Heart disease or defects that form before birth are called congenital. Of every 1,000 births in the United States, as many as eight babies are born with heart defects. Not only does congenital heart disease account for the most commonly occurring birth defects, but the condition is also the leading cause of death associated with birth defects during the first year of life. Sometimes the abnormalities in the heart cause immediate symptoms and problems, while other times issues may not show up until adulthood. Sometimes problems dealt with as children come back in adults. Sometimes the defect is so minor it's never detected.
Congenital heart disease can be part of chromosomal conditions like Down's Syndrome. Women who are pregnant while taking certain medications or abusing alcohol have increased risks of having children with heart defects. Viral infections like rubella in the first trimester of pregnancy can also cause problems. Many congenital heart defects don't have a specific cause.
Defects can happen in the walls, arteries, veins, and valves of the heart. Defects can slow the flow of blood or send the blood wrong direction. Defects can even stop blood from flowing at all. So many defects can happen and with varying severity. The list of the most common heart defects is actually a list of over 18 different issues.
Screening has greatly improved just in the last 10 years. Prenatal sonograms will find some defects. Pulse oxiometry in the first days after being born is helpful in finding more infants who should be screened more thoroughly. Pulse oxoimetry is noninvasive and measures factors in the blood. It's increasingly being used in hospitals as part of newborn screening.
Treating children with congenital heart disease can require multiple surgeries. When a child is born with a hole in his heart, the first step is often just to wait. Roughly 20 percent of these cases heal themselves in the first year of life, sparing infants surgery or length hospital procedures. The best news for treating children with congenital heart defects is that thanks to continuing research, they are living longer and with fewer medical interventions. We now know children with these heart issues are more at risk for endocarditis and can help parents lower the risk, with antibiotics, closely monitoring dental health, and even special nutrition.
Some people with congenital heart defects may not show symptoms until they are adults. Or, they may develop symptoms again after they were treated during childhood. Adult congenital heart disease symptoms include abnormal heart rhythms, shortness of breath, getting tired after even a little exercise, dizziness, and swelling. Additionally, adults may develop complications from their congenital heart disease which include arrhythmias, endocarditis (an infection of the heart lining), strokes, pulmonary hypertension, and heart failure.
When adults go in to their doctor for possible congenital heart problems, they will be given a set of tests. The simplest is the doctor listening to your heartbeat. If she hears a murmur, that's a first sign. An EKG (electrocardiogram) measures the electrical activity of the heart, giving more information about where a defect may be. Doctors may do an echocardiogram, take a chest x-ray, or do an exercise stress test. All these tests help to narrow the diagnosis. Your doctor may also ask for a cardiac MRI or cardiac catheterization.
For minor heart defects, the answer may just be more checkups. Some medications can help the heart work better. Sometimes doctors will want to put in pacemakers or other devices that keep their patients' hearts on track. Then there are more complicated treatments like catheterization, heart surgery, or even heart transplants.
For adults who had congenital heart disease as a child, you may think you are home free as you grow up. It doesn't work that way. Constant follow up throughout your life is necessary to catch any changes. The more you know about your heart, the better off you will be.