Congenital Heart Defects in Children

Congenital heart defect is an abnormality in the heart's structure that a kid is born with. Children with certain minor congenital cardiac abnormalities don't require therapy. More severe congenital cardiac problems in youngsters may need many operations spread out over several years. You may better comprehend your child's congenital heart problem and prepare for what lies ahead by being informed about it.

Congenital Heart Defects in Children: Causes

The baby's heart forms and begins to beat throughout the first six weeks of pregnancy. At this crucial period, the main blood arteries that travel to and from the heart also start to form.

Congenital cardiac abnormalities may start to manifest at this stage of a baby's development. The majority of these problems are not completely understood by researchers, but they speculate that genetics, specific medical disorders, particular drugs, and environmental or lifestyle factors, like smoking, may all be involved.

Altered Blood Vessel or Heart Connections

When normally blood wouldn't flow, altered connections allow it to. One instance of this kind of congenital cardiac abnormality is holes in the walls between the heart chambers.

Oxygen-rich blood may mingle with oxygen-poor blood as a result of a broken link. As a result, less oxygen is delivered to the body. The heart and lungs have to work harder because of the shift in blood flow.

A few examples of heart or blood vascular connections that have been changed are −

  • A hole between the upper heart chambers is known as an atrial septal defect (atria).

  • A hole in the wall between the right and left lower heart chambers is known as a ventricular septal defect (ventricles).

The main artery of the body and the lung arteries are connected by a structure called the patent ductus arteriosus (aorta). It is wide open throughout a baby's development in the womb and usually shuts shortly after delivery. Yet, in a few infants, it remains open, resulting in improper blood flow between the two arteries.

When all or portion of the blood vessels from the lungs (pulmonary veins) join to the incorrect location or parts of the heart, this condition is known as a total or partial anomalous pulmonary venous connection.

Congenital Issues with the Heart Valve

The blood arteries and the heart chambers are connected by doors called heart valves. To maintain normal blood flow, heart valves open and shut. Blood can't flow smoothly if the heart valves can't open and seal properly.

Problems with the heart valves might include those that are constricted and don't open fully (stenosis) or those that don't shut fully (regurgitation).

Congenital heart valve issues include the following examples −

  • An aortic stenosis. An aortic valve with one or two valve flaps (cusps) rather than three may be present in a newborn.

  • Thoracic stenosis. The pulmonary valve opening is reduced and blood flow is slowed by a lesion on or close to the pulmonary valve.

  • Ebstein anomaly. The tricuspid valve, which separates the right lower chamber (ventricle) from the right upper chamber (atrium), is deformed and frequently leaks.

Four congenital cardiac abnormalities are combined to form Tetralogy of Fallot −

  • A crack between the lower chambers of the heart (ventricles)

  • The right ventricle and pulmonary artery's constricted opening

  • A change in how the aorta and heart are connected

  • Right ventricle muscle thickening

Congenital Heart Defects in Children: Symptoms

Severe congenital cardiac abnormalities are typically discovered within the first few months of life or shortly after delivery. Symptoms and symptoms could include −

  • Blue or grayish-white lips, tongue, and fingernails (cyanosis)

  • Quickly breathing

  • Swelling around the eyes, in the stomach, or the legs

  • Breathing problems with meals, which prevents adequate weight growth

Congenital cardiac abnormalities that are less severe could not be discovered until later in infancy. Congenital cardiac abnormalities in older children may show the following signs and symptoms −

  • Having trouble breathing during exercise or activities

  • Quickly exhausted through physical exertion or exercise

  • Crashing out during a workout or activity

  • Hands, ankles, or feet swelling.

Congenital Heart Defects in Children: Risk Factors

The major risk factors include −

  • Rubella (German measles). Rubella during pregnancy can interfere with a baby's ability to form a heart. You may find out if you are immune to rubella by having a blood test before becoming pregnant. For people who lack immunity, there is a vaccination available.

  • Diabetes. Prenatal and perinatal blood sugar management with care can lower the baby's risk of congenital heart abnormalities. The chance of a baby being born with cardiac abnormalities is often not increased by gestational diabetes.

  • Medications. Pregnancy-related drug usage has been linked to birth abnormalities, including congenital heart problems. When attempting conception, be sure to provide your healthcare professional with a thorough list of all the drugs you use. Thalidomide, angiotensin-converting enzyme (ACE) inhibitors, statins, the acne treatment isotretinoin, several epilepsy medications, and some anxiety medications are among the medications known to raise the risk of congenital heart abnormalities.

  • Drinking alcohol while carrying a child. Alcohol use during pregnancy raises the possibility of congenital cardiac abnormalities.

Congenital Heart Defects in Children: Diagnosis

Electrocardiogram (ECG or EKG). This non-invasive examination captures the heart's electrical activity. On the chest, sticky patches containing sensors (electrodes) are applied. The patches are connected by wires to a computer, which shows the results. An ECG can be used to identify abnormal cardiac rhythms (arrhythmias).

Echocardiogram. Ultrasound waves are used in echocardiography to provide pictures of the beating heart. It demonstrates how the heart's valves and blood flow through the heart. Fetal echocardiography is an echocardiogram performed on a baby before birth.

Congenital Heart Defects in Children: Treatment

Congenital cardiac defects might have symptoms or problems that can be treated with medication. They can be utilized either alone or in conjunction with a cardiac operation. Congenital cardiac abnormalities are treated with medications like −

  • Blood pressure medications. Examples include beta blockers, angiotensin II receptor blockers (ARBs), and inhibitors of the angiotensin-converting enzyme (ACE).

  • Water tablets (diuretics). The pressure on the heart is lessened by this sort of drug since it decreases the body's fluid content.

  • Meds for heart rhythm. These drugs, known as antiarrhythmic, aid in regulating an irregular heartbeat (arrhythmia).

Congenital Heart Defects in Children: Prevention

Get appropriate prenatal care. Prenatal visits with a medical professional regularly can help mom and baby stay healthy.

  • Use a multivitamin that contains folic acid. It has been demonstrated that folic acid of 400 micrograms daily can lessen brain and spinal cord birth abnormalities. It could also lessen the chance of developing cardiac abnormalities.

  • Stop smoking and drinking. A baby's health might be harmed by certain lifestyle choices. Don't smoke around others, either.

  • Be vaccinated against rubella. Pregnancy-related rubella infection may have an impact on how a baby's heart develops. Before attempting to become pregnant, be immunized.


Congenital heart defects are quite prevalent, and the rate of early CHD identification is rising. To correctly quantify the prevalence, a good population-based investigation on a wide scale is required because the overall burden of CHD is also rising.

Dr. Durgesh Kumar Sinha
Dr. Durgesh Kumar Sinha


Updated on: 30-Mar-2023


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