heart defects are problems with how a baby's heart forms. "Congenital" means
that the heart problem develops before the baby is born or at birth.
congenital heart defects affect how blood flows
heart or through the blood vessels near the heart.
Some defects may cause blood to flow in a pattern that isn't normal. Others
can completely or partially block blood flow.
There are many
different types of congenital heart defects. They can be fairly simple, such as
a hole between the chambers of the heart or a heart valve that has not formed
right. Others are more serious and complex, such as a missing heart valve or
Some defects are discovered in the fetus (developing baby)
while a woman is pregnant. Others are not found until birth. Still others may
not be discovered until your child gets older or even until he or she is
No matter when a heart defect is discovered, having a
child with a heart problem is very stressful. Dealing with the fear and
uncertainty may seem overwhelming, especially when you have a fragile newborn.
It may help you to learn as much as you can about your child's treatment and to
talk to your doctor and other parents who have a child with similar
No one knows exactly what
causes most congenital heart defects. Genes passed down from a parent are a
possible cause. Viral infections also may play a role. For example, if a woman
gets German measles (rubella) while she is pregnant, it may cause problems with
how her baby's heart develops. Women who have
diabetes have a greater chance of having a child with
a congenital heart defect.
Congenital heart defects are more
common in babies who are born with genetic conditions such as
Taking some prescription
or other medicines during pregnancy may cause congenital heart defects. Women
who use illegal "street" drugs or who drink alcohol during pregnancy have a
higher risk of having a baby with a congenital heart defect.
Symptoms of congenital
heart defects will depend on what problem your baby has. Babies with congenital
heart defects may have one or more of these symptoms:
In some cases, your child's congenital heart defect may
be so mild that symptoms won't appear until the child is a teenager or young
most cases, congenital heart defects are found at birth or during a baby's
first few months.
You may find that your baby has trouble eating
or isn't gaining weight. Or your doctor may hear abnormal sounds or murmurs in
your baby's heart during a routine checkup. The first sign may be a bluish tint
to the baby's skin.
After a doctor suspects a heart defect, your
baby will probably need several tests, such as blood tests, an
echocardiogram, and possibly a heart catheterization.
The doctor may use the echocardiogram to check blood flow through your baby's
heart and to look at the valves, thickness, and shape of the heart. A heart
catheterization measures blood pressure in the heart and heart arteries and can
show how well the heart is pumping.
Having your child go through
this testing can be very scary. Don't be afraid to ask as many questions as
you need to ask to feel comfortable. Talk to your doctor and the nurses. And talk to the
people who are doing the testing.
Some defects get better on
their own and may not need treatment. Your baby's or child's treatment will
depend on the type of defect.
Medicines may be used to help the
heart work better. Medicines may also treat symptoms until the defect is
Some defects can be fixed by using a thin, flexible tube called a catheter. This procedure
doesn't require opening up the chest. The
doctor threads the catheter through a blood
vessel—typically in the groin—and into the heart. There, he or she uses the catheter to close holes or
open narrowed blood vessels or valves.
If a baby has a large or
complex defect, the baby may need one or more open-heart surgeries. The surgery
may be done right away, done over several steps, or delayed until the baby is
stronger. Sometimes surgery is delayed if the baby is premature or until the
baby is strong enough to handle the surgery. In some cases, the child may need
different types of surgery over time as he or she grows.
cases, a heart defect may be so serious that a heart transplant is
Frequently Asked Questions
Learning about congenital heart defects:
Living with congenital heart defects:
The exact cause of most
congenital heart defects is not known. But doctors do
know that certain things increase the risk that a baby will have a heart
defect. See What Increases Your Risk.
Congenital heart defects cause a wide range of symptoms. Your baby may have only mild
symptoms and tire easily, for example. He or she may have life-threatening
symptoms, such as
severe difficulty breathing. Or your baby may not have
any symptoms that you notice at birth but may have them later as he or she
Symptoms usually go away after the defect is corrected. A
congenital heart defect that is repaired at the right time is less likely to
permanently affect your child's growth and development.
Common symptoms include:
Symptoms of blood flow problems
Blood flow problems caused by heart defects can mean that
your baby gets less oxygen. This happens mostly in children who have
cyanotic heart defects ("blue babies").
If a baby has trouble getting oxygen or the heart is working extra hard, symptoms include:
Congenital heart defects happen when the heart doesn't form normally as the developing baby (fetus) grows in the uterus. Heart defects may
cause problems with
blood flow through the heart after a baby is born. The problems can affect the
baby's blood and oxygen supply.
There are many types of congenital heart defects. If the defect lowers the amount of oxygen in the body, it is called cyanotic. If the defect doesn't affect oxygen in the body, it is called acyanotic. Some defects require treatment right away. Other defects get better on their own
and don't require treatment.
Congenital heart defects happen in about 8 out of
1,000 babies born in the United States.1 But only about
one-third of these babies have major defects
that need surgery or have defects that may cause death during the first year of
life.1 The number of congenital heart defects among
premature babies is higher—about 2 out of 100 births.2
Congenital heart defects affect a similar number of boys and girls.
But the types of defects that are common in boys and girls tend to differ.2
Not all defects are found when a child is very young. Some defects don't cause symptoms and aren't life-threatening. These defects may not
be found until the teen years or later.
Although many children and adults
with corrected heart defects lead normal lives, heart defects can be related to
or cause long-term risks that may include:
If you are an adult with a congenital heart defect, see the topic Congenital Heart Defects in Adults.
have to make decisions about:
In most cases, the cause of a
congenital heart defect isn't known. But certain
things increase your baby's chances of having a heart defect. These include:
If you're concerned about having a baby with a congenital heart defect, you can take steps to lower your
risk. For healthy pregnancy choices, see the topic Pregnancy.
Call 911 or other emergency services immediately if your child has
severe difficulty breathing, faints, or has
Call your doctor immediately if your child
congenital heart defect has:
Talk to your doctor if your child with a congenital heart
The following health professionals can evaluate
symptoms of a congenital heart defect:
To prepare for your appointment, see the topic Making the Most of Your Appointment.
Testing a baby for
congenital heart defects can be done while a woman is
pregnant or after a baby's birth. Children and adults who have a heart defect need regular checkups throughout their lives.
echocardiogram, which can be done as early as 16 weeks
of pregnancy, is the best test before a baby's birth. The test uses sound waves
to take pictures of the baby's heart. The fetal echocardiogram may be done if:
Many congenital heart defects are found in the first
month after a baby is born. Your doctor may ask about the baby's symptoms, appetite, and other habits. He or she may do other tests to find a heart problem, such as:
More tests may be needed, depending on the symptoms and
type of defect. These may include:
Children, teens, and adults with congenital heart defects need regular checkups. They might have tests to check the health of the heart and to check for complications.
A stress test (exercise electrocardiogram) can be done to check if a child or an adult with a heart defect needs exercise restrictions or to see if exercise performance is changing over time. This test might be done before a child starts school or before a teen or adult starts a new exercise program.
Adults who have congenital heart defects need routine checkups. Be sure you have a primary care physician. You might also need to see your cardiologist regularly, such as once a year.
In families with a history of congenital heart
defects, genetic testing may be done.
A baby may be checked for
congenital heart defects if:
Your child's treatment for a
congenital heart defect will be based on the type of
problem he or she has. Your child's age, size, and general health also are
Treatment helps most children live fairly normal
lives. Your child may need:
Your child will also need regular visits to a pediatric cardiologist.
Caring for a child who has a heart problem can be
You may need to keep track of medicines and make frequent trips to
the doctor. Costs can be high. Try to
find support groups and other parents who can help you with the many emotions
Some children die from severe congenital heart defects or related
complications, such as heart failure. If your baby is born with
a severe heart defect, there's a good chance that he or she
will survive with treatment. But you must also prepare for the possibility that
your child may die. Talk with your doctor about local resources and
organizations that can help you manage your emotional and practical
struggles when faced with this possibility.
Congenital heart defects generally cannot be
If you or your partner has a congenital heart defect and you are planning to have a baby, see the topic Congenital Heart
Women who plan to get pregnant and women who are pregnant can lower their risk of having babies with congenital
heart defects by taking steps to have healthy pregnancies. For healthy pregnancy choices, see the topic Pregnancy.
Congenital heart defects often are repaired with surgery or heart catheterization, but home treatment also plays an important role. Some of the issues you'll face include:
For more information and help, see Congenital Heart Defects: Caring for Your Child.
Adults who have congenital heart defects have other issues, such as pregnancy, birth control, and employment. For help, see Congenital Heart Defects in Adults.
Medicines often are needed to treat
congenital heart defects until the defect can be
repaired or corrected. Some children and adults need to take medicine even after the defect is repaired. Children with certain defects that
cannot be completely corrected may have to take medicines for a long
Treatment with medicines depends on the:
Medicines might be used to treat complications, relieve symptoms, or prevent problems. They might not treat the defect itself.
The following are some of the medicines used for heart defects.
To treat complications and relieve symptoms
To treat a certain defect
To prevent problems
Know how to give medicine safely. Your child's heart medicines are very
strong and can be dangerous if they aren't given correctly. For help, see the topic Congenital Heart Defects: Caring for Your Child.
Surgery is done for more complex defects or when
catheterization cannot correct the defect. Or your child might need a combination of surgery and catheterization to fix a defect. The kind of surgery will depend on what defect the child has.
Some congenital heart defects can be completely repaired
with one surgery. Defects that are more complex often require several surgeries over time.
Prepare yourself for
what to expect at the hospital. It may be shocking to see your newborn or
child hooked up to so many machines and tubes.
If your child is older, you can help your child feel more
comfortable and secure by preparing him or her for what to expect. Your child's doctor or the hospital staff can help you prepare your child. Encourage your child to ask questions. And let him or her talk to the doctors too.
For more tips, see Congenital Heart Defects: Caring for Your Child.
general, the types of surgery are:
In rare cases, a heart transplant may be needed.
The type of surgery depends on the type of defect and the
If a young baby (for example, newborn to age 3 months) has a life-threatening defect, surgery may be needed right away. For some
defects, the best time for surgery is before the child is 2 years old. For
other defects, the best time may be between the ages of 2 and 4.
In some cases,
surgery may be done when a child is older. Surgery may be delayed if the defect
is likely to heal on its own.
Some types of surgery are more invasive and take longer to recover from than others. Even after
surgery, your child may still have symptoms such as weakness and a bluish tint
(cyanosis) to the skin, lips, and nail beds.
After surgery, it's possible for symptoms to return or for complications to develop later. In these cases, more surgeries also may be needed.
Heart catheterization may be used to correct certain
congenital heart defects. Children typically recover
more quickly from a heart catheterization procedure than from a surgery.
With heart catheterization, a
doctor threads a thin, flexible tube called a catheter through a blood
vessel—typically in the groin—and into the heart. This lets the doctor check the heart and treat a defect.
The Adult Congenital Heart Association (ACHA) is a nonprofit organization that helps adults with congenital heart defects. Its goal is to improve the health and quality of life for people with congenital heart defects. The ACHA provides electronic and print information for patients and their families. The ACHA promotes an online community and in person events at the local and national level. A directory on the website can help you find a clinic that specializes in care for adults with a congenital heart defect.
Visit the American Heart Association (AHA) website for information on
physical activity, diet, and various heart-related conditions. You can search for information on heart disease and stroke, share information with friends and family, and use tools to help you make heart-healthy goals and plans. Contact the AHA to find your
nearest local or state AHA group. The AHA provides brochures and information
about support groups and community programs, including Mended Hearts, a
nationwide organization whose members visit people with heart problems and
provide information and support.
This website is sponsored by the Nemours Foundation. It
has a wide range of information about children's health—from allergies and
diseases to normal growth and development (birth to adolescence). This website
offers separate areas for kids, teens, and parents, each providing
age-appropriate information that the child or parent can understand. You can
sign up to get weekly emails about your area of interest.
The March of Dimes tries to improve the health of babies
by preventing birth defects, premature birth, and early death. March of Dimes
supports research, community services, education, and advocacy to save babies'
lives. The organization's website has information on premature birth, birth
defects, birth defects testing, pregnancy, and prenatal care.
The U.S. National Heart, Lung, and Blood Institute
(NHLBI) information center offers information and publications about preventing
CitationsBrown DW, Fulton DR (2011). Congenital heart disease in children and adolescents. In V Fuster et al., eds., Hurst's The Heart, 13th ed., pp. 1827–1883. New York: McGraw-Hill.Bernstein D (2011). Epidemiology and genetic basis of congenital heart disease. In RM Kliegman et al., eds., Nelson Textbook of Pediatrics, 19th ed., online chap. 418. Philadelphia: Elsevier Saunders. Available: http://www.expertconsult.com.Other Works ConsultedBrickner ME (2007). Congenital heart disease. In EJ Topol, ed., Textbook of Cardiovascular Medicine, 3rd ed., pp. 502–536. Philadelphia: Lippincott Williams and Wilkins.Brown DW, Fulton DR (2011). Congenital heart disease in children and adolescents. In V Fuster et al., eds., Hurst's The Heart, 13th ed., pp. 1827–1883. New York: McGraw-Hill.Feltes TF, et al. (2011). Indications for cardiac catheterization and intervention in pediatric cardiac disease: A scientific statement from the American Heart Association. Circulation, 123(22): 2607–2652.Madriago E, Silberbach M (2010). Heart failure in infants and children. Pediatrics in Review, 31(1): 4–12.Sable C, et al. (2011). Best practices in managing transition to adulthood for adolescents with congenital heart disease: The transition process and medical and psychosocial issues: A scientific statement from the American Heart Association. Circulation, 123(13): 1454–1485.Warnes CA, et al. (2008). ACC/AHA 2008 Guidelines for the management of adults with congenital heart disease: Executive summary: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation, 118(23): 2395–2451.Webb GD, et al. (2012). Congenital heart disease. In RO Bonow et al., eds., Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine, 9th ed., pp. 1411–1464. Philadelphia: Saunders.
October 11, 2011
John Pope, MD - Pediatrics & Larry A. Latson, MD - Pediatric Cardiology
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