Congenital Heart Disease

One in 125 infants is born with congenital heart disease annually in the United States, a malformation caused by genetic or environmental factors. While Americans have fewer babies with birth defects than in other countries, the potential for life-threatening conditions still exists. In the first trimester of pregnancy, fetuses are susceptible to deformities, malformations and congenital diseases which may impact the viability of vital organs and adversely affect an infant’s ability to survive. Mothers and fathers may carry developmental or recessive genes which may not be evident until children are born. Cardiovascular health can be adversely impacted by genetic factors, including chromosomal abnormalities which cause defective openings in the upper or lower ventricles, or chambers of the heart. In infants, the smaller size of this vital organ can make corrective surgery difficult; and many times, cardiologists may advise waiting until babies are older and organs more mature before proceeding with delicate cardiovascular procedures. “Then were there brought unto Him little children, that He should put His hands on them, and pray: and the disciples rebuked them. But Jesus said, Suffer little children, and forbid them not, to come unto Me: for of such is the kingdom of heaven” (Matthew 19:13-14).
Physicians emphasize optimum prenatal care throughout pregnancy to circumvent birth defects and prevent mothers and infants from contracting diseases or becoming exposed to harmful toxins. Expectant mothers are admonished to refrain from smoking, drinking, taking certain prescription medicines, or abusing drugs which can harm the fetus. However, some situations are difficult to avoid; and women can become predisposed to conditions which adversely impact pregnancies. Adverse environmental factors include a mother’s contraction of German measles within the first two months of pregnancy or rarely, births at high altitudes. Downs syndrome babies have also been known to have defective cardiovascular systems caused by genetic conditions. Detected anywhere between birth to the first year, congenital heart disease results in an abnormal increase or decrease of blood flow due to enlarged openings or obstructions between the organ to the pulmonary artery. Symptoms in newborns to one-year-olds may include slight heart murmurs, slow growth rates, chronic and recurring pulmonary infections, and difficulty eating. Once diagnosed, physicians will try to control abnormal blood flow with medications or surgery, depending on the type of disease presented.

Congenital heart disease can exist in several forms: ventrical septal defect (VSD), atrial septal defect (ASD), patent ductus arteriosus, tetralogy of fallot, coarction of the aorta, aortic or pulmonary stenosis, and transposition or reversal of two great arteries. VSD accounts for twenty-five percent of all cases of congenital heart disease in infants; and is caused by an abnormal opening between the lower ventricles. This opening, which normally closes within the first year of birth, increases blood flow to the lungs under high pressure, increasing the baby’s risk of cardiac failure. In female infants, arterial septal defect, which presents an abnormal opening between the upper chambers or ventricles, also creates increased blood flow. Patent Ductus Arteriosus, also common in females, is a failure of the ductus arteriosus leading from the pulmonary artery to the aorta to close properly. Both conditions require surgery to correct the malformation, usually at the age of four or five when organs are more fully developed.

While irregular openings abnormally increase blood flow to the lungs, certain types of congenital heart disease obstruct the flow of blood to the upper and lower chambers. Newborns who present with obstructions or narrowing of the arteries are known as “blue babies,” indicative of the bluish cast to the skin, termed “cyanosis.” In tetralogy of fallot, blood flow to the heart’s right ventricle is obstructed and the position of the aorta, the largest vessel, may shift to the right. In aortic stenosis, the valve leading from the heart to the aorta is narrowed, causing murmurs or irregular beats. In severely cyanotic children, two major arteries arising from the organ can become reversed, causing blood flowing away from the heart to be pumped back into the body without passing through the lungs. These obstructive conditions are life-threatening and require immediate intervention to open valves or redirect blood flow.

Coarction, or constriction of the aorta, is a congenital heart disease which increases the baby’s blood pressure above the obstruction and must be surgically removed, usually when the child reaches the age of six. Milder cases of infant congenital heart disease may be treated with medication until babies develop sufficiently to endure delicate surgical procedures. Some openings close without surgery; and cardiologists can determine the severity of each condition. Babies who suffer such malformations will require ongoing cardiac care and continual monitoring. Developmental difficulties and digestive disorders can cause other problems, such as retarded growth due to an inability to properly process vital nutrients. Frequent upper respiratory infections also impede infants’ growth and may further exacerbate critical cardiac conditions.

Having a baby can be the most exciting time for parents, grandparents, and siblings. However, the hopes of having a healthy child can be dashed by a diagnosis of congenital heart disease. While parents may want to blame one another or even God for allowing their baby to suffer from a quirk of nature, help is available. Today, modern medicine has made tremendous strides in detecting and correcting genetic deficiencies, including heart disease; and infant mortality is on the decline. New advances and technologies should provide parents and doctors with an even greater hope that infants can survive congenital cardiovascular diseases. With proper diagnosis and effective treatment, including surgery and medicines; babies with defects are able to overcome life-threatening conditions to live normal, healthy, and wholesome lives.