The heart is a vital and complex organ. It is extremely important that the heart develops perfectly in the foetus, otherwise there may be congenital heart defects. Congenital heart defects are some of the most common birth defects. As the baby grows up, the abnormalities may disappear completely or partially by themselves. However, some complicated defects require medical attention, as they cannot get corrected automatically. Thanks to surgical advances over the last couple of decades, serious defects too can be corrected, and the affected children can live a normal, active life.
As it is a result of the involvement of a genetic factor, a congenital heart defect may run in families. A genetic disorder such as Down’s syndrome may also be responsible for a congenital heart defect. If, during pregnancy, the woman consumes alcohol or has drugs like the anti-convulsant phenytoin, risk of the foetus developing a congenital heart defect increases greatly. Infections like rubella in the expectant mother during the early days of pregnancy may lead to congenital heart defects in the baby. However, in many of the cases, the cause of congenital heart defect remains unknown.
Generally, a congenital heart defect affects one major blood vessel or only one part of the heart. If more than one blood vessel or several parts of the heart are affected by the defect, it indicates a serious condition and can be fatal. The types of congenital heart defects are as mentioned below.
1) Septal defect:
A hole in the heart, medically termed as a septal defect, is the most common type of congenital heart defect. In such a condition, the inner wall that divides the heart chambers has a hole. The hole is either between the two upper chambers (left and right auricle) or between the two lower chambers (left and right ventricle) of the heart. When a child suffers from septal defect, the oxygen-rich blood is sent back to the lungs instead of getting circulated in the body. This results into shortage of oxygen-rich blood in the body.
2) Patent ductus arteriosus:
The pulmonary artery is connected to the aorta through a small blood vessel called ductus arteriosus in the foetus. Because of this vessel, the blood bypasses the lungs. If this vessel does not close up soon after birth, it affects the normal blood circulation.
3) Coarctation of the aorta:
Sometimes there is a narrowing of an area in the aorta. This condition restricts the flow of the blood to the lower part of the body. As a result, the heart muscles start working harder, and thus blood pressure in the upper part of the body is raised. To correct this defect, surgical treatment becomes necessary.
4) Valve defects:
There are four valves in the heart and there is a possibility of any of the valves developing abnormally. However, most commonly, the pulmonary valve may develop abnormally. This valve opens to allow blood to flow from the right ventricle into the pulmonary artery, and as it is gets narrowed, the blood flow gets restricted. Defects of aortic valve are less common.
5) Multiple defects:
Sometimes the heart suffers from more than one defect. Fallot’s tetralogy is the most common multiple defect, in which four abnormalities occur simultaneously. Obstruction to blood flow from the right ventricle, a ventriculo-septal defect, a thickened right ventricle, and a displaced aorta – all of these together put extra strain on the heart. Another multiple defect is hypoplastic left heart syndrome. An even more rare multiple defect is reversal of the position of the pulmonary artery and aorta.
Symptoms and their severity largely depend upon the type of the congenital heart defect. Symptoms common to most of the congenital heart diseases may include shortness of breath, slow weight gain and growth. The lips and tongue may suddenly start to appear blue in colour if the oxygen level in the blood drops down. If a child is suffering from a congenital heart disease, he/she may be at a high risk of infection of the lining of the heart and is highly susceptible to a chest infection. If proper treatment is not given to the child, a congenital heart disease may damage the lungs permanently.
With time, many of these heart defects get corrected naturally. Regular monitoring of such children helps identify the possible complications, therefore, a child with such a defected is generally monitored throughout childhood. If the heart defect doesn’t correct itself with time and poses a serious threat to the child, a surgery is performed, mostly when the child is a little older. If chest infections are not treated immediately, the child with a congenital heart defect may have to face life-threatening consequences. Some children may need drugs to combat the symptoms of a heart defect. A heart transplant is also possible to treat a multiple heart defects.