Let’s Discuss Congenital Heart Disease

About 8 of every 1,000 infants are born with congenital heart disease (CHD) and some of these kids will develop chronic heart failure. So, what is CHD? What are the most common forms of CHD? How might they cause heart failure? Here’s what to know.¹

What is congenital heart disease?

Congenital anomalies are those you are born with and congenital hearts diseases are the most common ones.^1-2

The cardiovascular system (heart and blood vessels) begins forming during the 3rd week of gestation. This cardiovascular system usually forms miraculously well. Although, sometimes something goes wrong to cause some anomaly to occur within the heart and vessels.¹

There are various things that may trigger something to go wrong here:¹

• Genetic mutations. Changes occur to genes responsible for heart and blood vessel development. These changes occur something abnormal to occur.
• Environmental factors. Mom may be exposed to harmful substances in hear environment.
• Maternal illness. Certain sicknesses can cause the fetus to develop abnormally.
• Ingestion of toxins. Mom may ingest something harmful during fetal development.

What is the most common of the CHD's?

Some of the most common CHD's include:¹
Atrial septal defects. An opening in the wall between the left and right atria. It usually does not produce any symptoms because left atrial pressure from the left atria is higher than the right atria. So, oxygenated blood usually crosses through the opening, as opposed to the other way around.

Ventricular septal defects (VSD). An opening in the wall between the left and right ventricle. Whether it produces symptoms depends on the size of the opening. A large opening can cause unoxygenated blood from the right ventricle to mix with oxygenated blood in the left ventricle. This causes the volume of blood in the left ventricle to be too high which can cause heart failure over time.

Patent ductus arteriosis. Before birth, your body receives oxygen from your mother's placenta. This is the purpose of ductus arteriosis. It is a hole and small vessel that connects the pulmonary artery to the aorta. The pulmonary artery sends unoxygenated blood to the lungs to collect blood. But this is not needed before you are born, hence the opening. This allows blood to bypass the lungs and go directly to circulation. Under normal circumstances, after you are born this opening naturally closes. But sometimes it stays open. This causes oxygenated blood from the aorta to enter your pulmonary artery and lungs which can overwhelm your lungs with fluid and cause heart failure.

Congenital aortic stenosis (CAS). The aortic valve becomes stiff or hard. This makes the opening narrow, causing the left ventricle to have to work hard to pump blood through it and into the aorta. The left ventricle then becomes hypertrophied (larger than normal) which makes it a weaker pump. This can lead to heart failure, sometimes before the child reaches the age of one.

Pulmonic stenosis. Here the pulmonic valve becomes stiff and narrow. The right ventricle has to work hard to pump blood through it and this can cause right heart hypertrophy and right heart failure.

Coarctation of the aorta. The aorta is abnormally narrow. This causes the left ventricle to work hard to pump blood through it which can then lead to left ventricular hypertrophy and eventual heart failure.

Tetrology of Fallot. The aorta receives a mixture of oxygenated and unoxygenated blood. This causes low blood oxygen levels and this means your tissues will receive less oxygen than normal. This results in cyanosis (a bluish tinge to the skin).

Transposition of the great arteries. The aorta receives unoxygenated blood from the right ventricle and the pulmonary artery receives oxygenated blood from the left ventricle. This means that unoxygenated blood goes to all the tissues of the body. And oxygenated blood travels to the lungs. This causes very low blood oxygen levels and cyanosis. For the child to live, this anomaly must be repaired.

Survival rates

Survival rates have significantly improved! About 50 years ago, there was a high death rate among kids born with CHD's. However, in this short period of time, researchers have learned a ton about them. They have developed better ways of diagnosing them early and they have developed some nice treatment options, including medicine and surgery. This has significantly improved the survival rate among these children.^1-2

Today, the survival rate for even the most complex CHD is 90%. Furthermore, 96% of these children who survive the first year of life live to the age of 16. Although, 76% of children with CHD who died did so after the age of 18.¹

Adults with CHD's are also living longer now than ever. For instance, in 2002 the average life expectancy was 32. Five years later this life expectancy increased to 57. For those with the most complex CHD's, the median life expectancy has increased from 2 years in 1995 to 25 years today. At present, there are over a million people with CHDs in the United States.¹

Many of the kids will continue to have certain heart problems. About five percent of children develop heart failure and this percentage increases as they enter adulthood. So, most children and adults with CHD's will require regular visits with a cardiologist.

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