Congenital Heart Diseases (Cardiovascular Disorders) | Chapter Circulation video # 14

Congenital Heart Disease
Congenital heart disease, or a congenital heart defect, is a heart abnormality present at birth. The problem can affect:
• the heart walls (septal defects)
• the heart valves (pulmonary stenosis or aortic stenosis)
• the blood vessels
In some cases, doctors can find these problems during pregnancy. You might not get symptoms until adulthood, or you may not get any at all.
Types of Congenital Heart Disease
Though there are many different types of congenital heart defects, they can be divided into three main categories:
Heart valve defects: One may be too narrow or completely closed. That makes it hard for blood to get through. Sometimes, it can’t get through at all. In other cases, the valve might not close properly, so the blood leaks backward.
Problems with the heart’s "walls": It could be the ones between the chambers (atria and ventricles) of your heart. Holes or passageways between the left and right side of the heart might cause blood to mix when it shouldn’t.
Bad connections among blood vessels: In babies, this may let blood that should go to the lungs go to other parts of the body instead, or vice versa. These defects can deprive blood of oxygen and lead to organ failure.
OR
The arteries and veins that carry blood to the heart and back out to the body may not function correctly. This can reduce or block blood flow, leading to various health complications.
Cyanotic and Acyanotic Congenital Heart Disease
The main difference is that cyanotic congenital heart disease causes low levels of oxygen in the blood, and acyanotic congenital heart disease doesn’t. Babies with reduced oxygen levels may experience breathlessness and a bluish tint to their skin. Babies who have enough oxygen in their blood don’t display these symptoms, but they may still develop complications later in life, such as high blood pressure.
What Causes Congenital Heart Disease?
Things that make them more likely include:
• Problems with genes or chromosomes in the child, such as Down syndrome
• Taking certain medications, or alcohol or drug abuse during pregnancy
• A viral infection, like rubella (German measles) in the mother in the first trimester of pregnancy
What Are the Symptoms of Congenital Heart Disease?
In some cases, the symptoms of a congenital heart defect may not appear until shortly after birth. Newborns with heart defects may experience:
• bluish lips, skin, fingers, and toes
• breathlessness or trouble breathing
• feeding difficulties
• low birth weight
• chest pain
• delayed growth
In other cases, the symptoms of a congenital heart defect may not appear until many years after birth. Once symptoms do develop, they may include:
• abnormal heart rhythms
• dizziness
• trouble breathing
• fainting
• swelling
• fatigue
Diagnosis
Echocardiogram: A type of ultrasound that takes pictures of your heart.
Cardiac catheterization: A doctor guides a very thin, flexible tube (called a catheter) through a blood vessel in your arm or leg to reach your heart. She puts dye through the catheter and then uses X-ray videos to see inside your heart.
Chest X-ray: These can reveal signs of heart failure.
Electrocardiogram (ECG or EKG): This measures the heart’s electrical activity.
MRI : You get a scan that lets doctors see the heart’s structure.

Treatment
You might not need any treatment. Or you may need medications, surgery, or other procedures.
Medications
There are various medications that can help the heart work more efficiently. Some can also be used to prevent blood clots from forming or to control an irregular heartbeat.
Implantable Heart Devices
Some of the complications associated with congenital heart defects can be prevented with the use of certain devices, including pacemakers and implantable cardioverter defibrillators (ICDs). A pacemaker can help regulate an abnormal heart rate, and an ICD may correct life-threatening irregular heartbeats.
Catheter Procedures
Catheterization techniques allow doctors to repair certain congenital heart defects without surgically opening the chest and heart. During these procedures, the doctor will insert a thin tube into a vein in the leg and guide it up to the heart. Once the catheter is in the correct position, the doctor will use small tools threaded through the catheter to correct the defect.
Open-Heart Surgery
This type of surgery may be needed if catheter procedures aren't enough to repair a congenital heart defect. A surgeon may perform open-heart surgery to close holes in the heart, repair heart valves, or widen blood vessels.
Heart Transplant
In the rare cases in which a congenital heart defect is too complex to fix, a heart transplant may be needed. During this procedure, the child's heart is replaced with a healthy heart from a donor.

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