Congenital heart defects in children

Diagnosis

When a baby is born, it might have certain signs or symptoms that are indicative of a congenital heart defects such as heart murmurs.

Heart murmurs can be caused by altered directions of blood flow in the heart, and can be listened to with a stethoscope.

There are many tests available for diagnosis of a congenital heart defect, including:

• Pulse oximetry. A defect in the heart or lungs can cause an abnormally low amount of oxygen in the blood. A doctor uses a sensor placed on the fingertip to record the oxygen level.
• Electrocardiogram (ECG or EKG). A doctor uses this noninvasive test to evaluate for irregular heartbeats (arrhythmia). The electrical signals are recorded through patches with electrodes attached on the chest. The patches are connected to a computer with wires to show results.
• Echocardiogram. The results of this ultrasound-based test are shown as images of a beating heart and blood flow directions in the heart and its valves. A doctor might perform this test on a baby in the womb, which is called a fetal echocardiogram.
• Chest X-ray. A doctor can know if the heart and the lungs are working properly by looking at chest X-ray pictures which is used to diagnose heart failure and its symptoms, such as an enlarged heart and blood or fluid buildup in the lungs.
• Cardiac catheterization. A doctor inserts a catheter into a blood vessel in the groin area or any other part before guiding the tube to the heart. This catheter-based procedure is useful for showing if the heart is performing properly and blood is flowing in the correct directions. A catheter can also be used to treat certain cardiac diseases.
• Cardiac magnetic resonance imaging (MRI). Used to assess a congenital heart defect. An MRI of the heart shows results in clear 3D pictures of the organ and its chambers.

Treatment

Some children may have a mild congenital heart defect which needs no treatment as it will not cause any symptoms over time.

However, certain congenital heart defects are severe and need to be treated as soon as possible.

Many treatment options are available for congenital heart defects, including medications, heart procedures or surgeries, and a heart transplant.

Medications

A doctor might use medications alone or together with a cardiac procedure to treat a congenital heart defect or control its symptoms such as the following:

• Blood pressure drugs. They include angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers (ARBs) and beta blockers.
• Water pills. These diuretics prevent water retention inside the body and overworking of the heart.
• Heart rhythm drugs, or anti-arrhythmics. This kind of medications makes the heart beat regularly again.

Surgery or other procedures

A severe congenital heart defect in some children needs to be treated with a heart procedure or surgery.

There are many types of heart procedures and surgeries for a congenital heart defect, including:

• Cardiac catheterization. In this non-open-heart surgery, a doctor inserts at least one catheter into a blood vessel of the groin or any other part before delivering it to the heart in order to fix any defect that is there. This procedure can be used to treat many kinds of congenital heart defects, including a hole in the heart and a thickened area of the organ.
• Heart surgery. Some kinds of congenital heart disease present in children need to be treated with open-heart or minimally invasive surgery.
• Heart transplant. A heart transplant is an option for those who have a severe congenital heart defect that heart surgery fails to treat.
• Fetal cardiac intervention. This procedure is used to treat a severe congenital heart defect that is found in a baby in the womb, or to lower the chance of developing complications when they grows into adulthood. This rare kind of intervention is done before the mother delivers her baby and can be successfully done in a very specific environment.

In some cases, a doctor might need to perform several procedures and surgeries to treat congenital heart defects in children. The entire treatment can span a period of one’s entire life. A child who has undergone congenital heart defect surgery needs to receive a regular health checkup with a cardiologist.