Congenital Heart Diseases - Symptoms, Risk factors and Treatment

Congenital heart disease is an abnormality of the heart that is present since birth. It can involve the muscles, arteries, valves, and nearby veins of the heart. Congenital heart diseases can affect the blood flow, causing it to slow down, go in the wrong place, go in the wrong direction, or complete blockage. It can occur due or various reasons like 

• Genetic factors
• Socioeconomic factors 
• Demographic factors 
• Exposure to environmental pollutants
• Maternal infections such as rubella and syphilis 
• Maternal folate deficiency 
• Maternal exposure to alcohol, tobacco, or chemical pollutants

Congenital heart diseases are of two types- cyanotic and acyanotic. In cyanotic heart diseases, there are low levels of oxygen in the circulation due to defects in the heart. On the other hand, acyanotic diseases most often do not have low levels of oxygen in the circulation.

Cyanosis is a bluish discoloration of the skin due to low levels of oxygen in the blood. As mentioned earlier, in acyanotic heart diseases, the oxygen levels are often not compromised. Therefore, cyanosis does not develop, hence the name "acyanotic"-meaning without cyanosis. 

In some acyanotic heart diseases, blood flows from the left side of the heart to the right side- a condition known as a left-to-right shunt. 

Understanding the normal functioning of the heart

Your heart has four chambers, the upper two atria. And the lower two ventricles, and two sides- the left side and the right side. The right side of the heart pumps blood to your lungs to receive oxygen, while the left side of your heart receives that blood from the lungs and pumps it to the whole body. The left side of the heart has oxygenated blood and the right side of the heart has deoxygenated blood.

Since there is a left-to-right shunt in acyanotic heart disease-means the oxygenated blood mixes with deoxygenated and not vice-versa. Due to this, oxygen levels are not lowered in the circulation mostly.

Signs and Symptoms of Congenital Heart Disease

• Cough
• Breathlessness
• Weakness and fatigue
• Increased sweating
• High heart rate (Tachycardia)
• Deep breathing
• Faster breathing (Tachypnea)
• Mild cyanosis due to heart failure
• Abnormal heart rhythm (arrhythmias)
• Swelling of tissues or organs (edema)

Types of congenital heart diseases 

• Congenital heart defects in children
• Congenital mitral valve anomalies
• Double-outlet right ventricle
• Ebstein anomaly
• Eisenmenger syndrome
• Hypoplastic left heart syndrome
• Total anomalous pulmonary venous return
• Transposition of the great arteries
• Tricuspid atresia
• Partial anomalous pulmonary venous return
• Patent ductus arteriosus (PDA)
• Patent foramen ovale
• Long QT syndrome
• Pulmonary atresia with intact ventricular septum
• Atrial septal defect (ASD)
• Atrioventricular canal defect
• Bicuspid aortic valve
• Coarctation of the aorta
• Pulmonary atresia with ventricular septal defect
• Pulmonary valve stenosis
• Tetralogy of Fallot
• Pulmonary atresia
• Truncus arteriosus
• Vascular rings
• Ventricular septal defect (VSD)
• Wolff-Parkinson-White (WPW) syndrome

Risk Factors

Since these diseases are congenital, many factors during pregnancy can affect the normal development of the baby's heart;

Infections:

Rubella infection during the first trimester of pregnancy can affect the normal development of the baby's heart.

Alcohol intake:

Mothers consuming alcohol during pregnancy can affect the baby's heart that may cause fetal alcohol syndrome (FAS).

Medications:

Medications like thalidomide, ACE inhibitors, acne medications, lithium, or some anti-seizure medications can result in fetal heart deformities.

Smoking:

Smoking cigarettes during pregnancy can result in the baby having congenital heart defects.

Maternal Illnesses:

Maternal illnesses like phenylketonuria (PKU), diabetes, SLE, vitamin B deficiency, or folic acid deficiency can result in fetal heart malformations.

Conclusion 

Congenital heart disease is an abnormality of the heart that is present since birth. It can involve the muscles, arteries, valves, and nearby veins of the heart. Some of these diseases can be treated after childbirth, while some which do not cause any symptoms do not need any intervention.