Congenital Heart Disease

At Dr. Medical Clinic & Lab, we pay special attention to congenital heart diseases, of which there are many. To keep the information focused, we will mention the most common ones, such as congenital holes in the heart and narrowing of the main blood vessels. Some of them are:

Types of Congenital Heart Disease

1. Atrial Septal Defect – a hole in the wall between the two atria.
2. Ventricular Septal Defect – a hole in the wall between the two ventricles.
3. Atrioventricular Canal Defects – a hole at the level of the heart valves.
4. Narrowing of the main arteries of the heart, such as:
   • Aortic Stenosis
   • Pulmonary Artery Stenosis
5. Coarctation of the Aorta – a marked narrowing of the aorta outside the heart.
6. Tetralogy of Fallot – a large hole between the ventricles and a significant narrowing of the vessel that carries blood to the lungs.
7. Other rare and complex diseases – which in most cases cannot be fully corrected.

Symptoms

Children with holes in the heart usually show no symptoms, and the diagnosis may be made entirely by chance. For this reason, it is essential that every child has a TTE (heart ultrasound) after birth to rule out congenital heart disease. Some of these conditions, such as holes between the atria, do not even produce a murmur when the heart is listened to with a stethoscope, which is why TTE is decisive.

In cases of Tetralogy of Fallot, in addition to a pronounced heart murmur heard with a stethoscope, the child may also have:

• Bluish lips.
• Bluish fingers and “watch-glass” nails.
• Shortness of breath.
• Tiredness.
• Adopting a particular position – “squatting.”
• Changes in blood tests.

Diagnosis

TTE (Transthoracic Triplex Echocardiography) is essential to see how the heart functions and how its walls move. TTE shows holes in the heart very clearly, including:

• Their position.
• Their size.
• Their effect on the size and function of the heart.

TTE can also be used to observe and assess:

• The heart valves.
• The blood vessels leaving the heart.
• The blood vessels entering the heart.

The child’s further treatment also depends on the TTE result. What matters is that the sooner a congenital heart disease is diagnosed, the more effective the treatment.

Treatment

Treatment always depends on the diagnosis and may include:

• Periodic TTE
• Medication
• Surgery – which consists of:
  • Stitching the hole closed.
  • Closing it with a patch (a piece of the child’s own pericardium).
  • Widening narrowed sections.
  • In some cases, placing artificial valves.

When the diagnosis is made late, the child may become inoperable due to increased blood pressure on the right side of the heart and in the lungs. In some cases we may also encounter congenital diseases in adults, who may be patients diagnosed late who have not had serious problems or have neglected them.

Prevention

Prevention always involves the Obstetrician-Gynecologist, as well as the Pediatric Cardiologist who performs the fetal echocardiogram (intrauterine cardiac ultrasound – before the child is born). It also involves making pregnant women aware of the need to follow a certain regimen before and during pregnancy, and to have a series of tests and examinations throughout the pregnancy.

NOTE! The text on this page has been shortened and simplified to make it easier for the average patient to understand. It is intended to inform the public and should in no way replace specialist medical consultations.