Heart defect (congenital)

Article
2021-01-31

Also known as holes in the heart, atrial septal defect, ventricular septal defect, Fallot tetralogy, patent Ductus Arteriosus (PDA), congenital heart disease

Congenital heart defects or diseases are problems with the heart structure that are present at birth. They can change the normal blood flow through the heart. Congenital heart defects are the most common type of birth defect.

There are many types of congenital heart defects. The most common defects are the inner walls of the heart, the heart valves, or the great blood vessels that carry blood to and from the heart. Some defects do not require treatment, but some must be treated soon after birth. As the diagnosis and treatment of congenital heart defects has improved, more babies are surviving and many adults are now living with congenital heart defects.

To learn more about congenital heart defects, our role in research and clinical trials to improve health, and where to find more information, check out this health topic.

Symptoms

Some congenital heart defects cause few or no signs and symptoms. As more children with congenital heart defects are living longer, we now know that complications can arise later in life. Signs, symptoms, and complications will vary based on the type of congenital heart defect you or your child has.

Signs and symptoms can be different for newborns and adults. They also depend on the number, type and severity of the heart defect. Some common signs and symptoms are:

Cyanosis
Fatigue
Heart murmurs
Poor blood circulation
Breathe quickly

Congenital heart defects do not cause chest pain or other painful symptoms. Older children or adults may tire quickly or become short of breath during physical activity.

Did you know that undiagnosed and untreated tetralogy of Fallot causes a recognizable set of symptoms in babies and children?

Therapy

Treatment depends on the type of congenital heart defect you have. Treatments for congenital heart defects include medications, surgery, and cardiac catheterization procedures. Many congenital heart defects require no treatment at all. However, children with serious congenital heart defects will require surgery in the first year of life. Some people with congenital heart defects may require lifelong treatment, including repeat surgeries. All people with congenital heart defects should be monitored throughout their lives by a cardiologist, a doctor who specializes in the heart.

Medicines

Your child's doctor can prescribe medication to help close the open ductus arteriosus in premature babies.

Indomethacin or ibuprofen triggers the open ductus arteriosus to constrict or tighten, closing the opening.
Acetaminophen is sometimes used to close the ductus arteriosus.

Procedures

Cardiac catheterization is a common procedure that is sometimes used to repair simple heart defects, such as atrial septal defect and open ductus arteriosus, if they do not repair themselves. It can also be used to open valves or blood vessels that are narrowed or have stenosis.

In this procedure, a thin, flexible tube called a catheter is placed into a vein in the groin or neck. The tube is screwed to the heart. Potential complications include bleeding, infection and pain at the catheter insertion site and damage to blood vessels.

Surgery

In heart surgery, a heart surgeon opens the chest to work directly on the heart.

Surgery can be performed for these reasons:

To repair a hole in the heart, such as a ventricular septal defect or an atrial septal defect.
To repair an open 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 dilate narrowed blood vessels.

Surgeries that are sometimes necessary to treat congenital heart defects include:

Heart transplant . Children can receive a heart transplant if they have a complex congenital heart defect that cannot be surgically repaired or if the heart fails after surgery. Children can also receive a heart transplant if they are dependent on a ventilator or have severe symptoms of heart failure. Some adults with congenital heart defects may eventually need a heart transplant.
Palliative surgery. Some babies with only one ventricle are too weak or too small to undergo heart surgery. They must first undergo palliative surgery or temporary surgery to improve blood oxygen levels. In this surgery, the surgeon installs a shunt, a tube that creates an extra path for blood to travel to the lungs to get oxygen. The surgeon removes the shunt when the baby's heart defects are resolved during the full repair.
Ventricular device . For people with heart failure from a congenital heart defect, this device supports the heart until a transplant takes place. These devices can be difficult to use in people with congenital heart defects due to the abnormal structure of the heart.
Totally artificial heart. For some people with complex congenital heart defects, a full artificial heart may be required instead of a ventricular aid.

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