It’s estimated that 40,000 babies are born each year in the United States with CHD, or approximately 1 in every 100 children, making it the most common birth defect in this country today
By: Joseph W. Gaffney, M.D. in Collaboration with Gloria N. Beck
February, designated as Heart Month, also marks Congenital Heart Defect Week a good time to get educated about this condition and its effects on children.
Congenital Heart Defects (CHD) are abnormalities in the heart’s structure that occur in the early weeks of pregnancy and are present at birth.
The heart consists of four chambers (the left atrium and left ventricle and the right atrium and right ventricle, with four valves, the mitral, aortic, tricuspid and pulmonic) that direct the flow of blood between them. CHD can involve the walls between the chambers of the heart, its valves, arteries or surrounding veins or a combination of these.
While the location and severity of congenital heart defects vary, generally they compromise the heart’s ability to pump blood and to deliver oxygen to the tissues of the body
It’s estimated that 40,000 babies are born each year in the United States with CHD, or approximately 1 in every 100 children, making it the most common birth defect in this country today. More babies are born with CHD, in fact, than with Spina Bifida, Down syndrome and hearing loss combined.
Given the high incidence of CHD, it’s surprising to note that these defects can sometimes go undetected and are not routinely diagnosed in newborns.
As a child with mild CHD grows and additional demands are placed on the heart, symptoms may become more apparent, prompting evaluation and diagnosis. Furthermore, the effects of some congenital heart defects are cumulative, and symptoms may take a while to appear.
The most common types of heart defects in children are septal defects holes in the wall between the left and right side of the heart. These holes can occur between the right and left ventricles of the heart, causing Ventricular Septal Defects (VSD), or between the right and left atria, causing Atrial Septal Defects (ASD). These holes vary in location and size, and often the smaller defects gradually close on their own.
Other common congenital heart defects in children involve the function of the heart’s four valves.
In a healthy heart, when blood passes through the valves into the various chambers of the heart, they close completely and seal the heart chamber. When the valves don’t close completely, a condition known as "regurgitation" occurs, and blood can leak back through the valve. When the valve openings become narrowed or don’t open completely, stenosis can occur, which puts added strain on the heart as it forces the heart to pump harder.
Other defects can involve problems with the placement or development of blood vessels near the heart or with the development of the heart itself.
While the cause of most congenital heart defects is unknown, certain factors may increase the risk for CHD. Women who contract German measles (rubella) during the first three months of pregnancy are at a higher risk for having a child with heart defects. Exposure to toxic chemicals or X-rays, taking certain medications or drinking alcohol during pregnancy, may also increase the risk.
Also, there may be a genetic link, as CHD occurs more often in siblings or offspring of people with heart defects.
Parents should be alert to the following symptoms in infancy:
- Tires easily during feeding (i.e., falls asleep before feeding finishes
- Sweating around the head, especially during feeding;
- Fast breathing when at rest or sleeping;
- Pale or bluish skin color;
- Poor weight gain;
- Not playful or curious for any length of time;
- Puffy face, hands and/or feet, and
- Often irritable, difficult to console.
In older children, parents should be alert to the following:
- Gets out of breath during play;
- Difficulty "keeping up" with playmates;
- Tires easily or sleeps a lot;
- Coloring appears pale or has a bluish tint around mouth and nose during activities or sports;
- Frequent colds and respiratory illnesses;
- Slow growth and weight gain/poor appetite, and
- Complains of chest pain and/or heart pounding.
Because the symptoms can be related to any number of conditions or diseases, they should be evaluated by your child’s pediatrician.
Treatment for CHD varies depending on the type and severity of the defect. Some minor defects resolve themselves spontaneously over time and may simply require monitoring by your pediatric cardiologist. More complex defects may be treated with medication or corrective surgery.
While a diagnosis of CHD can be frightening, it’s important to remember that with proper treatment, most children with congenital heart defects grow up to lead healthy, productive lives.
For more information about congenital heart defects in children, or a referral to a pediatric cardiologist, call (888) 742-7496 or visit www.princetonhcs.org.