Congenital heart disease is a birth defect, occurring when a baby is born with a heart that has not formed properly. There are many different types of congenital heart disease. Some are uncomplicated and do not need any treatment, while some can be very serious and require many surgical procedures over several years. Show What are the types of congenital heart disease?Congenital heart disease is the most common birth defect in Australia and affects about 1 in 100 babies. A baby is born with the condition when the heart or the large blood vessels around the heart do not form properly. This can affect blood flow to the heart and the rest of the body. There are many different types of congenital heart disease: A hole in the heart (atrial or ventricular septal defect): Babies can be born with a hole in the wall between the heart chambers or in one of the blood vessels. This can mean not enough oxygen is pumped around the body. Problems with the blood vessels: Sometimes the large blood vessels entering the heart are not formed properly and are too narrow, or they are in the wrong position. This affects how the heart works. Problems with heart valves: If a valve is too narrow (called aortic stenosis), the heart has to work much harder to pump blood through. Sometimes the valve allows blood to leak backwards, putting an extra load on the heart. Often babies are born with a combination of different defects, such as a hole in the heart, a valve problem, thickening of the heart muscle and problems with the blood vessels. What are the symptoms of congenital heart disease?Sometimes congenital heart disease does not cause any symptoms. But it may be suspected in a newborn if:
In older children, the symptoms of congenital heart disease include:
How is congenital heart disease diagnosed?Heart defects in a baby are usually diagnosed during pregnancy or soon after birth. The doctor will do an examination and may order a range of heart tests including an echocardiogram, electrocardiogram, chest x-ray or MRI, tests to measure the oxygen in the blood, or catheterisation. How is congenital heart disease treated?A baby or child with congenital heart disease will be treated by a paediatric cardiologist (a heart doctor who specialises in children) and if necessary a paediatric heart surgeon. They may need to keep seeing specialists for the rest of their life. Some congenital heart problems do not need any treatment. For example, small holes in the heart usually fix themselves as the child grows up. Sometimes medicines may be used to improve how the heart works or to lower blood pressure. Some heart defects can be fixed using cardiac catheterisation, when a thin tube is threaded through the heart and tiny instruments are used to repair the defect. In more serious cases, heart surgery may be needed. Sometimes a baby can have heart surgery while they are still in the womb. If the defects are very serious, a heart transplant may be the only option. When should I seek help?If you have congenital heart disease, it is important to seek medical attention if you develop an infection or are planning to get pregnant. Living with congenital heart diseaseMany babies born with congenital heart disease go on to lead normal lives. However, they will probably need to keep seeing a cardiologist, who will monitor their condition. They may also need treatment from time to time over the years. Children may need to avoid some strenuous physical activities as they grow up. Your doctor will tell you what they can and cannot do. It is important for people with congenital heart disease to avoid infections, since this can be very dangerous for their heart. See a doctor immediately if your child develops any sign of infection, such as a chest infection. Ensure they know how important it is to keep their teeth and mouth clean, because bacteria can spread from the mouth to the heart. It is also very important for your child to have all their vaccinations. HeartKids provides support and information for children, teens and adults with congenital heart disease as well as those who have acquired a heart condition during childhood. You can call their helpline on 1800 432 785. Medically Reviewed by James Beckerman, MD, FACC on August 22, 2020 Heart failure affects nearly 6 million Americans. Roughly 670,000 people are diagnosed with heart failure each year. It’s the main reason people older than 65 go into the hospital. Heart failure doesn’t mean the heart has stopped working. Rather, it means that the heart works less efficiently than normal. Due to various possible causes, blood moves through the heart and body at a slower rate, and pressure in the heart increases. As a result, the heart can’t pump enough oxygen and nutrients to meet the body's needs. The chambers of the heart may respond by stretching to hold more blood to pump through the body or by becoming stiff and thickened. This helps to keep the blood moving, but the heart muscle walls may eventually weaken and become unable to pump as efficiently. The kidneys may respond by causing the body to retain fluid (water) and salt. If fluid builds up in the arms, legs, ankles, feet, lungs, or other organs, the body becomes congested. Congestive heart failure is the term used to describe the condition. Heart failure is caused by many conditions that damage the heart muscle, including: You may not have any symptoms of heart failure, or the symptoms may be mild to severe. Symptoms can be constant or can come and go. The symptoms can include: If you have heart failure, you may have one or all of these symptoms or you may have none of them. They may or may not indicate a weakened heart. Systolic dysfunction (or systolic heart failure) happens when the heart muscle doesn't contract with enough force, so there is less oxygen-rich blood pumped throughout the body. Diastolic dysfunction (or diastolic heart failure) happens when the heart contracts normally, but the ventricles don’t relax properly or are stiff, and less blood enters the heart during normal filling. A calculation done during an echocardiogram, called the ejection fraction (EF), is used to measure how well your heart pumps with each beat to help determine if systolic or diastolic dysfunction is present. Your doctor can discuss which condition you have. Your doctor will ask you many questions about your symptoms and medical history. You’ll be asked about any conditions you have that may cause heart failure (such as coronary artery disease, angina, diabetes, heart valve disease, and high blood pressure). You’ll be asked if you smoke, take drugs, drink alcohol (and how much you drink), and about what drugs you take. You’ll also get a complete physical exam. Your doctor will listen to your heart and look for signs of heart failure as well as other illnesses that may have caused your heart muscle to weaken or stiffen. Your doctor may also order other tests to determine the cause and severity of your heart failure. These include: Other tests may be ordered, depending on your condition. There are more treatment options available for heart failure than ever before. Tight control over your medications and lifestyle, coupled with careful monitoring, are the first steps. As the condition progresses, doctors specializing in the treatment of heart failure can offer more advanced treatment options. The goals of treating heart failure are to try to keep it from getting worse (lowering the risk of death and the need for hospitalization), to ease symptoms, and to improve quality of life. Some common types of medicines used to treat it are: Your doctor may also recommend a program called cardiac rehabilitation to help you exercise safely and keep up a heart-healthy lifestyle. It usually includes workouts that are designed just for you, education, and tips to lower your chance of heart trouble, like quitting smoking or changing your diet. Cardiac rehab also offers emotional support. You can meet people like you who can help you stay on track. In 2001, the American Heart Association (AHA) and American College of Cardiology (ACC) described the "Stages of Heart Failure." These stages, which were updated in 2005, will help you understand that heart failure is often a progressive condition and can worsen over time. They will also help you understand why a new medication was added to your treatment plan and may help you understand why lifestyle changes and other treatments are needed. The stages classified by the AHA and ACC are different than the New York Heart Association (NYHA) clinical classifications of heart failure that rank patients as class I-II-III-IV, according to the degree of symptoms or functional limits. Ask your doctor what stage of heart failure you are in. Check the table below to see if your therapy matches what the AHA and ACC recommend. Note that you cannot go backward in stage, only forward. The table below outlines a basic plan of care that may or may not apply to you, based on the cause of your heart failure and your special needs. Ask your doctor to explain therapies that are listed if you do not understand why you are or are not receiving them.
The New York Heart Association (NYHA) clinical classifications of heart failure rank people as class I-II-III-IV, according to the degree of symptoms or functional limits. You can ask your doctor if you want to know what stage of heart failure you’re in.
In an effort to prevent further heart damage: There are several different types of medications that are best avoided in those with heart failure including:
If you’re taking any of these drugs, discuss them with your doctor. It’s important to know the names of your medications, what they’re used for, and how often and at what times you take them. Keep a list of your medications and bring them with you to each of your doctor visits. Never stop taking your medications without discussing it with your doctor. Even if you have no symptoms, your medications decrease the work of your heart so that it can pump more effectively. There are several things you can do to improve your quality of life if you have heart failure. Among them:
In heart failure, surgery may sometimes prevent further damage to the heart and improve the heart's function. Procedures used include: Heart failure management is a team effort, and you are the key player on the team. Your heart doctor will prescribe your medications and manage other medical problems. Other team members -- including nurses, dietitians, pharmacists, exercise specialists, and social workers -- will help you achieve success. But it is up to YOU to take your medications, make dietary changes, live a healthy lifestyle, keep your follow-up appointments, and be an active member of the team. If you notice anything unusual, don't wait until your next appointment to discuss it with your doctor. Call them right away if you have: Nausea or poor appetite Go to the ER or call 911 if you have: With the right care, heart failure may not stop you from doing the things you enjoy. Your prognosis or outlook for the future will depend on how well your heart muscle is functioning, your symptoms, and how well you respond to and follow your treatment plan. Everyone with a long-term illness, such as heart failure, should discuss their desires for extended medical care with their doctor and family. An "advance directive" or "living will" is one way to let everyone know your wishes. A living will expresses your desires about the use of medical treatments to prolong your life. This document is prepared while you are fully competent in case you are unable to make these decisions at a later time. |