Congenital heart disease (congenital heart defect) is an abnormality in your heart's structure that you're born with. Congenital heart disease was often fatal, but it's far more treatable today. Although congenital heart disease is often considered a childhood condition, advances in surgical treatment mean most babies who once died of congenital heart disease survive well into adulthood.In addition, minor congenital heart defects that don't cause symptoms may not be diagnosed until a person is an adult or reaches middle age.
Even today's more advanced treatments cannot necessarily "cure" congenital heart disease or permanently prevent recurrent heart problems. Many adults who were born with a heart condition require lifelong follow-up with a cardiologist. They may also need treatments, such as special medications, implantation of pacemakers, or procedures to repair new or recurrent, heart defects
Types of Congenital Heart Defects
- Aortic stenosis
- Atrial septal defect (ASD)
- Atrioventricular canal defect
- Brugada syndrome
- Coarctation of the aorta
- Coronary artery anomalies
- Double outlet right ventricle (DORV)
- Ebstein's anomaly
- Hypoplastic left heart syndrome
- Patent ductus arteriosus
- Patent foramen ovale (PFO)
- Persistent truncus arteriosus
- Pulmonary atresia
- Pulmonary stenosis
- Tetralogy of Fallot
- Total anomalous pulmonary venous connection
- Transposition of the great arteries
- Tricuspid atresia
- Ventricular septal defect (VSD)
Causes
In most cases, no obvious cause of congenital heart disease is identified. However, there are some things known to increase the risk of the condition, including:
- Down's syndrome – a genetic disorder that affects a baby's normal physical development and causes learning difficulties
- the mother having certain infections, such as rubella, during pregnancy
- the mother having poorly controlled type 1 diabetes or type 2 diabetes
Symptoms
Symptoms or signs of congenital heart disease may not show up until later in life. They may recur years after you've had treatment for a heart defect. Some typical congenital heart disease symptoms you may have as an adult include:
- Abnormal heart rhythms (arrhythmias)
- A bluish tint to the skin (cyanosis)
- Shortness of breath
- Tiring quickly upon exertion
- Dizziness or fainting
- Swelling of body tissue or organs (edema)
Diagnosis
Congenital heart disease is diagnosed by a murmur on a physical exam and several diagnostic tests:
Treatment
A variety of approaches can be taken in treating and managing a congenital heart defect depending on the type and severity of the defect.
Observation: Some minor congenital heart defects discovered in adults will never need to be treated or repaired. However, these patients should receive regular cardiac checkups to make sure that the defect does not deteriorate over time.
Drug Therapies: Some minor congenital heart defects can be treated with drugs to help the heart work better. These include drugs to:
- Slow the heartbeat (beta blockers)
- Help relax the blood vessels (calcium channel blockers)
- Help prevent blood clots, such as warfarin
- Remove excess fluid in the body (diuretics)
Not all drugs work for all types of congenital heart defects. Some drugs that work for one type of defect can actually make other types worse.
Many patients with a congenital heart defect are at risk for an infection of the heart, especially a condition called endocarditis, even if their defect has been repaired. Some patients need to take antibiotics before any dental or surgical procedure to reduce the risk of a life-threatening infection. Ask your doctor whether you need to take antibiotics.
Surgery/Catheter Intervention: Some congenital heart defects discovered during adulthood will need to be repaired surgically. For many of these, the surgery can be performed through a catheter-a tube that is run through a blood vessel to the heart. Catheter techniques can be used to repair small septal defects and some defective valves. Catheter techniques are also employed in balloon angioplasty or to place a stent to open a blood vessel or valve. Some small adjustments to repairs performed in childhood can also be done using a catheter.
Valve replacement and the repair of more complicated congenital heart defects can be done through open-heart surgery.
Although it is rare, a patient with a life-threatening congenital heart defect may receive a heart transplant or a heart-lung transplant. These procedures are performed only in patients who are healthy enough to undergo major surgery.
Please Note
Each person with congenital heart disease has a different set of risks and concerns, so it's hard to generalize what's best for you.Thousands of adults with congenital heart disease lead full, long and productive lives. But it's important not to ignore your condition. Become informed about your disease; the more you know, the better you'll do.
