Congenital Heart Illness: occurence symptoms and other aspects

Definition of a Congenital Heart Illness

Congenital heart illness, also known as congenital heart defect or CHD, refers to issues or abnormalities in the structure of a baby's heart that are present at birth. These abnormalities can affect the heart muscle itself, the valves inside the heart, or the arteries and veins supplying the heart. The defects can affect the baby's health by slowing down the flow of blood, blocking the blood flow completely, or causing the blood to flow in the wrong direction. Congenital heart defects are the most typical kind of major birth defect; they range from minor issues that do not cause any obvious symptoms to life-threatening abnormalities.

Doctors divide congenital heart defects into two main categories depending on regardless of whether they cause a bluish-gray discoloration of the mouth, lips, and nail beds called cyanosis. Cyanosis occurs when the blood flowing through the blood vessels close to the skin surface is not carrying sufficient oxygen to give the lips or mouth their normal pinkish color. Some congenital heart defects lead to cyanosis while other people are known as noncyanotic defects because they don't produce this skin discoloration.

Description

The signs and symptoms of congenital heart defects vary significantly in severity. Most of these defects produce a heart murmur a characteristic whispering sound that the doctor can hear through a stethoscope. Some defects, however, may produce no other noticeable symptoms, while other people might lead to shortness of breath, cyanosis, chest pain, sweating, frequent respiratory infections, underdeveloped limbs and muscles, poor feeding, or slowed growth. Cyanotic congenital heart defects include:

Tetralogy of Fallot. This is the most common cyanotic heart defect, accounting for 5-7 percent of all congenital heart defects. It is named for a French physician who described it in 1888. Tetralogy indicates that this defect involves four various interrelated abnormalities: a hole between the two bottom chambers (ventricles) of the heart; an aorta in an abnormal location; a narrowing of a heart valve that prevents regular blood outflow from the correct ventricle; and a larger than regular correct ventricle.
Transposition of the fantastic vessels (TGA). TGA is really a defect in which the aorta and also the pulmonary artery (the artery that carries blood from the heart to the lungs) are switched, so that the heart receives blood that has not been oxygenated in the lungs and sends this oxygen-poor blood out to the rest of the body.
Persistent truncus arteriosus. The truncus arteriosus is a structure discovered in human embryos that normally divides to form the aorta and also the pulmonary artery prior to birth. If that division doesn't happen, the baby is born with a single big blood vessel instead of two regular arteries and can develop heart failure within a few weeks after birth.
Tricuspid atresia. Tricuspid atresia is a heart defect in which the valve between the two chambers on the correct side of the heart doesn't open. In addition, the heart's correct ventricle is unusually small. Noncyanotic congenital heart defects include:
Ventricular septal defect (VSD). A VSD is a hole in the wall of tissue that normally divides the two lower chambers of the heart. It's the most typical type of CHD, accounting for 30-60 percent of all CHDs.
Atrial septal defect (ASD). An ASD is a hole in the tissue that normally separates the two upper chambers of the heart.
Patent ductus arteriosus (PDA). The ductus arteriosus is really a temporary passageway that connects the pulmonary artery and also the aorta that usually closes within a few hours or days after the baby is born. Patent indicates that the passageway remains open. PDAs are more typical in babies born prematurely than in full-term babies.
Aortic stenosis. Aortic stenosis is really a defect in which the aortic valve a heart valve that controls the flow of blood from the left ventricle to the aorta is narrower than regular and slows down the flow of blood out of the heart.
Coarctation of the aorta (COA). In COA, a portion of the aorta is abnormally narrow, reducing the quantity of blood that the heart can pump to the rest of the body.

Demographics

Congenital heart disease is one of the most common birth defects, occurring in eight out of every 1,000 newborns in the United States, or about 40,000 babies in an average year according to the March of Dimes. Most congenital heart defects either heal by themselves or respond well to treatment; however, 4,000 babies with CHDs won't survive their first year of life. Twice as many children die each year from CHDs than from all kinds of children's cancers combined. Risk factors for congenital heart illness include:

Premature birth.
Family history of CHD. Having one baby with a CHD increases the risk of having a second child with a heart defect by a factor of five. If the baby's mother has a CHD, the risk for a child to be born with CHD ranges 2.5-18 percent, with an average risk of 6.7 percent. If the father has CHD, the risk for a child to be born with CHD ranges 1.5-3 percent.
Rubella in the mother during early pregnancy.
Mother's abuse of alcohol or drugs during pregnancy.
Chronic diseases in the mother, particularly diabetes and lupus.
Mother's use of certain antiseizure medications.

Congenital Heart Illness: Causes and Symptoms

Most cases of congenital heart illness (85-90 percent) don't have a recognized cause. Some recognized causes of CHDs include:

Genetic disorders involving parts of a chromosome (5-8 percent of CHDs): these include Down syndrome, Edwards syndrome, Patau syndrome, and Turner syndrome.
Single-gene defects (3-5 percent): Marfan syndrome is the most common single-gene disorder linked to CHDs.
Environmental factors (2 percent). Symptoms of CHDs vary somewhat depending on the particular heart defect but might include:
Heart murmur
Cyanosis
Rapid breathing
Lack of appetite and poor feeding
Failure to gain weight
Sweating during feedings
Weak pulse

Diagnosis

Some CHDs can be detected during pregnancy or during the baby's first physical examination when the physician listens to the heart and looks for cyanosis, rapid breathing, a weak pulse, or indications of heart failure. Little heart defects might not be detected until the child is older or even until the adult years. Particular tests that can be done to evaluate the kind and severity of a congenital heart defect include:

Echocardiogram. This is a test that uses sound waves to produce an image of the baby's heart. It could be done during the fourth or fifth month of pregnancy to plan treatment for the baby after it is born. An echocardiogram may also be performed to diagnose babies after birth.
Chest x ray. This test may be done to see whether the baby's lungs are normal as well as regardless of whether its heart is abnormally big.
Electrocardiogram (ECG or EKG). An ECG is really a tracing of the heart's electrical activity. It shows the speed of the heartbeat and regardless of whether the heart rhythm is regular or irregular.
Pulse oximetry. This test uses a sensor placed on the baby's fingertip or toe to measure how much oxygen is carried in the blood.
Cardiac catheterization. A catheter is a lengthy thin tube that is passed via a vein in the baby's neck, arm, or upper thigh to reach the heart. A unique dye that could be seen on x ray is injected through the catheter into the blood vessels or the heart itself. This test allows the doctor to trace the path and the direction that the blood takes through the chambers and major blood vessels of the heart.

Congenital Heart Illness Treatment

Treatment of congenital heart disease varies depending on the kind of defect and its severity. Some small defects might not need any particular treatment. In some cases the doctor might prescribe medications usually diuretics to help the baby eliminate excess water via the urine; or digoxin, a drug that helps the heart muscle contract with greater force, thus strengthening the heart.

Some congenital heart defects need one or more surgical procedures to repair the abnormalities. Atrial septal defects and aortic valve stenosis could be repaired by using a catheter. The surgeon inserts the catheter through a vein and threads it into the heart. A small device can be positioned through the catheter to fill an ASD, or a balloon could be threaded via the catheter to open a partially closed valve. The balloon can then be collapsed and also the catheter removed.

Open-heart surgery is generally necessary to replace a badly damaged valve; to close large holes in the septa between the ventricles or atria; or to repair a complex defect like tetralogy of Fallot. In a couple of extremely rare cases, the baby might need a heart transplant if you will find several defects that are too severe or complicated to repair by surgery.

Prognosis

The prognosis of congenital heart illness varies. About 10 percent of infants with CHDs die during their first year of life. Advances in surgery since the 1980s mean that most children with congenital heart disease can live into adulthood and enjoy normal and productive lives. Numerous do not need any unique care, although some will need periodic checkups with a heart specialist as well as with their pediatrician as they grow older.

Prevention

Most CHDs cannot be prevented because their trigger is still unknown. Some could be prevented, however, by the following measures:

Vaccination against rubella before getting pregnant.
Avoiding alcohol and drugs during pregnancy.
Consulting a genetic counselor before becoming pregnant if there is a family history of CHD.
Consulting a doctor before becoming pregnant if the mother is being treated for diabetes, lupus, or seizure disorder.

The Future

Congenital heart illness is not likely to turn out to be more common in the general population in the near future. Research in the field is directed toward a better understanding of the genetic factors that may be involved in CHD, and closer study of the development of a baby's heart during pregnancy. This information in turn may guide the invention of new or improved surgical methods to treat congenital heart defects as early as possible, perhaps even before the baby's birth.

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