is a heart abnormality present from birth. The diagnosis and course of treatment may start soon after birth, in infancy, or in adulthood, depending on the abnormality. Treatment and diagnosis may take longer for certain problems because they don't show symptoms until the child reaches adulthood. In these situations, chest pain, dyspnea, extreme exhaustion, and decreased exercise tolerance could be signs of a recently identified congenital cardiac disease. 

It's critical that you keep visiting your doctor for follow-up care, no matter what. While treatment might not reverse your illness, it can support you in leading an engaged and fruitful life. Additionally, it will lower your chance of developing major side effects like heart infections, heart failure, and stroke.
 

Frequently Asked Questions (FAQs)

Q: How to stay healthy with congenital heart disease?
A: A heart-healthy diet that includes eating lots of fruits, vegetables, and whole grains will help lower heart disease risk factors like obesity and high blood pressure. Make healthy lifestyle choices to support this diet. Engage in regular physical activity. Most people with congenital heart disease can be physically active.

Q: How to treat CHD in babies?
A: Surgery may be advised soon after birth if the baby is delivered with serious symptoms. If the symptoms are not as severe, surgery will usually be carried out when your child is 4 to 6 months old. During surgery, the surgeon will close the hole in the heart and open up the narrowing in the pulmonary valve.