CONGENITAL HEART DISEASE

• A congenital heart defect is a problem with the

structure of the heart. It is present at birth.

• Congenital heart defects are the most common type of

birth defect.

• The defects can involve the walls of the heart, the valves
of the heart, and the arteries and veins near the heart.
They can disrupt the normal flow of blood through the
heart. The blood flow can slow down, go in the wrong
direction or to the wrong place, or be blocked
completely.
• What causes congenital heart defects?
• Heart defects develop in the early weeks of pregnancy
when the heart is forming, We’re not sure what causes
most congenital heart defects, but these things may play
a role:
• Medical conditions in mom
• Diabetis
• lupus an autoimmune disorder. Autoimmune disorders are
conditions that happen when antibodies (cells in the body that fight
off infections) attack healthy tissue just about anywhere in the body
by mistake. Lupus may cause problems with a person’s heartbeat. 
•  Rubella(German measles) in the first 3 months of pregnancy
• Being obese (very overweight). An obese person has a body mass
index (also called BMI) over 30.
• Phenilketonuria (PKU) and not following the PKU meal plan 
• Children with chromosomal and genetic conditions are
likely to have congenital heart defects:
•  Down syndrome. This condition includes a combination
of birth defects, such as intellectual disabilities, heart
defects, certain facial features, and hearing and vision
problems.
• Turner syndrome. This condition affects a girl’s
development. Girls who have it are short, and their
ovaries don’t work properly. Ovaries are where eggs are
stored in a female’s body.
• Noonan syndrome. This condition prevents normal
development in different body parts. It may affect facial
features and can lead to short height and heart
problems.
• What heart defects are part of CCHD?

• Critical congenital heart disease (also called CCHD) is

group of the seven most severe congenital heart defects.
They may affect the shape of a baby’s heart, the way it
works, or both. Babies with CCHD need treatment within
the first few hours, days or months of life. Without
treatment, CCHD can be deadly.
•  Hypoplastic left heart syndrome
• Hypoplastic left heart syndrome (HLHS) is a birth defect that affects
normal blood flow through the heart. As the baby develops during
pregnancy, the left side of the heart does not form correctly. Hypoplastic
left heart syndrome is one type of congenital heart defect. Congenital
means present at birth. Because a baby with this defect needs surgery
or other procedures soon after birth, HLHS is considered a critical
congenotal heart defect (CCHD).
• Hypoplastic left heart syndrome affects a number of structures on the
left side of the heart that do not fully develop, for example:
• The left ventricle is underdeveloped and too small.
• The mitral valves is not formed or is very small.
• The aortic valve is not formed or is very small.
• The ascending portion of the aorta is underdeveloped or is too small.
• Often, babies with hypoplastic left heart syndrome also have an  atrial
septal defect which is a hole between the left and right upper chambers
(atria) of the heart.

• . 
• In a baby without a congenital heart defect, the right side
of the heart pumps oxygen-poor blood from the heart to
the lungs. The left side of the heart pumps oxygen-rich
blood to the rest of the body. When a baby is growing in
a mother’s womb during pregnancy, there are two small
openings between the left and right sides of the heart:
the patent ductus arteriosus and the patent foramen
ovale. Normally, these openings will close a few days
after birth.
• in babies with hypoplastic left heart syndrome:
• the left side of the heart cannot pump oxygen-rich blood to the body
properly. During the first few days of life for a baby with hypoplastic left
heart syndrome, the oxygen-rich blood bypasses the poorly functioning left
side of the heart through the patent ductus arteriosus and the patent
foramen ovale.
• The right side of the heart then pumps blood to both the lungs and the rest
of the body. However, among babies with hypoplastic left heart syndrome,
when these openings close, it becomes hard for oxygen-rich blood to get to
the rest of the body.
• Babies with hypoplastic left heart syndrome might not have trouble for the
first few days of life while the patent ductus arteriosus and the patent
foramen ovale (the normal openings in the heart) are open, but quickly
develop signs after these openings are closed
• Tetralogy of Fallot is a birth defect that affects normal
blood flow through the heart. It happens when a baby’s
heart does not form correctly as the baby grows and
develops in the mother’s womb during pregnancy.
• What is Tetralogy of Fallot?
• Tetralogy of Fallot is made up of the following four defects of the heart
and its blood vessels:
• A hole in the wall between the two lower chambers―or ventricles―of
the heart. This condition also is called a ventricular septal defect.
• A narrowing of the pulmonary valve and main pulmonary artery. This
condition also is called pulmonary stenosis.
• The aortic valves, which opens to the aorta, is enlarged and seems to
open from both ventricles, rather than from the left ventricle only, as in
a normal heart. In this defect, the aortic valve sits directly on top of the
ventricular septal defect.
• The muscular wall of the lower right chamber of the heart (right
ventricle) is thicker than normal. This also is called ventricular
hypertrophy.
• An atrioventricular septal defect or AVSD is a heart defect
affecting the valves between the heart’s upper and lower chambers
and the walls between the chambers.

• What is Atrioventricular Septal Defect?

• An atrioventricular septal defect (AVSD) is a heart defect in which
there are holes between the chambers of the right and left sides of
the heart, and the valves that control the flow of blood between
these chambers may not be formed correctly.
• In AVSD, blood flows where it normally should not go.
• The blood may also have a lower than normal amount of oxygen,
and extra blood can flow to the lungs. This extra blood being
pumped into the lungs forces the heart and lungs to work hard and
may lead to congestive heart failure.
• Pulmonary atresia (also called PA). In this condition, a baby’s
heart’s pulmonary valve doesn’t form properly. This means that
enough blood can’t flow from the heart to the lungs. Treatment may
include medicines to help blood flow, open heart surgery or heart
transplant. 

•  
• Total anomalous pulmonary venous return (also
called TAPV or TAPVR). In this condition, the veins that take
blood from the lungs to the heart don’t connect to the heart the right
way. It causes blood to circle back and forth between the heart and
lungs. But blood never flows out to the rest of the body like it should.
A baby with this condition needs surgery as soon as possible.
Without treatment, the heart can get bigger, leading to heart failure.
Heart failure is when the heart can’t pump enough blood.
•  Transposition of the great arteries (also called
TGA). Babies with this condition have the positions of two important
arteries switched. This means the blood that’s pumped to the body
may not have enough oxygen. Babies with TGA need heart surgery
and lifelong medical care.

• Transposition of the great arteries is a serious but rare heart defect

present at birth (congenital), in which the two main arteries leaving the
heart are reversed (transposed). The condition is also called dextro-
transposition of the great arteries. A rarer type of this condition is
called levo-transposition of the great arteries.

•  Tricuspid atresia (also called TA). In this condition, the heart’s

tricuspid valve is missing or doesn’t develop normally. If this valve
doesn’t open, enough blood can’t flow into the lungs to pick up the
oxygen it needs. Babies with TA need surgery.
• Truncus arteriosis. Babies with this condition have only one
artery that leaves the heart instead of two. This causes blood with
oxygen to mix with blood that doesn’t have oxygen. Babies with this
condition need surgery because over time, they can develop a life-
threatening problem called pulmonary hypertension. This is high
blood pressure in the arteries to the lungs.
• What are other common congenital heart
defects ?
• Septal defects, like atrial septal defect (also called ASD) and
ventricular septal defect (also called VSD). These defects leave a
hole in the septum. The septum is the wall inside the heart that
separates the right and left atria and right and left ventricles. The
atria are parts of the heart that receive blood coming from other
parts of the body. Ventricles parts of the heart that pump blood out
to other parts of the body. A hole in the septum can cause blood to
go in the wrong direction or to the wrong place. About half of all
ASDs close on their own. Heart surgery and procedures with
catheters (thin, flexible tubes) can fix medium and large ASDs.
Heart surgery may be needed to fix VSDs. 
• Coarctation of the aorta (COA). In this condition, part of the
aorta is narrow. The aorta is the large artery that carries blood from
the heart to rest of the body. Having COA means the heart has to
work harder to get blood through the aorta. COA is treated with
balloon angioplasty. In this procedure, a provider uses a catheter
with a tiny balloon to push open the aortic valve. Or he may treat it
with a stent, which is a small mesh tube used to treat narrow or
weak arteries. Babies with more severe COA need heart surgery.

• Heart valve abnormalities. 

• These happen when heart valves don’t close the right way or valves
are narrow or blocked, so blood can’t flow smoothly. Mild heart
valve abnormalities don’t need treatment. Procedures with catheters
can treat many severe heart valve defects. Some may need
surgery.
• Cyanotic and Acyanotic Congenital Heart Disease
• Many doctors classify congenital heart disease as either cyanotic
congenital heart disease or acyanotic congenital heart disease. In
both types, the heart isn’t pumping blood as efficiently as it should.
The main difference is that cyanotic congenital heart disease
causes low levels of oxygen in the blood, and acyanotic congenital
heart disease doesn’t. Babies with reduced oxygen levels may
experience breathlessness and a bluish tint to their skin. Babies
who have enough oxygen in their blood don’t display these
symptoms, but they may still develop complications later in life, such
as high blood pressure.