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A congenital heart defect (CHD) is a defect in the structure of
the heart and great vessels of anewborn. Most heart defects either
obstructblood flow in the heart orvessels near it or cause
blood to flow through the heart in an abnormal pattern, although
other defects affecting heartrhythm (such as long QT syndrome) can
also occur. Heart defects are among the most common
birth defects and are the leading cause of birth defect-related
deaths.
[edit] Signs and Symptoms
Symptoms and signs are related to the type and severity of the
heart defect. Some children have
no signs while others may exhibit shortness of breath, cyanosis,
chest pain, syncope, sweating,heart murmur, respiratory infections,
underdeveloping of limbs and muscles, poor feeding, or
poor growth, build up of blood and fluid in lungs, feet, ankles
and legs. Congenital heart defectscause abnormal heart structure
resulting in production of certain sounds called heart murmur.
Doctors can simply detect it with stethescope. However, all
heart murmurs are not caused bycongenital heart defects. CHD
symptoms frequently present early in life, but it's possible
for
some CHDs to go undetected throughout life.
[edit] Cause
The cause may be due to a geneticpredisposition or an
environmental exposure during
pregnancy.
Known genetic causes of heart disease includes chromosomal
abnormalities such as trisomies21,13, and 18, as well as a range of
newly recognised geneticpoint mutations,point deletions and
other genetic abnormalities as seen in syndromes such as
Velo-Cardio-Facial Syndrome, familial
ASD with heart block, Alagille syndrome,Noonan syndrome, and
many more.
Known antenatal environmental factors include maternal
infections (Rubella), drugs (alcohol,hydantoin, lithium and
thalidomide) and maternal illness (diabetes
mellitus,phenylketonuria, and
systemic lupus erythematosus).
[edit] Classification
[edit] Hypoplasia
Main article: Hypoplastic left heart syndrome
Hypoplasia can affect the heart, which typically results in the
failure of either the right ventricle
or the left ventricle to develop adequately, leaving only one
side of the heart capable of pumpingblood to the body and lungs.
Hypoplasia of the heart is rare but is the most serious form of
CHD;
it is called hypoplastic left heart syndrome when it affects the
left side of the heart andhypoplastic right heart syndrome when it
affects the right side of the heart. In both conditions,
the presence of apatent ductus arteriosus (and, when hypoplasia
affects the right side of the
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y tetralogy of Fallot (ToF)y dextro-Transposition of the great
arteries (d-TGA)y Tricuspid atresiay Truncus arteriosusy
Ventricular septal defect (VSD)y
Bicuspid aortic valvey Mitral stenosisy Shone's syndrome/
Shone's complex / Shone's anomalyy Scimitar syndrome (SS)
This is an incomplete list, which may never be able to satisfy
certain standards forcompletion. You can help by expanding itwith
reliably sourcedadditions.
single ventricle Some conditions are not in the heart itself,
but are closely related to the region,
and are often treated in the same category as the above
conditions.
yCoarctation of the aorta (Co
A)
y Interrupted aortic arch (IAA)y Partial anomalous pulmonary
venous connection (PAPVC)y Total anomalous pulmonary venous
connection (TAPVC)
[edit] Management
Sometimes CHD improves with no treatment necessary. At other
times the defect is so small and
does not require any treatment. Most of the time CHD is serious
and requires surgery and/ormedications. Medications include
diuretics, which aid the baby in eliminating water, salts, and
digoxin and in strengthening the contraction of the heart. This
slows the heartbeat and removes
some fluid from tissues. Some defects require surgical
procedures to repair as much as possibleto restore circulation back
to normal. In some cases, multiple surgeries are needed to
beperformed to help balance the circulation. Interventional
cardiology now offers patients
minimally invasive alternatives to surgery. Device closures can
now be treated with a standardtranscatheter procedure using a
closure device mounted on a balloon catheter.[citation needed]
