Congenital heart disease, also known as CHD, is any birth defect which affects the heart or the large blood vessels. Congenital means that the defect is present at birth.
There are many different birth defects that can affect the heart. For example, the valves of the heart may be missing or not work properly. In other cases, there may be holes in the walls of the heart or abnormal connections between blood vessels and the heart. The defects may be mild and cause no problems. Or they may be life threatening and require surgery hours after birth. Some common congenital heart defects include:
Many times the cause of CHD is unknown. Known causes of CHD include:
Symptoms of CHD can be present at birth or in early infancy or may only develop later in life. Symptoms depend on the type and severity of the defect. Examples of symptoms and signs of CHD include:
The physical exam usually makes the doctor suspect CHD. There are many tests that can help diagnose CHD. These include:
Often nothing can be done to prevent CHD. Women of childbearing age should make sure they have received all standard vaccines. This can help prevent cases due to certain viral infections during pregnancy, such as rubella. Avoidance of alcohol and substance abuse during pregnancy will prevent those causes of CHD.
Small defects may eventually repair themselves and cause no long-term effects. The long-term effects usually depend on how severe the CHD is. Some untreated heart defects can be fatal. Larger defects usually cause more symptoms. Whether or not surgery can repair the defect will greatly affect the outcome.
Until the defect is corrected, the heart is under a lot of strain. The heart can get larger in size and may not beat in a normal rhythm. People who have this disease can develop high blood pressure, and their lungs can become congested. Those with heart defects are often at an increased risk for heart infections, which may be life threatening.
CHD itself is not catching and poses no risk to others. However, infections that cause CHD, such as the rubella virus, may be contagious. Genetic causes of CHD may be passed on to one's children. Genetic counseling may be helpful for some parents.
Treatment often involves open heart surgery to correct the heart defect. Sometimes more than one defect occurs at the same time and more than one operation is needed. With certain defects, medicine may be all that is needed. In others, no treatment other than observation is needed.
Surgery to correct a heart defect can be simple or very complicated. Side effects of treatment depend on the severity of the defect. Some people recover completely, while others may still have a problem with high blood pressure and a very strained heart. The heart may not beat in a normal rhythm. Surgery itself can be very risky and sometimes fatal. Bleeding and infection may also occur.
The person needs time to recover fully after surgery. Antibiotics to help fight infection and other medicines to help the heart may be given after surgery. Close monitoring of the heart and lungs is needed. Sometimes, a person will need more surgery later in life.
Regular visits to the doctor and regular testing are needed. This helps check that the heart is working properly and the lungs remain clear. Any new or worsening symptoms should be reported to the doctor.
Author:Eric Berlin, MD
Date Written:
Editor:Crist, Gayle P., MS, BA
Edit Date:05/29/02
Reviewer:Adam Brochert, MD
Date Reviewed:07/24/01
Harrisons Textbook of Medicine 1991
Merck Manual 2000
Current Therapy and diagnosis 1996