Symptoms and treatment of congenital heart disease

Congenital heart disease is the defect in the structure of the heart that is still developed inside the mother's belly, capable of causing impaired heart function, and is born with the newborn.

There are different types of heart disease, which can be mild and only be discovered in adulthood, even the most serious, which are cyanotic heart diseases, capable of causing alteration of blood flow to the body. They may have genetic causes, as in Down syndrome, or be caused by interference in pregnancy, such as the abuse of drugs, alcohol, chemicals or infections of the pregnant woman.

Congenital heart disease can still be detected in the maternal uterus by ultrasound and echocardiogram. This disease can be cured because its treatment can be done through surgery to correct the defect, which will depend on the type and complexity of the heart disease.

Main types

Heart disease can be classified as:

1. Congenital cyanotic heart disease

This type of heart disease is more serious, as the defect in the heart can significantly affect the blood flow and the oxygenation capacity of the blood, and, depending on its severity, can cause symptoms such as pallor, blue color of the skin, lack of air, fainting and even convulsions and death. The main ones include:

• Tetralogy of Fallot: prevents blood flow from the heart to the lungs, due to a combination of 4 defects, characterized by narrowing in the valve that allows blood to pass into the lungs, communication between the cardiac ventricles, alteration in the positioning of the aorta and hypertrophy of the right ventricle; Ebstein's anomaly: hinders blood flow due to anomalies in the tricuspid valve, which communicates the chambers of the right heart; Pulmonary atresia: causes absence of communication between the right heart and lungs, preventing blood from being properly oxygenated.

Ideally, congenital cyanotic heart disease should be diagnosed as early as possible, either in the mother's womb or shortly after birth, using echocardiograms that detect these cardiac changes, to schedule an intervention, and to prevent sequelae to the baby.

2. Congenital acyanotic heart disease

This type of heart disease causes changes that do not always cause such serious repercussions on cardiac functioning, and the amount and intensity of symptoms depends on the severity of the cardiac defect, ranging from the absence of symptoms, symptoms only during efforts, to heart failure.

Depending on the symptoms caused, these changes can be discovered soon after birth, or only in adulthood. The main ones are:

• Interatrial communication (ASD): abnormal communication occurs between the cardiac atria, which are the uppermost chambers; Interventricular communication (IVC): there is a defect between the walls of the ventricles, causing inadequate communication between these chambers and the mixture of oxygenated and non-oxygenated blood; Persistence of the ductus arteriosus (PDA): this channel exists naturally in the fetus to connect the right ventricle of the heart to the aorta, so that the blood moves towards the placenta and receives oxygen, but must close soon after birth. Its persistence can cause difficulties in oxygenating the newborn's blood; Defect in the atrioventricular septum (DSVA): it causes an inadequate communication between the atrium and the ventricle, making cardiac function difficult.

Regardless of the type of congenital heart disease, whether cyanotic or acyanotic, it can be said to be complex when the heart suffers from an association of several defects that most seriously influence its function, and which is more difficult to treat, as usually happens in the tetralogy of Fallot, for example.

Signals and symptons

The signs and symptoms of congenital heart disease depend on the type and complexity of the heart defects. In newborns and babies, they can be:

• Cyanosis, which is the purple coloration on the fingertips or on the lips; Excessive sweat; Excessive tiredness during feedings; Paleness and apathy; Low weight and little appetite; Fast and short breathing even at rest; Irritation.

In older children or adults, symptoms can be:

• Accelerated heart and purple mouth after efforts; Frequent respiratory infections; Easy tiredness in relation to other children of the same age; Does not develop nor gain weight normally.

Changes in the size of the heart can also be observed, confirmed through an x-ray examination and an echocardiogram.

How the treatment is done

The treatment of congenital heart disease can be done with the use of medications to control the symptoms, such as diuretics, beta-blockers, to regulate the heart rate, and inotropes, to increase the intensity of the beats. However, the definitive treatment is surgery for correction, indicated for almost all cases, being able to cure heart disease.

Many cases take years to be diagnosed and can be resolved spontaneously throughout the child's growth, making his life normal. However, more severe cases require surgery in the first year of life.

In addition, several genetic syndromes may have cardiac defects, and some examples are Down's syndrome, Alagille, DiGeorge, Holt-Oram, Leopard, Turner and Williams, for example, so the functioning of the heart should be well evaluated if the child is diagnosed with these diseases.