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FACTS:

• Congenital heart diseases are caused by improper development of the heart during fetal development.
  
• A human heart has four sections.  The two top sections are the atria, and the two bottom sections are the ventricles.  Defects can occur in any of these sections as well as in the valves that control blood flow, the arteries, and the veins. 
  
• Even though having heart disease may sound scary, many heart defects can be treated through medicines and/or surgery.
  
• Some defects are mild and may go unnoticed with no apparent symptoms. Some defects are more severe and symptoms may include a bluish tint to the skin, fingernails, or lips, trouble breathing, low blood pressure, fainting, feeding problems, or poor weight gain.
  
• Children with congenital heart defects that receive treatment often live long, healthy, active, and productive lives.
  
• The sooner congenital heart disease is diagnosed and treated, the better the chance the child has to live a healthy and normal life.

TYPES OF HEART DEFECTS:

There are many types of heart defects. The following are the most common:

VSD (Ventricular Septal Defect). This is a common heart condition where one or more holes occur in the muscular wall that separates the lower chambers of the heart.   This hole often causes increased blood pressure in the pulmonary arteries and lungs.   VSDs range in size from small to large.

• Small VSDs usually allow only a small amount of blood flow between the ventricles. Most small VSDs do not cause symptoms in infants and children, often close on their own by school age, and rarely need surgery to close the defect.
• Moderate VSDs are less likely than small defects to close on their own. They may require surgery to close and may cause symptoms during infancy and childhood.
• Large VSDs allow a large amount of blood to flow from the left ventricle to the right ventricle. A large VSD can cause more symptoms in infants and children, and surgery is usually needed to close it.

ASD (Atrial Septal Defect).    This is a defect of the upper chambers of the heart (atria) where the wall between the right and left atria does not close completely.   Many children with small ASDs have no symptoms at all.   Many larger ASDs can now be closed with a catheter and not by opening a child’s chest for surgery.

PDA(Patent Ductus Arteriosis).When the baby is in the birthmother’s womb, there is a blood vessel that is open in all infants, that allows blood to bypass the baby’s lungs.  At birth, this vessel is supposed to close.   When it does not, a child then has a PDA, which allows extra blood to pass to the lungs.   Children with PDAs often have a heart murmur and shortness of breath.

TOF (Tetralogy of Fallot). This more serious heart issue has four defects,  including a ventricular septal defect, a  narrowing of blood out of the right ventricle to the lungs, an aorta that is shifted to the right, and enlargement of the right ventricle since it must work harder.   TOF children normally have lower oxygen levels, and they may have spells where they turn blue from crying or feeding.   Surgery should be done as young as possible.

Transposition of the Great Arteries (TGA), often called TGV (transposition
of the great vessels). It often presents with other defects, particularly
valve defects and/or ASDs and VSDs- The "great arteries" in this anomaly refer to the Aorta and the Pulmonary Artery, the two major arteries carrying blood away from the heart. This means that blue (poorly oxgenated) blood is pumped out to the body and red (oxygen rich blood) is sent back to the lungs. Without surgery in the first year, most of these cases would be fatal without the mix of oxygen rich blood, usually due to another defect in the valves.

SV (Single Ventricle). Normal hearts have two ventricles, but some children are born with only one, or the second one might be poorly developed.   Babies with single ventricle often appear quite blue. These children will most likely require 2-3 surgeries done in stages, and with surgery their outlook is now very promising.

Sometimes heart defects present with other birth defects such as cleft lip/palate or limb differences this may be the result of a problem during the same time of fetal development and rarely due to a syndrome. Specialists should be consulted for each birth defect.

EFFECTS:

Over time, having an untreated heart defect can cause:

• Congestive heart failure.   Babies with heart defects often have hearts that must work harder to pump the blood through the body.   This can increase the heart rate and the body’s demand for energy.  The extra bloodflow in the lungs may cause rapid breathing as well.  
  
• Growth failure, especially in infancy.   A baby may not be able to eat enough to keep up with his or her body's increased energy demands.  A  baby may lose weight or fail to grow and develop as he or she should.
  
• Bacterial endocarditis is an infection of the lining of the heart, valves, or arteries. Endocarditis often occurs following dental and medical procedures.
  
•  Irregular heartbeat or rhythm (arrhythmia). The extra blood flowing through the heart can cause it to stretch and enlarge. When this occurs, a child can develop a fast heartbeat with symptoms such as dizziness or fainting.
  
• Pulmonary hypertension (PH). Increased blood flow to the pulmonary arteries causes them to become thick and stiff, and eventually the amount of blood reaching the lungs is decreased.   If a child’s pulmonary hypertension becomes too high, they are unable to have surgery.    The PH number is an important one to watch with any child with a heart condition.

TREATMENT:

• Some heart defects do not require treatment.
  
• If treatment is necessary, physicians can choose from a variety of therapies including medicines, therapeutic catheterization, or surgery.

HEALTH MAINTENANCE:

A child’s growth and development may be affected by congenital heart defects.  Caring for a child with heart disease may be challenging, but also rewarding.  Listed are a few suggestions for maintaining the health of the child:

• Feeding – Children with heart defects may tire easy when they’re feeding.  If feeding makes the child tired, try feeding the child smaller quantities at more frequent intervals.
  
• Adequate nutrition– Try and use a special formula with extra calories to help the baby gain weight.
• Routine Medical Check-ups– It is important for the child to receive routine medical check-ups and immunizations.
• Medicine – Some children need medicine to make the heart stronger or to prevent other problems.  It is very important to give medicine as directed by your doctor.
• Reduce Exposure to Illness-  Children with congenital heart disease are at risk for the development of bacterial endocarditis, an infection of the tissue that lines the heart and blood vessels.  Good dental care is important as well to avoid bacterial infections.