Heart disease

Congenital heart disease in infants and children

Congenital heart disease in infants and children


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According to the Spanish Heart Foundation and the Spanish Society of Cardiology, the congenital heart diseaseMost common in infants and children are ventricular septal defect (VSD), tetralogy of Fallot, and atrial septal defect (ASD). Early diagnosis is essential for the treatment of these heart diseases, whose prognosis is increasingly favorable due to advances in surgery.

1. Ventricular communication in the baby

It is the most common congenital heart disease at birth and consists of the presence of an orifice that connects the two ventricles.

Causes. Its exact cause is unknown, but having a family history of heart defects can be a risk factor.

Symptoms. They depend on the size of the VSD orifice rather than its location. If the hole is small, the patient will not have symptoms in his entire life, only a very striking heart murmur, when his doctor examines him. But when the defect is large, heart failure, fatigue, sweating, slow growth, and a heart murmur occur. In this case, if the patient is not treated properly, pulmonary hypertension, shortness of breath and cyanosis (purple fingers and lips) may appear.

Treatment. VSD can be closed spontaneously in up to 40 percent of cases, mostly in the first 6 months of life. Treatment depends on the size of the VSD. Small VSDs do not cause symptoms and do not require treatment. Many tend to close over time and also get proportionally smaller with increasing size of the heart. They should be reviewed periodically and do not usually require restorative treatment in adult life.

Patients can lead a totally normal life. Large VSD causes symptoms in the baby, and in addition to treatment for heart failure, surgical closure of the ventricular defect must be performed. It is advisable to intervene from the sixth month of life (mortality is 20 percent in the first month and drops to 2-3 percent after the sixth month of life). It is not advisable to delay surgery after two years of age, due to the danger of developing severe and intractable pulmonary hypertension.

2. Tetralogy of Fallot in the baby

It is a complex congenital heart disease that includes ventricular septal defect, pulmonary artery stenosis, encirclement of the aorta (the aortic artery does not leave the left ventricle, but rather above the ventricular septal defect, that is, between the right ventricle and the left) and hypertrophy of the right ventricle (the right ventricle is thickened due to increased workload).

Causes. This pathology is associated with excessive alcohol consumption during pregnancy, suffering from rubella during pregnancy, poor nutrition during pregnancy, and the use of medications to control seizures and diabetes.

Symptoms. Although there are asymptomatic patients, the majority present cyanosis from birth, with decreased tolerance to effort, thickening of the ends of the fingers and hypoxemic attacks due to the decrease in oxygenation of the blood in the face of certain stimuli such as crying or pain.

Treatment. Surgical treatment can achieve complete correction of this congenital heart disease. It is recommended as soon as the child is diagnosed, even if it is a baby because the prognosis of these patients is very bad without surgery and clearly improves in the long term after reconstructive surgery.

Only 6 percent of non-operated patients have reached their 30s, and only 3 percent have reached their 40s. Of the children operated, with good results, the majority reach adults leading a relatively normal life. A small percentage of patients may have, after many years, some complications such as arrhythmias or heart failure due to myocardial dysfunction.

3. Interatrial communication (ASD)

During fetal formation, there is an opening between the left and right atria (upper chambers) of the heart. This hole usually closes shortly after birth. If it does not close completely, the problem is called ostium secundum CIA. Ostium secundum ASD is the most common type of ASD. Other types are ostium primum ASD and sinus venous ASD. Each type of ASD is related to a hole in a different part of the interatrial septum.

Causes. The cause of this condition is unknown and it is generally not genetic, that is, it is not a disease that is inherited from the parents.

Symptoms. In some cases, infants or children have no symptoms, but others may have fatigue, sweating, rapid breathing, shortness of breath, poor growth, tiredness with exercise, palpitations, and frequent respiratory infections.

Treatment. The first-line treatment is surgery. In recent years, atrial septal defect closure devices have been developed through catheters (in the case of small holes). This technique allows its implantation without surgery by puncture through the femoral vein.

When an early diagnosis and repair of ASD is performed, the result is generally excellent and minimal follow-up is required. If it is diagnosed late or complications occur after the procedure, the overall outlook is as good.

You can read more articles similar to Congenital heart disease in infants and children, in the category of heart disease on site.


Video: Tetralogy of fallot. Circulatory System and Disease. NCLEX-RN. Khan Academy (May 2022).


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