Congenital heart defects

Congenital heart defects affect how blood flows through your heart and body. Some congenital heart defects can be life-threatening, while less serious ones may not pose problems. The heart doctors at Atrium Health Floyd and Harbin Clinic offer the latest treatments for all types of congenital heart defects.

What is a congenital heart defect?

A congenital heart defect is a heart structure problem that’s present at birth. This structural change affects how well blood flows through your heart to other parts of your body. Also called congenital heart disease, congenital heart defects are the most common birth defect.

Serious congenital heart defects are noticeable at birth and often require immediate treatment. Mild congenital heart defects may go undetected until adulthood. Some heart defects don’t cause problems and never need treatment.

Causes of congenital heart defects

A congenital heart defect occurs while a baby develops in the womb. The baby’s heart or nearby blood vessels don’t form properly. Experts aren’t sure why this happens. In some cases, a gene change may play a role. This gene change may be inherited or occur on its own.

Congenital heart defects occur early in conception, often before a person knows they are pregnant. Certain factors during pregnancy may increase the risk of a child having a congenital heart defect, including:

• Drinking alcohol or smoking
• Exposure to secondhand smoke
• Obesity
• Taking certain medications that treat acne, high blood pressure or mental health disorders
• Type 1 or Type 2 diabetes
• Viral infections like rubella (German measles)

Congenital heart defect symptoms

Signs of congenital heart defects vary depending on the specific condition and severity.

Serious congenital heart defects cause symptoms soon after birth, such as:

• Excessive sleepiness or fatigue
• Pale blue or gray tint to skin, lips, tongue or fingernails (cyanosis)
• Rapid breathing
• Shortness of breath, especially during feedings, which leads to poor weight gain
• Swollen belly, legs or eyes

Less serious congenital heart defects may not cause symptoms until later in childhood or adulthood. Symptoms may include:

• Fainting, especially during physical exertion
• Swollen hands, ankles or feet
• Unusual shortness of breath or extreme fatigue during physical activity

Congenital heart defect types

There are two main types of congenital heart defects: cyanotic and noncyanotic.

Cyanotic congenital heart defects affect how much oxygen your heart sends to your body. Babies with cyanotic heart disease often have a blue or gray skin tint from low oxygen levels. Types include:

• Ebstein’s anomaly
• Hypoplastic left heart syndrome
• Tetralogy of Fallot
• Tricuspid atresia

Noncyanotic congenital heart defects (also called acyanotic congenital defects) cause your heart to pump blood through your body in an abnormal way. Types include:

• Coarctation of the aorta
• Heart valve defects (stenosis)
• Holes in the heart (septal defects)
• Patent ductus arteriosus

Congenital heart defect diagnosis

Your OB-GYN may notice a heart defect while performing a routine prenatal ultrasound. Your provider may order a fetal echocardiogram, which uses sound waves to capture images of an unborn baby’s heart.

Tests that can help detect congenital heart defects in children and adults include:

• Cardiac catheterization to see how well the heart pumps blood
• Chest X-ray to view the heart and lungs
• Echocardiogram (echo) to get images of heart valves and chambers
• Electrocardiogram (EKG or ECG) to measure the heart’s electrical activity
• Genetic testing to look for gene changes that cause heart defects
• Imaging tests, such as a cardiac MRI or CT scan, to get detailed heart images
• Pulse oximeter to measure blood oxygen levels

Congenital heart defect risk factors

Children with certain genetic conditions are more likely to have congenital heart defects. These conditions include:

• DiGeorge syndrome
• Down syndrome
• Marfan syndrome
• Noonan syndrome
• Patau syndrome
• Turner syndrome

Complications of congenital heart defects

Complications of congenital heart defects vary depending on the specific condition and disease severity. Possible complications include:

• Blood clots
• Congestive heart failure
• Heart or heart valve infection (endocarditis)
• Irregular heartbeat (arrhythmia)
• Liver or kidney disease
• Pulmonary hypertension
• Slowed growth, speech issues or developmental delays
• Stroke

Congenital heart defect prevention

Taking these actions before and during pregnancy may help lower a baby’s risk of a congenital heart defect:

• Avoiding harmful substances like alcohol, cigarettes and secondhand smoke
• Getting proper prenatal care
• Getting the rubella vaccine
• Managing chronic conditions like diabetes
• Reviewing all medications and supplements with your doctor
• Seeking help for addictions
• Taking a daily prenatal vitamin or multivitamin that has 400 micrograms of folic acid

Congenital heart defect treatments

Pediatric cardiologists treat congenital heart defects in children, while cardiologists treat adults. Treatment options depend on the specific heart condition and severity. Congenital heart defects that don’t affect your health may not require treatment.

Congenital heart defect treatments may include:

• Medications to manage blood pressure or arrhythmias
• Cardiac catheterization to repair a heart defect using a thin tube (catheter) threaded through a blood vessel
• Heart surgery to repair a heart defect
• Heart transplant to replace a diseased heart with a healthy heart from an organ donor