This is an automatically translated article.
The article is professionally consulted by Master, Doctor Pham Van Hung - Department of Medical Examination & Internal Medicine, Vinmec Danang International General Hospital.When a baby is in the womb, the heart develops incompletely, creating defects known as congenital heart disease. It is the most common type of birth defect and is the cause of many deaths in the first years of life. However, with some diseases, if detected early, the treatment of congenital heart disease can bring positive results.
1. What is congenital heart disease?
A baby's heart begins to develop at conception, but is fully formed after the first eight weeks of pregnancy. Congenital heart defects occur during the critical first eight weeks of a baby's development. Specific steps must take place for the heart to form correctly. Often, a congenital heart defect is the result of one of these important steps not happening at the right time. For example, a defect exists in the atrial or ventricular septum, or there is a ductus arteriosus connecting the aorta and pulmonary artery.2. What causes congenital heart?
Most congenital heart defects have no known cause. Mothers will often wonder if something they did during pregnancy caused heart problems. In most cases, no specific cause can be found. Mostly because in the first 3 months of pregnancy the mother has some infectious diseases.Some heart problems run more often in families, so there may be a genetic relationship to some heart defects. In addition, maternal illness while pregnant and taking medications, such as the anti-epileptic drug or the acne drug isotretinoin, is also considered a cause of congenital heart disease.
3. Congenital heart diseases are treatable
Ventricular septal defect Congenital heart disease is the most common, accounting for about 25% of congenital heart diseases. Due to defects in fetal development, the two ventricles may communicate with each other by one or more holes. This vent can be in different positions and sizes as well.Diagnosis of the disease is not complicated. When children are young, there may be no symptoms, children often have recurrent pneumonia. Auscultation of the heart will reveal a systolic murmur. If not detected and treated, there may be signs of shortness of breath, reduced exercise capacity. Echocardiography will clearly show the location and size of the stoma, assess the degree of the flow and pulmonary artery pressure, and help in the treatment and prognosis.
Treatment is mainly surgical patching of the stoma with extracorporeal circulation. In addition, it is possible to close the hole with a percutaneous instrument, this method has now been applied in many interventional cardiology centers and has positive results.
When the child has not received surgery or thorough treatment, it is necessary to prevent a major complication, which is infection. From a small infection such as pharyngitis, tooth decay... can lead to very dangerous infective endocarditis.
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Mild pulmonary stenosis has a good prognosis and rarely requires intervention. In case of severe pulmonary stenosis, the main treatment method is percutaneous balloon angioplasty, with positive results. In addition, surgery can be performed to widen the narrowing of the valve.
Tetralogy of fallot This is a complex and very common birth defect, with 4 malformations (so called tetralogy). The first sign of the disease is cyanosis right from birth. The baby's lips and extremities are purple, especially when crying or feeding, sometimes the baby faints. The tips of the fingers and toes are drumstick-shaped, and the nails are cupped. If you listen to your heart, you will hear a loud murmur.
The median age of these children (if untreated) is 10 years, rarely living to adulthood. A potentially fatal complication is a brain abscess. When a child has tetralogy of Fallot, only surgery can help them live a long and healthy life.
There are two types of surgery
Temporary surgery: when the branches of the pulmonary artery are too small, use a branch from the great circulation (usually taking the subclavian artery) to connect the pulmonary artery, helping the child to exchange oxygen well. rather than purple. After about 5-10 years, the child will undergo radical surgery to repair the entire child.
Radical surgery: with the artificial heart and lung machine, the surgeon will completely correct the deformities, the child can have a normal life.
Atrial septal defect The disease usually progresses slowly and quietly, making it difficult to detect. Sometimes the disease is discovered incidentally during a physical examination. Listen to the right heart and see a soft murmur. To confirm the diagnosis, echocardiography should be done to detect the atrial septal defect, measure the size of the hole, and measure the pressure in the pulmonary artery.
For treatment, if the hole is small and the lesion is suitable, endovascular intervention can be performed. Otherwise, surgery is required to patch the hole with an artificial patch or with the patient's own pericardium.
Should have surgery before going to school so that the child can develop normally like other children. Without treatment, the right heart pressure gradually increases and blood flows from the right atrium to the left atrium, causing the patient to appear cyanotic lips, purple fingers and toes, and the patient is no longer able to operate.
And ductus arteriosus accounts for about 10% of congenital heart diseases. The disease is not difficult to diagnose and if treated (surgery or endovascular intervention) will bring the child back to a normal life. Common signs when children with this disease are pneumonia, often sick, rickets, malnutrition
Coarctation of the aorta Expressed by signs such as fatigue, palpitations or headache. The blood pressure readings of the arms and legs will diagnose the disease. The complications above the narrowing are the consequences of high blood pressure such as: brain hemorrhage, heart failure, blurred vision...
4. Effective methods of treating congenital heart disease
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The article references Stanford Children's Health
