Congenital heart disease is the defect in the structure of the heart that is still developed within the mother's belly, capable of causing compromised heart function, and is already born with the newborn.
There are different types of cardiopathies, which can be mild and only discovered in adulthood, even the most serious ones, which are cyanotic heart diseases, capable of causing a change in blood flow to the body. They may have genetic causes, such as in Down syndrome, or be caused by interferences in pregnancy, such as by abusive use of drugs, alcohol, chemicals, or infections of the pregnant woman.
Congenital heart disease can still be detected in the mother's womb, by ultrasound and echocardiography. This disease can be cured because its treatment can be done through surgery to correct the defect, which will depend on the type and complexity of the heart disease.
Main types
The heart disease can be classified as:
1. Congenital cyanotic cardiomyopathy
This type of heart disease is more serious because the defect in the heart can significantly affect the blood flow and oxygenation capacity of the blood and, depending on its severity, can cause symptoms such as pallor, blue color of the skin, lack of air, fainting and even convulsions and death. The main ones include:
- Tetralogy of Fallot : prevents the flow of blood from the heart to the lungs due to a combination of 4 defects, characterized by a narrowing in the valve that allows blood to pass into the lungs, communication between the cardiac ventricles, change in aortic and right ventricular hypertrophy;
- Ebstein's anomaly : Impaired blood flow due to anomalies in the tricuspid valve, which communicates the chambers of the right heart;
- Pulmonary atresia : causes lack of communication between the right heart and lungs, preventing blood from being properly oxygenated.
Ideally, cyanotic congenital heart disease should be diagnosed as early as possible, even in the mother's womb or soon after birth, through echocardiograms that detect these cardiac changes, to schedule an intervention, and to prevent sequelae of the baby.
2. Acyanotic congenital heart disease
This type of heart disease causes changes that do not always cause such serious repercussions on cardiac function, and the amount and intensity of symptoms depends on the severity of the heart defect, ranging from absence of symptoms, symptoms only during exertion, to heart failure.
Depending on the symptoms, these changes can be discovered soon after birth, or only in adulthood. The main ones are:
- Interatrial communication (ASD) : abnormal communication occurs between cardiac atriums, which are the uppermost chambers;
- Interventricular communication (VSD) : there is a defect between the walls of the ventricles, causing an inadequate communication of these chambers and the mixture of oxygenated and non-oxygenated blood;
- Persistence of the ductus arteriosus (PCA) : This channel naturally exists in the fetus to connect the right ventricle of the heart to the aorta, so that the blood follows the placenta and receives oxygen, but should close soon after birth. Its persistence can cause difficulties in the oxygenation of the blood of the newborn;
- Defect in the atrioventricular septum (AVVA) : it causes an inadequate communication between the atrium and the ventricle, hampering cardiac function.
Regardless of the type of congenital heart disease, whether cyanotic or acyanotic, it can be said to be complex when the heart suffers from an association of several defects that more seriously influence its function, and is more difficult to treat, as is usually the case in tetralogy of Fallot, for example.
Signals and symptons
The signs and symptoms of congenital heart disease depend on the type and complexity of heart defects. In newborns and infants, they can be:
- Cyanosis, which is purple at the fingertips or on the lips;
- Excessive sweating;
- Excessive tiredness during feedings;
- Pallor and apathy;
- Low weight and little appetite;
- Breathing fast and short even at rest;
- Irritation.
In older children or adults, the symptoms may be:
- Accelerated heart and purple mouth after exertion;
- Frequent respiratory infections;
- Easy fatigue in relation to other children of the same age;
- It does not develop nor gain weight normally.
Changes in heart size may also be seen, confirmed by an x-ray examination and echocardiogram.
How is the treatment done?
Treatment of congenital heart disease can be done by using medication to control symptoms, such as diuretics, beta-blockers, to regulate heart rate, and inotropes to increase the intensity of heartbeat. However, the definitive treatment is surgery for correction, indicated for almost all cases, being able to cure the heart disease.
Many cases take years to diagnose and can be solved spontaneously throughout the child's growth, making your life normal. However, more severe cases require surgery in the first year of life.
In addition, several genetic syndromes may present with cardiac defects, and some examples are Down syndrome, Alagille, DiGeorge, Holt-Oram, Leopard, Turner and Williams, for example, so heart function should be well evaluated if the child is diagnosed with these diseases.
