CONGENITAL HEART DISEASE

Congenital heart disease is one or more problems with the heart's structure that exist
since birth. Congenital means that you're born with the defect. Congenital heart
disease, also called congenital heart defect, can change the way blood flows through
your heart. Some congenital heart defects might not cause any problems. Complex
defects, however, can cause life-threatening complications.

Advances in diagnosis and treatment have allowed babies with congenital heart
disease to survive well into adulthood. Sometimes, signs and symptoms of congenital
heart disease aren't seen until you're an adult.

If you have congenital heart disease you likely will need care throughout your life.
Check with your doctor to determine how often you need a checkup.

Risk factors

Certain environmental and genetic risk factors might play a role in the development of
congenital heart disease, including:

Your genes. Congenital heart disease appears to run in families (inherited) and is

associated with many genetic syndromes. For instance, children with Down syndrome
often have heart defects. Genetic testing can detect Down syndrome and other
disorders during a baby's development.

German measles (rubella). Having rubella during pregnancy may affect how the
baby's heart develops while in the womb.

Diabetes. Having type 1 or type 2 diabetes during pregnancy also may affect a baby's
heart development. Gestational diabetes generally doesn't increase the risk of
congenital heart disease.

Medications. Taking certain medications while pregnant can cause congenital heart

disease and other birth defects. Medications linked to heart defects include lithium for
bipolar disorder and isotretinoin (Claravis, Myorisan, Zenatane, others), which is used
to treat acne. Always tell your doctor about the medications you take.

Alcohol. Drinking alcohol while pregnant also contributes to the risk of heart defects
in the baby.

Smoking. A mother who smokes while pregnant increases her risk of having a child
with a congenital heart defect.
Complications

Congenital heart disease complications that might develop years after you receive
treatment include:

 Irregular heartbeats (arrhythmias). Arrhythmias occur when the electrical

signals that coordinate your heartbeat don't work properly. Your heart may beat
too fast, too slowly or irregularly. In some people, severe arrhythmias can cause
stroke or sudden cardiac death if not treated. Scar tissue in your heart from
previous surgeries can contribute to this complication.
 Heart infection (endocarditis). Endocarditis is an infection of the inner lining
of the heart (endocardium). It generally occurs when bacteria or other germs
enter your bloodstream and move to your heart. Untreated, endocarditis can
damage or destroy your heart valves or trigger a stroke. If you are at high risk of
endocarditis, it's recommended that you take antibiotics one hour before dental
cleanings. Regular dental checkups are important. Healthy gums and teeth
reduce the risk that bacteria will enter the bloodstream.
 Stroke. A congenital heart defect can allow a blood clot to pass through your
heart and travel to your brain, where it reduces or blocks blood supply.
 Pulmonary hypertension. This is a type of high blood pressure that affects the
arteries in your lungs. Some congenital heart defects send more blood to the
lungs, causing pressure to build. This eventually causes your heart muscle to
weaken and sometimes to fail.
 Heart failure. Heart failure (congestive heart failure) means your heart can't
pump enough blood to meet your body's needs. Some types of congenital heart
disease can lead to heart failure.
Adult congenital heart disease and pregnancy

Women with mild congenital heart disease can have a successful pregnancy.
However, some women with complex congenital heart defects are advised against
pregnancy.

If you're thinking about becoming pregnant, talk to you doctor about the possible risks
and complications. Together you can discuss and plan for any special care you might
need during pregnancy.

Prevention

Both men and women with congenital heart disease are at increased risk of passing
some form of congenital heart disease to their children. Your doctor might suggest
genetic counseling or screening if you plan to have children

PNEUMONIA
Pneumonia is an infection that inflames the air sacs in one or both lungs. The air sacs
may fill with fluid or pus (purulent material), causing cough with phlegm or pus,
fever, chills, and difficulty breathing. A variety of organisms, including bacteria,
viruses and fungi, can cause pneumonia.

Pneumonia can range in seriousness from mild to life-threatening. It is most serious

for infants and young children, people older than age 65, and people with health
problems or weakened immune systems.

Risk factors

Pneumonia can affect anyone. But the two age groups at highest risk are:

Children who are 2 years old or younger

People who are age 65 or older

Other risk factors include:

Being hospitalized. You're at greater risk of pneumonia if you're in a hospital

intensive care unit, especially if you're on a machine that helps you breathe (a
ventilator).

Chronic disease. You're more likely to get pneumonia if you have asthma, chronic
obstructive pulmonary disease (COPD) or heart disease.

Smoking. Smoking damages your body's natural defenses against the bacteria and
viruses that cause pneumonia.

Weakened or suppressed immune system. People who have HIV/AIDS, who've had

an organ transplant, or who receive chemotherapy or long-term steroids are at risk.

Complications

Even with treatment, some people with pneumonia, especially those in high-risk
groups, may experience complications, including:

 Bacteria in the bloodstream (bacteremia). Bacteria that enter the bloodstream

from your lungs can spread the infection to other organs, potentially causing
organ failure.
 Difficulty breathing. If your pneumonia is severe or you have chronic
underlying lung diseases, you may have trouble breathing in enough oxygen.
 You may need to be hospitalized and use a breathing machine (ventilator) while
your lung heals.
 Fluid accumulation around the lungs (pleural effusion). Pneumonia may cause
fluid to build up in the thin space between layers of tissue that line the lungs and
chest cavity (pleura). If the fluid becomes infected, you may need to have it
drained through a chest tube or removed with surgery.
 Lung abscess. An abscess occurs if pus forms in a cavity in the lung. An
abscess is usually treated with antibiotics. Sometimes, surgery or drainage with
a long needle or tube placed into the abscess is needed to remove the pus.
Prevention

To help prevent pneumonia:

 Get vaccinated. Vaccines are available to prevent some types of pneumonia

and the flu. Talk with your doctor about getting these shots. The vaccination
guidelines have changed over time so make sure to review your vaccination
status with your doctor even if you recall previously receiving a pneumonia
vaccine.
 Make sure children get vaccinated. Doctors recommend a different pneumonia
vaccine for children younger than age 2 and for children ages 2 to 5 years who
are at particular risk of pneumococcal disease. Children who attend a group
child care center should also get the vaccine. Doctors also recommend flu shots
for children older than 6 months.
 Practice good hygiene. To protect yourself against respiratory infections that
sometimes lead to pneumonia, wash your hands regularly or use an alcohol-
based hand sanitizer.
 Don't smoke. Smoking damages your lungs' natural defenses against
respiratory infections.
 Keep your immune system strong. Get enough sleep, exercise regularly and
eat a healthy diet.