Heart disease health centre

Congenital heart disease

Congenital heart disease is a type of defect or malformation in one or more structures of the heart or blood vessels that occurs before birth.

These defects occur while the foetus is developing in the uterus and affects an estimated six in every 1,000 children.

Congenital heart defects may produce symptoms at birth, during childhood, and sometimes not until adulthood.

What causes congenital heart disease?

In the majority of people, the cause of congenital heart disease is unknown. However, there are some factors that are associated with an increased chance of getting congenital heart disease. These risk factors include:

• Genetic or chromosomal abnormalities in the child such as Down’s syndrome
• Taking certain medications or alcohol or drug abuse during pregnancy
• Maternal viral infection, such as rubella (German measles) in the first trimester of pregnancy
• Having type 1 diabetes or type 2 diabetes (not gestational diabetes)

The risk of having a child with congenital heart disease is higher if a parent or sibling has a congenital heart defect - the risk increases from eight to 16 in 1,000.

What types of congenital heart problems are there?

The most common congenital heart problems include:

• Heart valve defects. Narrowing or stenosis of the valves or complete closure that impedes or prevents forward blood flow. Other valve defects include leaky valves that don't close properly and allow blood to leak backwards.
• Defects in the walls between the atria and ventricles of the heart (atrial andventricular septal defects). These defects allow abnormal mixing of oxygenated and unoxygenated blood between the right and left sides of the heart.
• Heart muscle abnormalities that can lead toheart failure.

What are the symptoms of congenital heart disease in adults?

Congenital heart disease may be diagnosed before birth, right after birth, during childhood, or not until adulthood. It is possible to have a defect and no symptoms at all. In adults, if symptoms are present, they may include:

• Shortness of breath.
• Limited ability to exercise.

How is congenital heart disease diagnosed?

Congenital heart disease is often first detected when your GP hears an abnormal heart sound or heart murmur when listening to your heart.

Depending on the type of murmur your GP hears, they may order further testing such as:

• Echocardiogram or transoesophageal echocardiogram (TEE)
• Cardiac catheterisation
• Chest X-ray
• Electrocardiogram (ECG or EKG)
• MRI

How is congenital heart disease treated?

Treatment is based on the severity of the congenital heart disease. Some mild heart defects do not require any treatment. Others can be treated with medications, procedures, or surgery. Most adults with congenital heart disease should be monitored by a heart specialist and take precautions to prevent endocarditis (a serious infection of the heart valves) throughout their life.

How can I prevent endocarditis?

Those with congenital heart disease are at risk of getting endocarditis, even if the heart was repaired or replaced through surgery. To protect yourself:

• Tell all doctors and dentists you have congenital heart disease. You may want to carry a card with this information.
• • Seek medical advice if you have symptoms of an infection ( sore throat, general body aches, high temperature).
• Take good care of your teeth and gums to prevent infections. See your dentist for regular visits.
• • Follow your doctor’s recommendations before you undergo any procedure that may cause bleeding, such as: any dental work (even a basic teeth cleaning), invasive tests (any test that may involve blood or bleeding), and most major or minor surgery. Check with your doctor about whether you need to take antibiotics.