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Congenital Heart Diseases

What is congenital heart disease?
The word "congenital" means existing at birth. Congenital heart disease or congenital heart defects are defects in one or more structures of the heart or blood vessels that occurs before birth. Some patients born with congenital heart disease can have simple defects with no symptoms, while other patients may have complex defects that are life-threatening and require lifelong care.

There are many types of congenital heart disease including but not limited to atrial septal defect (ASD), patent foramen ovale, pulmonary artery stenosis, ventricular deptal defect (VSD) and pulmonary hypertension.

The atrial septum is a wall that divides the upper two chambers of the heart. An atrial septal defect is an opening or “hole” in this wall resulting from inadequate development before birth. A patent foramen occurs when a flap that covers the atrial septum fails to close shortly after birth. A ventricular septal defect (VSD), (which can be congenital or develop after a heart attack), is a hole in the wall that separates the bottom two chambers of the heart.

What are the risk factors for congenital heart disease?
Genetics play a strong role in the development of congenital heart disease. Many chromosomal abnormalities can cause congenital defects. In other cases, mutations in genes can lead to congenital heart disease that can be passed down to the next generation. Maternal illnesses, infections, and environmental exposures, including smoking during pregnancy are also risk factors for congenital heart disease.

What are the warning signs?
Newborns, infants and children with serious defects often have abnormal breathing, cyanosis (a bluish tint to the skin, lips and fingernails), fatigue, shortness of breath and poor blood circulation. Many mild defects go unnoticed, but can present later in life as shortness of breath or fatigue.

How is congenital heart disease diagnosed and treated?
Severe defects are generally found during pregnancy ultrasounds or shortly after birth. Less severe defects may not be diagnosed until children are older or reach adulthood since there may be few or no symptoms. A murmur noted during a physical exam may be the first indication of a congenital defect. Electrocardiogram and echocardiography are useful tests to diagnose the presence of many congenital heart defects.

Because of the improvement in diagnostic tests and treatments, medications and cardiac surgery, many children born with severe congenital heart disease are surviving into adulthood and living active, productive lives. People with congenital heart disease should be monitored by a cardiologist throughout their lives.

Treatment for atrial septal defects depends on the size of the opening. Small defects may close on their own and only require careful monitoring by routine echocardiograms, while large atrial septal defects may require closure as they can lead to damage to your heart over time. The defects can be surgically closed, or can be using a catheter related procedure. The approach to closure (if required) depends on the presence of any other congenital heart defects and other medical conditions that may be present. If the hole can be closed by a catheter procedure, it is done by inserting a thin hollow tube into a vein in your groin in a process that is similar to a cardiac catheterization. Special equipment is then inserted through the tube, sealing the hole with a patch.

Patent foramen ovales generally do not require treatment; however, in specific cases where treatment is needed, the defect is closed in a manner similar to an ASD.

The location and size of the ventricular septal defect plays a role in determining treatment. Small holes require long-term monitoring and may close on their own. The larger holes may require surgical treatment.

To make an appointment with a Women’s Heart NY physician, please call
(877) WOMEN-00/(877) 966-3600.

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