What is CHD in babies?
Congenital heart disease is a condition in which a baby is born with an abnormally structured heart and may also have large blood vessels. This may include conditions in which certain parts of the heart are absent or improperly developed, or have certain parts of the heart that have narrow or leaky chambers.
A heart defect is a congenital malformation of the heart or large blood vessels. It is caused by a disturbance of the heart during the embryonic development of the child. The exact cause can not be determined in about 90 percent of affected children. About 8 percent is based on a genetic defect, such as Down syndrome (trisomy 21). Other causes may be, for example, rubella infection or heavy consumption of alcohol and medication in early pregnancy.
Causes of CHD in babies
Currently, no obvious cause of congenital heart disease has been identified. However, there are several factors known to significantly increase the risk of this disease. Some of them are:
1. Down Syndrome
This genetic disorder affects the baby's normal physical development and often causes learning difficulties.
2. Infections
Certain infections in the mother during pregnancy, such As rubella, can also increase the risk of congenital heart defects in the baby.
3. Other complications
Poor mother control over existing health conditions, such as type 1 or type 2 diabetes, could also significantly increase the risk of congenital heart defects in the baby.
4. Chromosomal abnormality
Many scientists also accuse congenital heart defects for chromosome disorders and individual genetic defects.
5. Environmental factors
Certain environmental factors, in particular maternal diseases such as depression, may also affect the risk of congenital heart defects in infants.
Common heart defects
Some common heart defects that can be classified as congenital heart disease are:
1. Aortic stenosis
In this condition, the aortic valve is stiffened and has a narrow opening that loads the heart.
2. Atrial septal defect
This condition is basically a hole in the wall separating the left and right atria, allowing additional blood flow.
3. Atrioventricular Canal Defect
This condition is characterized by a poorly shaped central area of the heart.
4. Hypoplastic Left Heart Syndrome
In this condition, the left structures of the heart tend to be underdeveloped and can not adequately pump the blood to the whole body.
5.Pulmonary stenosis
In this condition, the pulmonary valve tends to become stiff, which narrows the opening, causing increased stress on the right side of the heart.
6. Fallot Tetralogy
This condition is actually a combination of 4 heart defects - right ventricular thickening, pulmonary stenosis, a hole in the lower chambers of the heart, and an aorta that receives blood from both the left and right ventricles.
Signs and symptoms of congenital heart disease
Many congenital heart defects are diagnosed when an ultrasound scan is performed during pregnancy (usually at the week); In some cases, however, they are not found even after the birth of the baby. And in rare cases they are not detected even after reaching adulthood.
In most babies and toddlers, congenital heart disease presents the following signs and symptoms, which may vary depending on the severity of the condition.
- fast heartbeat
- breathing problem
- chest pain
- extreme tiredness
- excessive sweating
- bluish complexion on the skin
- bad diet
Many babies with congenital heart disease may not require specific treatment. For acute symptoms, resuscitation may be required. Severe disorders that negatively affect blood circulation may require surgical correction.
Congenital heart disease in infants is a serious condition. Therefore, it is important that you undergo a preliminary examination during pregnancy and maintain a healthy diet to reduce the risk.
Alternative Treatment
How a congenital heart defect is treated depends on the severity, age and health of the child. About 80 percent of those affected are operated on or treated with interventional therapy with a heart catheter. In the case of very severe heart defects, the children often have to be operated on in their infancy and are later treated medically. About 20 percent of children do not need surgery.
With the advances of modern medicine, surgeries in the womb are another way of treating a heart defect. In the minimally inverse form of fetal surgery, a so-called fetoscope is inserted through a small hole in the abdominal wall of the pregnant woman. Compared to open fetal surgery, this minimally inversive method is gentler for both mother and child as it requires only a small incision and keeps the unborn child in the protective womb. So far, there are only a few centers in Germany that specialize in this treatment.
Prenatal diagnosis is very important
Heart defects are among the most common congenital malformations in the child: Of 100 newborns, a child with a heart defect is born. It is estimated that around 600 babies with a heart disease are born each year in Switzerland. They are sometimes diagnosed in the womb or immediately after birth. But a heart defect can also go undetected for years.
Different shapes
There are a variety of congenital heart defects that can vary in severity: ranging from simple defects that usually require no treatment, to moderate and severe heart defects that require surgical treatment or death.
At 31 percent, the so-called ventricular septal defect (a hole in the septum between the two chambers of the heart) is one of the most common congenital heart defects in children. While minor defects usually do not cause discomfort, larger ones can lead to heart failure with rapid breathing, lung infection and growth disorders. Depending on the severity of the Ventrikelseptumsdefektes appropriate therapy, for example by medication or surgery, is necessary. But heart valve defects or reversed vessels are among the congenital heart defects in children.
These symptoms can occur
First signs of a heart defect can be an accelerated breathing and drinking problems in the infant. The infant does not drink much and therefore does not gain much. Particularly striking is the so-called cyanosis (blue addiction), in which the skin and mucous membranes of the infant turn blue. The cause of cyanosis is a lack of oxygen in the blood. Other symptoms of heart failure can be a fast heartbeat. In older children, constant tiredness and sweating at low stress can be signs. Children with mild malformations of the heart show virtually no symptoms.
Diagnosis
Due to the very good development of prenatal diagnosis, malformations of the heart can often be detected in the womb as early as the 20th week of pregnancy with an ultrasound examination. Thus, the baby can be ensured of optimal care in a special clinic immediately after birth.
As a rule, however, these defects are only recognized after birth if a characteristic heart murmur occurs during the initial examination. Or the pediatrician notices the heart defect in his regular examinations. In case of suspicion, the affected child is referred to a specialist or a specialist clinic, which can diagnose a possible heart defect with various methods. In addition to ECG and ultrasound, the cardiac catheter is one of the most important diagnostic techniques for congenital heart defects.
Impact on the development of the child
In Switzerland, about one in every 100 newborns with a heart defect is born. That's 600 to 800 children every year. In the last 25 years, the chances of survival have increased sharply: In 1989 still 20 percent, the number today is less than 3 percent. Today, the goal of the treatment is no longer the survival of those affected, but the creation of a life as active as possible. It is not possible to say in general terms how a heart defect affects the further development of a child because, on the one hand, it depends on the form of the heart defect and, on the other hand, on how the respective child deals with his illness. Various studies suggest that heart defects can have adverse effects on children's motor, cognitive and socio-emotional development.
Therefore, in children with a congenital defect of the heart, it is particularly important to strengthen self-esteem and not to exclude it. Especially in sports activities at school, a healthy middle ground should be found: The affected children should be busy, but not be overwhelmed. It is advisable to consult with the attending physician: he can best estimate which activities the affected child is allowed to participate in.
Most children learn to hear with a congenital heart defect when overburdened on the signs of her body: the first calls then a break when it is too much. Children with a simple heart defect have a good chance of leading a healthy life later. For more serious defects, many patients have to remain in treatment continuously even in adulthood.
Quality of life of children with heart defects
So far, there is little information about how children with heart defects and their families rate their quality of life. There is also little information about improving the quality of life through targeted therapy (eg occupational therapy, psychological support, nutritional counseling). This is to be changed now, thanks to the LISA study "Quality of Life Diagnosis in Children and Families with Congenital Heart Defects - Interventions and Influences of Networking of Inpatients and Outpatient Sectors" launched by the Stiftung KinderHerz.
The Swiss Heart Foundation also informs about congenital heart diseases and their treatment. Further details can be found here
Possibilities of prevention
Although most congenital heart defects in children can not be prevented, there are ways for pregnant women to minimize the risk. In addition to regular visits as part of preventive care, this includes abstinence from alcohol and medication. In addition, women who wish to have children should be vaccinated against rubella if they have not yet had the disease. If the exam identifies a heart defect in the embryo, parents should seek detailed advice to find a suitable maternity clinic where cardiac surgeons work closely with pediatricians or pediatric surgeons.
CONCLUSION
- 1 percent of all newborns is affected
- Cause for most heart defects (90%) is unclear
- Other causes: Genetic defect, rubella infection, drug abuse and alcohol
- Defects are recognized in the womb or after birth, sometimes only after years
- Hole in the septum is the most common heart defect
- Treatment is decided by severity
- About 80 percent are treated (surgery or therapy with the cardiac catheter)
- Good chances for an active life