The heart can be described as the muscle pump of the body. A congenital heart problem can arise when there is abnormal heart development that happens in utero, before birth. The American Heart Association (AHA) states that annually approximately 36,000 babies are born with a heart defect. For the majority, there appears to be no known cause, while for others, it can be as a result of congenital rubella or chromosomal abnormalities, such as in Down, Turner, DiGeorge and Marfan syndromes. While some are asymptomatic, others need to be treated to avoid the risk of death. Congenital heart diseases can be divided into two types, cyanotic and non-cyanotic.
Cyanotic
With cyanotic heart problems, there is severe oxygen deprivation, as the blood bypassing the lungs and goes straight into the systemic circulation. This is known as a right to left shunt, and it causes a bluish discoloration of the skin upon birth. The most common form is tetralogy of fallot, other forms include transposition of great vessels, and tuncus rteriosus. The transposition of great vessels is not compatible with life, and if surgery is not performed, infants usually die within a few months. With tetralogy of fallot, the most important determinant of prognosis is the severity of pulmonary stenosis.
Non-cyanotic
Non-cyanotic heart problems are usually less severe because they cause a left to right shunt, from the systemic to the pulmonary circulation. They can be easily treated, and infant may appear normal initially. The three forms are ventricular septal defect (VSD), atrial septal defect (ASD) and patent ductus arteriosus (PDA). The most common of all congenital heart problems is the ventricular septal defect. Here there is shunting of blood from the left ventricle to the right ventricle, which causes the lung to receive increased blood volume, under high pressure. The size of the defect is important in determining the damage done to the lungs. If non-cyanotic heart problems are uncorrected, this increased lung pressure can progress to pulmonary hypertension, reversing the shunt. This is known as Eisenmenger's syndrome.
Tests
Congenital heart problems are usually diagnosed during a physical exam. Sometimes the infant's persistent cries might alert the physician to the abnormality. An electrocardiogram (ECG or EKG) can be performed to measure the electrical conduction of the heart. Chest X-ray can be done to gain insight into condition of the lungs, as well as the heart's size and shape. An echocardiogram can equally be conducted to observe the heart structure and the movement of blood through the vessels. According to the AHA, an echocardiogram is effective enough to detect almost all congenital heart defects and problems.
