What is Congenital Heart Disease?
Congenital Heart Disease is a congenital defect of the structure of the heart with which, in most cases, the patient is born with. In times gone by, Congenital Heart Disease was considered as potentially a fatal condition and the baby was not able to survive but with the advancements made in the field of medical science and the technology involved these days children are able to successfully survive for a much longer period of time. Even with the considerable advances that medical science has made in terms of Congenital Heart Disease people still are not able to get adequate followup care which is a matter of concern. Once you are diagnosed with Congenital Heart Disease then it is extremely vital that you get regular checkups with the physician even if you may not been having any symptoms.
What Causes Congenital Heart Disease?
In order to understand Congenital Heart Disease, it is vital to understand as to how the heart functions. The heart is divided into four chambers of which two are on the right and two are on the left. The basic function of the heart is to supply blood to the rest of the body. In performing so, the heart makes use of these chambers for different purposes. The right side of the heart facilitates movement of the blood to the lungs where the blood gets oxygenated and comes back to the heart. The left side of the heart then pumps this oxygenated blood to the rest of the body.
Now the question arises as to how do Heart defects develop. The answer to this is majority of the defects of the heart develop while the baby is still not born. At the beginning of the pregnancy the fetal heart starts to function. As the pregnancy progresses, various structures of the heart form and this when usually heart defects develop. It is not entirely clear as to what causes these defects to develop but researchers' point that certain medical conditions, substance abuse during pregnancy, some medications and even to some extent genetic factors also play a role in the development of Congenital Heart Disease.
Another question which arises quite frequently is that once a heart defect is treated successfully in childhood then why is it that the condition reappears when the patient reaches adulthood. The answer to this is that heart defects are not cured but repaired and hence there is always a chance of them reappearing later in life.
What are the Risk Factors for Congenital Heart Disease?
Some of the risk factors for development of Congenital Heart Disease are:
Rubella Infection: If the mother got infected with this infection during pregnancy then the risk of the child being born with heart abnormalities increase.
Diabetes Mellitus: Children of diabetic mother's are also at risk for developing Congenital Heart Disease.
Medications: Taking certain classes of medications while pregnant may increase the risk of developing Congenital Heart Disease in the child. Some of the medications are isotretinoin used for treating acne and lithium used for bipolar disorder.
Genetic Factors: Some studies suggest that there is a genetic link to the development of Congenital Heart Disease
What are the Symptoms of Congenital Heart Disease?
Congenital Heart Disease if diagnosed and treated while an infant may lie dormant for some years without any symptoms but may resurface as an adult with the patient experiencing the following symptoms:
- Cardiac arrhythmias
- Dyspnea at rest or with activity
- Exertional fatigue
How is Congenital Heart Disease Diagnosed?
If the physician suspects that you have a Congenital Heart Disease then the first thing he or she will do is to conduct a physical examination based on your symptoms. The physician will listen to your heart to look for any abnormal murmurs. Once performing the physical examination, the physician will order certain studies to confirm the diagnosis.
Electrocardiogram: This test shows the heartbeat in the form of electrical impulses. This test can show whether there is any abnormality in the rhythm of the heart and whether the heart is functioning normally.
Echocardiogram: This test makes use of ultrasound waves to look at the functioning of the heart. This test can accurately identify any abnormality of the functioning of the heart.
Treadmill Stress Test: This test is conducted to find out the exercise tolerance of the patient and how much distance the patient can cover on the treadmill before the patient starts having symptoms. This is quite helpful in confirming the diagnosis of a heart block and formulating a treatment plan.
Cardiac Catheterization: This is a minimally invasive test in which a catheter is inserted in the heart through the leg. This test accurately measures the pressure that is exerted on the chambers of the heart.
How is Congenital Heart Disease Treated?
As Congenital Heart Disease may be mild to severe in nature hence treatment depends on the severity of the disease condition. The first and foremost treatment will be to correct the deformity and prevent any complications that the defect (CHD) may cause.
Some of the treatment options for Congenital Heart Disease may be:
Close follow-up: Minor defects may just require close observation to check the status of the heart and may not require any specific aggressive treatment
Medications for CHD: In some cases, Congenital Heart Disease requires medications for treatment. These medications facilitate smooth functioning of the heart. Medications may also be given to prevent clotting and to maintain regular heartbeats in cases of arrhythmias.
In some cases surgical procedures are required to control the symptoms of Congenital Heart Disease. These procedures may be done to implant a device which will control the heart rate in cases of arrhythmias and even improve the function of the heart. Some of the devices which can control the heart rate are pacemaker and an ICD device. These devices help a long way in preventing complications that may arise due to Congenital Heart Disease.
Catheterization for CHD: In some cases, Congenital Heart Disease is repaired using catheter techniques, which allow repairing the defect without actually opening the chest and heart. In this procedure the surgeon will insert a thin catheter through a leg vein into the heart. Once the catheter is positioned at the site of the defect then the deformity is repaired using specially made tools which are inserted at the site through the catheter. The catheter has in place a small camera through which the surgeon is able to clearly visualize the defect and repair it.
Open Heart Surgery for CHD: If catheters are insufficient to correct the problem then an open heart surgery may be done in which an incision will be made in the chest area and the surgeon goes into the heart at the site where the defect is and corrects the deformity.
Transplant: If all else fails and the patient still has significant symptoms then the only option left is a heart transplant to treat Congenital Heart Disease.