Congenital heart defects, often termed congenital heart diseases, are abnormalities in the heart's structure or surrounding blood vessels. These anomalies commence during the heart's developmental phase in the womb, notably between the 5th to 12th week of pregnancy. Genes, acting as the blueprint for the body, play a pivotal role in shaping an infant's heart.
However, an anomaly in the gene sequencing can cause structural discrepancies in the heart. Notably, while some genetic defects leading to CHD have been pinpointed, for many patients, pinpointing the exact cause remains elusive. However, certain risk factors during pregnancy can heighten the chances of CHD.
CHD Risk Factors
1. Genetic Predispositions:
- Down Syndrome: This results from an extra copy of chromosome 21 leading to cognitive and motor development delays. Remarkably, around 40% of children with Down syndrome manifest heart defects.
- Turner Syndrome: Resulting from a missing X chromosome, it leads to stunted growth and infertility in girls. Approximately 30% of them also exhibit heart defects.
2. Mother's Health and Actions during Pregnancy:
- Chronic Illnesses: Poorly managed diabetes during pregnancy can boost the chances of CHD in infants.
- Infections: If a pregnant mother contracts influenza during pregnancy, it will increase the risk of her child developing congenital heart defects. Therefore, it is important for the mother to prioritize her own health during pregnancy. Prior to becoming pregnant, the mother should consider getting vaccinated for German measles and influenza (if she is not already immune).
Additionally, if the mother experiences a high fever during pregnancy, it can also lead to congenital heart defects in the child. In such cases, the mother should take medication to alleviate fever symptoms, and paracetamol is a safe option for this purpose during pregnancy. However, it is important for the mother to avoid using other medications like aspirin to reduce fever, as aspirin can cause heart defects in unborn children. Pregnant mothers should exercise caution, minimize medication usage, and consult a doctor before taking any form of medication during pregnancy.
- Medications & Chemical Exposure: Over-the-counter drugs, alcohol, narcotics, and certain chemicals can adversely affect the fetus. It's imperative for expectant mothers to consult their physicians before taking any medication.
Symptoms of CHD
The manifestation of CHD symptoms hinges on the defect's nature and severity. Some common indicators include:
- Bluish skin tint
- Accelerated heartbeat and breathing
- Fatigue and reduced food intake
- Slow growth and weight gain
- Excessive sweating
Diagnosing CHD
While some heart defects can be detected in-utero via ultrasound, others might only surface post-birth or even during adulthood. If CHD is suspected, a range of tests, including echocardiograms, electrocardiograms, chest X-rays, cardiac catheterisation, MRI scans, and CT scans, can be conducted.
Treatment of CHD
Patients with mild congenital heart defects who are asymptomatic and have a normal growth pattern typically do not require treatment. However, those who experience severe symptoms such as heart failure, shortness of breath, or fatigue may need medication to manage their symptoms.
If the symptoms do not improve with medication, catheter intervention or heart surgery may be necessary to correct the defects. Certain defects, such as a hole in the heart wall, can be treated using heart catheterization to avoid open heart surgery. During the procedure, a specially designed device is attached to the tip of a small plastic tube, which is inserted into a large blood vessel, usually through the groin, and guided to the site of the defect. The device is then deployed to close off the defect.
Taking Care of Children with CHD
For children with CHD:
- Monitoring growth is crucial as CHD can affect nutrient absorption, leading to slow weight gain.
- Most affected children can partake in regular school activities, but some might face developmental or learning challenges.
- Good oral hygiene is paramount to prevent heart infections.
- Periodic check-ups and surgeries might be needed throughout their lives.
