Congenital heart disease is not usually passed along to your children, but there is some risk. Exposure to certain substances during pregnancy may increase your risk of having a baby with a congenital heart defect. Some medical conditions increase the risk of having a baby with a congenital heart defect, such as:.
Congenital heart defects can occur in either sex. Congenital heart defects are slightly more common at birth in boys than girls. Some congenital heart defects are a characteristic of conditions such as Turner syndrome that more commonly affect females. Almost all newborns in the United States are screened for congenital heart defects in the first few days after birth.
However, if you are at high risk for having a baby with a congenital heart defect, your doctor may recommend screening before the baby is born or strategies to help prevent a congenital heart defect. Echocardiography is a painless test that uses sound waves to create moving pictures of the heart. Your doctor may recommend a fetal echocardiogram during pregnancy if the routine ultrasound shows any sign that your developing baby may have a heart defect or if you have risk factors for congenital heart defects.
Fetal echocardiography is usually done at 18 to 22 weeks. If an echocardiogram is done before 16 weeks, your doctor may have to repeat the screening later to make sure any subtle heart defects are captured. Pulse oximetry determines whether a newborn has low levels of oxygen in the blood, which may be a symptom of critical congenital heart defects. This test is recommended for all newborns in the United States. Pulse oximetry is done when the baby is more than 24 hours old or before the baby is sent home, if the baby is being sent home less than 24 hours after birth.
Low oxygen levels in the blood could be due to a congenital heart defect or could be a sign that something else is wrong. If your child has low oxygen levels, the doctor may have the test repeated or may have your child undergo more specific tests to diagnose a congenital heart defect. Learn about the prevention strategies your doctor may recommend based on your risk factors.
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Some congenital heart defects cause few or no signs and symptoms. Since more children with congenital heart defects are living longer, we now know that complications can develop later in life. Signs, symptoms, and complications will vary based on the type of congenital heart defect that you or your child have.
Signs and symptoms may be different for newborns and adults.
They also depend on the number, type, and severity of the heart defect. Some common signs and symptoms include:. Congenital heart defects do not cause chest pain or other painful symptoms. Older children or adults may get tired easily or short of breath during physical activity. Did you know undiagnosed and untreated tetralogy of Fallot causes a recognizable set of symptoms in babies and children? Children with tetralogy of Fallot also may have clubbing. This is rare in the United States and is usually seen in older children who have not had the heart defect repaired.
Complications depend on the type of congenital heart defect you have. Some of the possible complications include:. Some congenital heart defects are diagnosed during pregnancy or soon after birth. Others may not be diagnosed until adulthood. To diagnose a congenital heart defect, your doctor may have you or your baby undergo some of the following tests and procedures:.
Treatment will depend on which type of congenital heart defect you have. Treatments for congenital heart defects include medicines, surgery, and cardiac catheterization procedures. Many congenital heart defects do not require treatment at all. However, children with critical congenital heart defects will need surgery in the first year of life.
Some people with congenital heart defects may need treatment, including repeated surgery, throughout their lives. All people with congenital heart defects should be followed by a cardiologist, a doctor who specializes in the heart, throughout their whole life.
Your child's doctor may prescribe medicines to help close patent ductus arteriosus in premature infants. Cardiac catheterization is a common procedure that is sometimes used to repair simple heart defects, such as atrial septal defect and patent ductus arteriosus, if they do not repair themselves. It may also be used to open up valves or blood vessels that are narrowed or have stenosis. In this procedure, a thin, flexible tube called a catheter is put into a vein in the groin or neck.
The tube is threaded to the heart. Possible complications include bleeding, infection, and pain at the catheter insertion site and damage to blood vessels. In heart surgery , a cardiac surgeon opens the chest to work directly on the heart. The outlook for children who have congenital heart defects is much better today than it was in the past. Advances in diagnosis and treatment allow most of these children to survive to adulthood, which means that more and more adults are living with congenital heart disease.
Even if your congenital heart defect was repaired in childhood, you need regular medical follow-up to maintain good health. Adults should go to medical centers that have specialized programs for adults with congenital heart disease. Return to Treatment to review possible treatment options for congenital heart defects. Some babies and children who have congenital heart defects do not grow as fast as other children. They may not eat as much as they should and, as a result, may be smaller and thinner than other children.
Children with congenital heart defects may also start certain activities—such as rolling over, sitting, and walking—later than other children. Children who have developmental problems as a result of their heart defects may need tutoring, special education, physical therapy, occupational therapy, or speech therapy.
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Congenital heart defects can lead to emotional health issues for the person with the health problem and his or her close family. Adult women with congenital heart defects are at increased risk of pregnancy complications and have special health considerations for birth control and pregnancy. Talk to your doctor about the following:.
Start planning as soon as your teen is able and willing to fully take part in this process. A transition plan also can help your teen think about other important issues, such as future education and employment, birth control and pregnancy planning, and making healthy choices about heart-healthy eating, physical activity, and other heart-healthy lifestyle changes. Emotional health should also be part of the transition plan.
For the transition plan, work with healthcare providers to compile a packet of medical records and information that covers all aspects of the heart defect, including:.
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Several laws protect the employment rights of people who have health conditions, such as congenital heart defects. The Americans with Disabilities Act and the Work Incentives Improvement Act try to ensure fairness in hiring for all people, including those who have health conditions. People with congenital heart defects, and their caregivers or family members, can take steps to help prevent complications of their condition or from surgical treatments of their congenital heart defect. We are committed to advancing science and translating discoveries into clinical practice to promote the prevention and treatment of heart, lung, blood, and sleep disorders, including congenital heart defects.
Learn about the current and future NHLBI efforts to improve health through research and scientific discovery. Learn about some of the pioneering research contributions we have made over the years that have improved clinical care. In support of our mission , we are committed to advancing congenital heart defects research in part through the following ways. We lead or sponsor many studies on congenital heart defects. See if you or someone you know is eligible to participate in our clinical trials. Learn more about participating in a clinical trial. View all trials from ClinicalTrials. After reading our Congenital Heart Defects Health Topic, you may be interested in additional information found in the following resources.
In January , a working group recommended steps that can be taken to create a network of data about congenital h They may change the normal flow of blood through the heart. Congenital heart defects are the most common type of birth defect. The most common defects involve the inside walls of the heart, the valves of the heart, or the large blood vessels that carry blood to and from the heart.
Some defects require no treatment, but some require treatment soon after birth. Because diagnosis and treatment of congenital heart defects has improved, more babies are surviving and now many adults are living with congenital heart defects. Explore this Health Topic to learn more about congenital heart defects, our role in research and clinical trials to improve health, and where to find more information.
Figure A shows the structure and blood flow inside a normal heart. The blue arrow shows the flow of oxygen-poor blood as it is pumped from the body into the right atrium and then to the right ventricle. From there, it pumps through the pulmonary artery to the lungs, where it picks up oxygen.
The oxygen-rich blood, shown by the red arrows, flows from the lungs through the pulmonary veins into the left atrium. Figure B shows a heart with an atrial septal defect. The hole allows oxygen-rich blood from the left atrium to mix with the oxygen-poor blood from the right atrium.
The mixed blood is shown with a purple arrow.
Closing Holes in the Heart
Normal heart and heart with patent ductus arteriosus. Figure A shows the interior of a normal heart and normal blood flow. The oxygen-rich blood, shown with a red arrow, flows from the lungs through the pulmonary veins into the left atrium. Figure B shows a heart with patent ductus arteriosus.
The defect connects the aorta with the pulmonary artery, a connection that should have closed to form the ligamentum arteriosum see Figure A at birth. Cross-section of a normal heart and a heart with a ventricular septal defect. Figure B shows two common locations for a ventricular septal defect. The defect, or hole, allows oxygen-rich blood from the left ventricle to mix with oxygen-poor blood in the right ventricle before the blood flows into the pulmonary artery.
Tetralogy of Fallot is a combination of four defects: A large ventricular septal defect. With this defect, the aorta is located between the left and right ventricles, directly over the ventricular septal defect. As a result, oxygen-poor blood from the right ventricle can flow directly into the aorta instead of into the pulmonary artery.
In this case, the muscle of the right ventricle is thicker than usual because it has to work harder than normal. Figure B shows a heart with the four defects of tetralogy of Fallot, which includes pulmonary stenosis, ventricular septal defect, an overriding aorta, shown in the figure as increased output in the aorta; and a thickened right ventricular hypertrophy. These defects can cause the heart to work harder or allow oxygen-rich blood to mix with oxygen-poor blood.
Other critical congenital heart defects. Common congenital heart defects include: Risk Factors will discuss medical conditions that can increase the risk of having a baby with a congenital heart defect. Family history and genetics. Smoking during pregnancy or exposure to secondhand smoke. Taking some medicines—such as angiotensin-converting enzyme ACE inhibitors for high blood pressure and retinoic acids for acne treatment—in the first trimester.
Some medical conditions increase the risk of having a baby with a congenital heart defect, such as: Your risk is higher if you have diabetes before pregnancy, or if you are diagnosed with diabetes while you are in your first trimester. However, a diagnosis of gestational diabetes, which occurs later in the pregnancy, is not a major risk factor. This rare, inherited disorder affects how your body processes a protein called phenylalanine, which is found in many foods.
Getting phenylketonuria under control before getting pregnant can reduce your risk of having a baby with a congenital heart defect. Infection with the rubella virus, also known as German measles, during pregnancy increases your risk. It is sometimes possible to detect congenital heart defects before your baby is born.
Avoid certain medicines if you are trying to get pregnant or are pregnant. Talk to your doctor about what medicines you take and what is safe to take during pregnancy. Control existing conditions, such as diabetes and phenylketonuria, which increase your risk of having a baby with a congenital birth defect. Meet with a genetic counselor if you, your spouse, or one of your children have a congenital heart disease and you are planning to have another child.
A genetic counselor can answer questions about the risks and explain the choices that are available. Quit smoking and avoid secondhand smoke. Diagnosis will discuss tests and procedures that your doctor may use to diagnose types of congenital heart defects. Living With will explain what your doctor may recommend to manage your condition and prevent it from getting worse or causing complications. Research for Your Health will explain how we are using current research and advancing research on congenital heart defects.
Participate in NHLBI Clinical Trials will explain our ongoing clinical studies that are investigating prevention strategies for congenital heart defects. Signs, Symptoms, and Complications. Some common signs and symptoms include: Cyanosis Fatigue Heart murmurs Poor blood circulation Rapid breathing Congenital heart defects do not cause chest pain or other painful symptoms.
In a tet spell, the baby turns very blue and may also show these signs and behaviors: Difficulty breathing Fatigue Lack of response to a parent's voice or touch Limpness Loss of consciousness Unusual fussiness Children with tetralogy of Fallot also may have clubbing. Some of the possible complications include: Children with congenital heart defects are more likely to have problems with behavior. Depression, anxiety, and post-traumatic stress disorder are common among people with congenital heart defects. Endocarditis , a type of heart inflammation Endocrine disorders, including thyroid problems, bone health issues, and diabetes.
Problems with the hormones that deal with calcium can cause bone problems. Heart failure is the leading cause of death in adults with congenital heart defects. Some children with congenital heart defects develop heart failure. Kidney disease Liver disease Pneumonia. Pneumonia is a leading cause of death in adults with congenital heart disease. Women with congenital heart defects have an increased risk of complications during pregnancy and childbirth.
Read more in our Living With section. During a physical exam, your doctor will do the following: Some children with certain heart defects also have genetic syndromes that make them look a certain way. Look for signs of a heart defect, such as shortness of breath, rapid breathing, delayed growth, signs of heart failure, or cyanosis. Diagnostic tests and procedures.
To diagnose a congenital heart defect, your doctor may have you or your baby undergo some of the following tests and procedures: Fetal echocardiography can sometimes diagnose a congenital heart defect before a baby is born. Cardiac catheterization to measure the pressure and oxygen level inside the heart chambers and blood vessels. This can help the doctor figure out whether blood is flowing from the left side of the heart into the right side of the heart, instead of going to the rest of the body.
Chest X-ray to show whether the heart is enlarged. It can also show whether the lungs have extra blood flow or extra fluid, a sign of heart failure. Genetic testing to determine if particular genes or genetic syndromes such as Down syndrome are causing the congenital heart defect. Your doctor may refer you or your child to a specialist in genetic testing. Pulse oximetry to estimate how much oxygen is in the blood.
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Return to Risk Factors to review family history, smoking, and medicines that increase your risk of having a baby with a congenital heart defect. Return to Signs, Symptoms, and Complications to review common signs and symptoms of congenital heart defects. Return to Screening and Prevention to review how to screen for congenital heart defects. Indomethacin or ibuprofen triggers the patent ductus arteriosus to constrict or tighten, which closes the opening. Acetaminophen is sometimes used to close patent ductus arteriosus. Surgery may be done for these reasons: To repair a hole in the heart, such as a ventricular septal defect or an atrial septal defect.
To repair a patent ductus arteriosus. To repair complex defects, such as problems with the location of blood vessels near the heart or how they are formed. To repair or replace a valve. To widen narrowed blood vessels. Surgeries that are sometimes needed to treat congenital heart defects include: Children may receive a heart transplant if they have a complex congenital heart defect that cannot be repaired surgically or if the heart fails after surgery.
Holes in the wall between the ventricles are called ventricular septal defects VSDs. As with atrial septal defects, there are several types of VSDs and their treatment may be based on their location. Muscular septal defects exist in the thicker, muscular part of the wall between the two ventricles the ventricular septum.
There can be just one hole, but often there may be several along the wall. These kinds of VSDs are commonly detected shortly after birth because they cause a sound that can be heard with a stethoscope when the blood passes through the hole. This sound is called a heart murmur. In many situations, muscular VSDs close by themselves over time as the heart muscle naturally becomes thicker. Even if a muscular VSD does not completely close, it may not require any therapy at all. Larger muscular VSDs can cause symptoms of congestive heart failure in babies and may need to be closed.
Some muscular VSDs can be closed with special catheter-delivered devices while others are best closed by surgery. Perimenbranous VSDs are found in the thin area of the ventricular septum, near the middle of the heart. This area of the wall between the lower chambers of the heart is called the crux.
Like muscular VSDs, these holes can close by themselves over time, often when tricuspid valve tissue clogs and seals the opening over time. Sometimes smaller perimembranous VSDs can be related to leakage of the aortic valve a condition called aortic insufficiency. These holes often require closure to prevent progression of aortic valve leakage. Large perimembranous VSDs are typically closed by surgery, although some VSDs can be closed with catheter-based devices. There is currently no device approved by the U. Perimembranous VSDs can also be associated with other congenital heart defects.
Holes may be found near the large blood vessels that deliver blood from the heart to other parts of the body the aorta and pulmonary artery. These holes are known as outlet VSDs and supracristal VSDs Outlet VSDs that are near the aorta may be associated with other heart defects, such as with Tetralogy of Fallot, double outlet right ventricle and truncus arteriosus. Outlet VSDs are almost always closed by surgery. Supracristal VSDs are found near the pulmonary artery. They are more common in Asians. These also are also typically closed by surgery.
Sometimes a hole can develop in the heart after a heart attack myocardial infarction. This type of VSD may develop if tissue in the wall between the two lower chambers of the heart is severely damaged from the heart attack to a heart attack. The area weakens and then ruptures, causing a new hole where one did not exist previously. When this happens, the patient can become very ill very quickly. Usually, patients are too sick to undergo emergency heart surgery.
However, special catheter-delivered devices can sometimes be used to close post-infarction VSDs. The ductus arteriosus is a natural connection between the two large arteries that leave the heart the pulmonary artery and the aorta. In fact, there is ittle blood flow through the lungs before birth. The tissue of the ductus arteriosus is programmed to naturally constrict and close. This usually happens within the first week of life. Persistent or Patent Ductus Arteriosus PDA occurs when this natural connection stays partially open instead of fully closing.
Persistent ductus arteriosus occurs more commonly in premature babies. This condition creates a situation where the blood cannot flow efficiently. Oxygenated blood is forced to travel from the aorta back into the lung vessels through the PDA. If the PDA is causing problems for the baby, his or her doctor may recommend treatment with one of many catheter-delivered devices that can be used to permanently close the PDA.
Some very large PDAs, particularly in premature babies, may require surgical closure. Catheter-based devices are continually being developed to try to treat holes in the heart without surgery. The ideal device to close a hole in the heart would allow tissue to grow over the device and then the whole device would melts away. This device has not yet been developed, but is an area of active research. Find an Interventional Cardiologist. Browse Treatments by Procedure Coming Soon! What Causes Atrial Fibrillation? It Takes a Team: