Congenital Heart Disease (CHD) refers to a range of heart defects present at birth that affect the structure and function of the heart. These defects can involve the heart walls, heart valves, arteries, and veins near the heart, leading to disrupted blood flow and affecting how blood circulates through the body.

Types of Congenital Heart Disease

  1. Septal Defects:
    • Atrial Septal Defect (ASD): A hole in the wall (septum) between the heart’s two upper chambers (atria).
    • Ventricular Septal Defect (VSD): A hole in the wall between the heart’s two lower chambers (ventricles).
  2. Patent Ductus Arteriosus (PDA): A condition where the ductus arteriosus, a blood vessel that connects the pulmonary artery to the aorta, fails to close after birth, allowing oxygen-rich and oxygen-poor blood to mix.
  3. Tetralogy of Fallot: A complex condition involving four defects: a large VSD, pulmonary stenosis, right ventricular hypertrophy, and an overriding aorta.
  4. Coarctation of the Aorta: A narrowing of the aorta that restricts blood flow from the heart to the rest of the body.
  5. Transposition of the Great Arteries: The positions of the pulmonary artery and the aorta are switched, leading to improper circulation of blood.
  6. Hypoplastic Left Heart Syndrome: The left side of the heart is underdeveloped, affecting normal blood flow.
  7. Tricuspid Atresia: The tricuspid valve is missing or abnormally developed, obstructing blood flow between the right atrium and right ventricle.
  8. Pulmonary Atresia: The pulmonary valve is not properly formed, blocking blood flow from the heart to the lungs.
  9. Total Anomalous Pulmonary Venous Return (TAPVR): Pulmonary veins connect to the wrong part of the heart, causing oxygen-rich blood to enter the wrong chamber.

Causes and Risk Factors

  • Genetic Factors: Certain genetic conditions, such as Down syndrome, can increase the risk of CHD.
  • Environmental Factors: Maternal infections (like rubella), certain medications, alcohol, and drug use during pregnancy can contribute to the risk.
  • Family History: A higher risk if a parent or sibling has CHD.
  • Maternal Health: Conditions such as diabetes, obesity, and uncontrolled phenylketonuria (PKU) during pregnancy.

Symptoms

  • Cyanosis: Bluish tint to the skin, lips, and fingernails due to poor oxygenation.
  • Rapid breathing or difficulty breathing.
  • Fatigue: Easily tiring during feeding or exercise.
  • Poor weight gain in infants.
  • Heart murmurs: Unusual heart sounds heard during a physical exam.
  • Swelling in the legs, abdomen, or around the eyes.
  • Chest pain or palpitations in older children and adults.

Diagnosis

  • Prenatal Ultrasound: May detect some heart defects before birth.
  • Echocardiogram: Uses sound waves to create detailed images of the heart’s structure and function.
  • Electrocardiogram (ECG): Records the electrical activity of the heart.
  • Chest X-ray: Can show the size and shape of the heart.
  • Cardiac MRI: Provides detailed images of the heart and blood vessels.
  • Cardiac Catheterization: Invasive test to directly measure pressures and oxygen levels inside the heart chambers and vessels.

Treatment

  • Medications: To manage symptoms and prevent complications, such as diuretics, beta-blockers, and ACE inhibitors.
  • Catheter-Based Interventions: Procedures like balloon angioplasty or stent placement to open narrowed vessels or close holes.
  • Surgery:
    • Open-heart surgery to repair or replace defective heart structures.
    • Corrective surgery for complex conditions, such as Tetralogy of Fallot or Transposition of the Great Arteries.
    • Palliative surgery to improve blood flow and oxygen levels in more severe defects.
  • Heart Transplant: In severe cases where the heart defects cannot be repaired.

Long-Term Management

  • Regular follow-ups with a cardiologist, especially for adults with CHD.
  • Lifestyle modifications: Including a heart-healthy diet, exercise, and avoiding smoking.
  • Endocarditis Prevention: Maintaining good dental hygiene and possibly taking antibiotics before certain medical or dental procedures.
  • Monitoring and managing associated conditions: Such as arrhythmias, heart failure, or pulmonary hypertension.

With advances in medical and surgical treatments, many individuals with congenital heart disease can live full, active lives, though lifelong monitoring and care are often required to manage the condition and prevent complications.

At Precious Medical Group (PMG), we are here to assist you further. Please feel free to contact us for any enquiry.