North Jersey Pediatric Cardiology
Congenital
Heart Disease
The heart begins to form long before you can hear it beat. In about the third week of pregnancy, the heart begins to develop from a single tube. As the weeks pass, the tube develops into the chambers, vessels and valves of a working heart. Development of the heart is complete by the eighth week of pregnancy. But sometimes development of the heart goes wrong and a congenital heart defect results.
About eight in 1,000 babies are born with congenital heart disease (CHD). While the cause of most defects is rarely discovered, sometimes CHD is traced to a chromosomal abnormality, fetal exposure to drugs and alcohol or to a viral disease.
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Causes of CHD
Any part of the heart or cardiovascular system can be affected by congenital problems. The following lists just a few examples of CHD. Among the different types are those with:
Abnormal blood flow through the heart. This can be caused by conditions such as atrial septal defects (ASD) and ventricular septal defects (VSD). Commonly referred to as “holes in the heart,” septal defects occur when the opening in the walls that divides the heart into left and right chambers fails to close at birth. ASDs occur in the heart’s upper chambers, VSDs in the lower chambers.
Obstructed blood flow in the heart or major blood vessels. This may be caused by a defect such as coarctation of the aorta, which occurs when the artery carrying blood from the heart to the rest of the body is pinched. In that case, blood flow to the lower body is blocked and pressure builds in the upper body. Associated with this, one or more of the valves in the heart can also be obstructed.
Abnormal circulation caused by abnormal development of the heart.
In rare cases, the positions of the pulmonary artery and the aorta are switched in a malformation called transposition of the great vessels. When that happens, blood is pumped back to the body without passing through the lungs. Infants born with this defect look blue and need immediate medical attention. There are many other causes of “blue babies.”
Good reason for optimism:
Quality diagnostic tools and regular checkups can help doctors detect congenital heart disease early. Noninvasive tests such as echocardiography and magnetic resonance imaging make diagnosis painless. Ultrasound examination can also detect CHD before a baby is even born.
Treatment of CHD depends on the type and extent of the defect. Sometimes, monitoring alone is required. A small hole in the heart, for example, may heal on its own. Medication may be necessary to make the heart beat more efficiently; sometimes, surgery is necessary.
While many cases of CHD are discovered early in childhood or infancy-murmurs, feeding difficulties, rapid heart beat and excessive perspiration are among the symptoms-sometimes a congenital problem goes undetected until adulthood.