What is congenital heart disease?
A congenital heart disease is a malformation of the heart or adjacent blood vessels that is present in the newborn or fetus. It should be noted that some heart diseases manifest themselves clearly months or years later.
In this case, we are talking about a birth problem in which the heart has some type of congenital defect, such as an incomplete heart, with narrowed blood vessels, with leaky valves or holes in the septum….
There are different types of congenital heart defects, some of which are mild and pose little risk to the child’s health, while others may require immediate surgery.
Heart defects can be classified as follows:
- Heart defects that cause obstructed blood flow.
- Cyanogenic congenital heart diseases, in which abnormal blood flow goes from the pulmonary circulation to the systemic circulation, passing unoxygenated blood to the organs and tissues.
- Those that produce left-right shunts (the passage of blood from the systemic circulation to the pulmonary circulation, including ventricular septal defects and atrial septal defects).
- Ventricular septal defect: they have an orifice that communicates both ventricles, being the most frequent congenital heart disease. It may be asymptomatic and the hole may close on its own, although if it continues to grow, excessive blood will be pumped to the lungs, leading to heart failure.
- Atrial septal defect: this is a hole between the atria that allows blood to pass between them. The blood will fluctuate between the left and the right, and in the event that too much blood reaches the right, the lungs will be pressurized. Normally, atrial septal defects do not cause problems, although sometimes they cause too many, such as heart failure, hypertension, strokes…
- Tetralogy of Fallot: this is a complex heart disease in which ventricular septal defect, stenosis of the pulmonary artery, hypertrophy of the right ventricle and overriding of the aorta stand out. It prevents blood from reaching the lungs for oxygenation. The baby takes on a sickly blue or purple hue. Advances in new surgical techniques make it possible to correct these problems.
- Long QT syndrome: this is a structural abnormality in the potassium and sodium channels of the heart. It can cause arrhythmias leading to syncope, seizures, arrest and even sudden death.
- Short QT syndrome: this is a syndrome of genetic origin related to the presence of atrial fibrillation. It is characterized by a shorter than normal electrocardiogram QT interval.
- Brugada syndrome: this is a genetic disease characterized by the presence of an electrocardiographic abnormality. It is a hereditary disease.
These cardiological disorders are related to sudden death diseases.
Most congenital heart disease is detected before birth by ultrasound.
Medical tests for congenital heart disease
Most congenital heart diseases are diagnosed by ultrasound before delivery as part of routine tests performed on pregnant women to monitor the progress of the pregnancy and the health status of both mother and fetus.
Some heart diseases are detected only at birth or shortly thereafter. In the case of severe congenital heart disease, these will be identified at the baby’s check-ups after birth.
Prognosis of congenital heart disease
As mentioned in the previous section, there are numerous congenital cardiopathies whose severity varies, ranging from practically imperceptible problems that resolve spontaneously with the passage of time to really serious diseases in which the patient will require hospital admission and almost emergency surgery.
Causes of congenital heart disease
The causes of congenital heart disease are unknown, although a number of factors have been identified that may increase these diseases:
- Genetic cause: they may be part of some genetic or chromosomal syndromes such as Down syndrome, Marfan syndrome, Noonan syndrome or Turner syndrome.
- Nutritional status of the mother: iodine and folate deficiency, overweight or diseases such as diabetes are related to the appearance of congenital anomalies in the fetus, according to the World Health Organization.
- Infections and toxic substances: the consumption of alcoholic beverages and/or tobacco, some medicines or chemical substances and even diseases such as rubella can favor the appearance of heart disease.
Can congenital heart disease be prevented?
There are primary prevention measures for congenital malformations that can reduce the frequency with which these problems appear.
- Improve the diet of pregnant women with vitamins and minerals, such as folic acid.
- Eliminate smoking and alcohol consumption in pregnant women.
- Control blood glucose levels in case the pregnant woman suffers from diabetes.
- Avoid exposure to toxic substances
Treatments for congenital heart disease
- Pharmacological treatment: this is given in the acute phase, when the patient has suffered angina pectoris or infarction. It is an infarction due to total occlusion of the artery, and an attempt is made to unblock it. The medication used is acetylsalicylic acid (aspirin), antiplatelet agents, anticoagulants, beta-blockers, nitroglycerin, thrombotics or fibrinolytics and drugs to prevent pain.
- Surgical treatment: given in severe problems or when medication is insufficient. Surgery is performed on the artery. Angioplasty or percutaneous revascularization, coronary revascularization surgery or bypass.
- Long-term treatment: consists of modifying the patient’s lifestyle. Smoking cessation, moderation of alcohol consumption, balanced diet, regular exercise, control of risk factors and relaxation.
What specialist treats congenital heart disease?
Infants or children with congenital problems are diagnosed and treated by the pediatric cardiologist. If an intervention is necessary, then the cardiac surgeon or cardiovascular surgeon will be in charge of dealing with the disease.
Heart disease can have different levels of severity and a wide variety of symptoms. A mild heart disease may become asymptomatic and a severe one that may be latent may show up suddenly.