Heart disease is the number one cause of death in the US. This stat mostly applies to adults, but there are some heart abnormalities, or congenital heart defects, that appear in childhood and are important for you to know. Congenital heart defects are the most common type of congenital defect and the number continues to rise. Although they are somewhat rare, they can have expensive and exhausting implications for the future. Here is a list of common heart disorders that can present in childhood, their signs and symptoms, and what you can do about them.

Types of Congenital Heart Defects

Ventricular Septal Defect

The most common congenital heart defect is a ventricular septal defect. The heart is divided into four separate chambers, or compartments: right atria, right ventricle, left atria, left ventricle. Blood flows through the chambers in that order while also passing through the lungs in between the right and left side. After passing through the left ventricle, oxygenated blood then exits the aorta and flows to the rest of the body.

In ventricular septal defect (VSD), there is a problem with the wall between the ventricles. This means that instead of blood flowing in the correct order, it flows back and forth between the two ventricles. This is problematic as oxygenated blood might get trapped in the heart and deoxygenated blood (or blood without proper levels of oxygen) are sent out to the body. Every organ in the body requires oxygen for proper functioning. Anything that interferes with oxygen deliver (I.e. congenital heart disease) can cause problems in these organs.

Diagnosing VSD normally happens after birth and the size of the defect, usually a hole, influences the severity of these symptoms. Large holes may cause symptoms that will mostly occur during feeding because that is when babies work the hardest. These symptoms include shortness of breath, fast or heavy breathing, sweating, fatigue while feeding and poor weight gain.

During a physical exam at the doctor’s office, the physician may hear a whooshing sound, called a heart murmur. If the doctor hears a murmur and the symptoms are present, then the physician will order an echocardiogram which is an ultrasound of the heart. This can show a problem with the structure of the heart, how large the hole is and how much blood is flowing through the holes.

Atrial Septal Defect

Atrial septal defect (ASD) is very similar to VSD in the sense that there is a hole in the wall between the atrias. Blood can travel across this hole from the left atrium to the right atrium and travel into the lung arteries. The extra blood in the heart and lungs can cause both to work harder, eventually causing damage. If the hole is small, it may not cause symptoms or problems because the heart and the lungs won’t have to work too much harder. This can also be referred to as a Patent Foramen Ovale.

In children with a large ASD, the main risk is to the blood vessels in the lungs because more blood than normal is being pumped there. Over time, usually many years there may be damage to the lung blood vessels.

Tetralogy of Fallot

Tetralogy of Fallot is a heart defect that features four problems: a hole between the ventricles, an obstruction from the heart to the lungs, the aorta (large blood vessel from the heart to the rest of the body) lies over the hole in the lower chambers, and the muscle surrounding the lower right ventricle becomes overly thickened.

The cause of this defect is unknown in most children even though it’s a common heart defect. It may be seen more commonly in Down Syndrome or DiGeorge syndrome. Some children can have other heart defects as well.

There is a similar problem with Tetralogy of Fallot as seen in VSD and ASD. There is a hole in which oxygenated blood can travel back through the heart instead of out to the rest of the body. Also an obstruction of the pulmonary artery (the blood vessel that carries deoxygenated blood to the lungs) causes less blood to travel to the lungs. This can present as a blue, or cyanotic, child due to their organs not receiving an adequate amount of oxygen.

This is nowhere near a complete list of all the possible congenital heart defects as there are many that can affect various regions of the heart. Some can be asymptomatic, but others can be very dangerous as they interrupt the delivery of oxygen to vital organs, including the brain. If you notice any signs of your child being fatigued or seemingly they’re low energy, then definitely consult your doctor to see if there is an issue with the blood or heart.

Treatment/Therapy for Congenital Heart Defects

Treatment or therapy for congenital heart defects depends on the severity of the problem. If there are no symptoms, then you may not even know that your child has a defect. If the symptoms are so severe that your child’s body is not receiving enough oxygen, then a surgical repair may be the best option. Surgery for congenital heart defects includes repairing or closing the hole, opening any vessels that may be blocked or occluded, and any other interventions that ensure the correct flow of blood.

Most of these surgical interventions are done early in life due to the high oxygen demand in infants and children. Because they grow so fast and have a high metabolism, it’s important that they receive as much oxygen and nutrients as possible. Long-term consequences may be mild to none depending on the extent of the repair. If there is still leakage, then there may be some limit. However, if a complete repair is possible, then there may be no long-term consequences. There is also a chance of physical, developmental or cognitive disorders as a long-term consequence. This is probably due to the amount of time that there was a lack of oxygen flowing to the brain or any other parts of the body that influence development.

Resources

For children who have long-term disability, Diverse Health Services can help with any tasks or functions that make your life, or the caregiver’s life, easier. These include day-to-day functions like transportation, medication, cleaning and feeding. Click on our services to see what we offer and if we are a good fit for what you need.

Sources:

• https://www.cdc.gov/ncbddd/heartdefects/data.html
• https://www.cdc.gov/ncbddd/heartdefects/ventricularseptaldefect.html
• https://www.marybridge.org/services/heart-center/childhood-heart-conditions/
• https://www.heart.org/en/health-topics/congenital-heart-defects/about-congenital-heart-defects/tetralogy-of-fallot
• https://www.heart.org/en/health-topics/congenital-heart-defects/about-congenital-heart-defects/atrial-septal-defect-asd