Heart Problems

What causes congenital heart disease?

The exact cause of congenital heart disease in children is often not found. Most paediatric cardiology problems in children are congenital in nature (something people are born with) due to a problem in the way the heart was put together during the very early stages of pregnancy.

The underlying reasons for this are likely to be due to multifactorial and may include a genetic basis, environmental factors or infection. A positive family history of heart problems in children, or symptoms and signs such as a murmur, cyanosis or breathlessness are often common reason to seek review.

Some medications taken during pregnancy such as epilepsy drugs or maternal health conditions such as diabetes have been shown to cause a small increase in the risk of having a baby with a cardiac problem. Babies or children with a syndrome, or proven chromosomal problem, are often at much higher risk of having a coexisting heart problem eg. Downs Syndrome (Trisomy 21) where up-to 60% of patients have some form of heart disease.

A smaller group of heart problems in children are due to underlying muscle problems with the heart muscle itself, due an acquired infection in childhood or due to electrical irregularity in the way the heart contracts as it pumps blood around the body.

As parents, we often feel guilt when are children are unwell. The likelihood that a heart problem was caused directly by a parent’s action during pregnancy or early life is very rare.

Is it always awful news?

Confirming that a child has a heart problem is upsetting for any parent. It is important to understand that there is a huge variation in the severity, impact and management of lesions. A hole-in-the-heart may be a tiny defect that whilst producing an extra heart sound (or murmur), has no clinical impact upon the child’s life, long-term health or future prospects.

Other, larger holes may require closer supervision in the clinic alone, whereas very big defects may cause the baby or child to struggle with feeds and require child heart surgery for repair.

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An important aspect of the work of a skilled paediatric cardiologist (baby heart doctor) is to stratify the risks associated with each lesion and individualise patient care. If an operation is necessary, we will time the procedure to minimise the assocaited surgical risks. Sometimes, waiting a few months for the child to grow and gain a little weight will make operting easier.

What treatment is available?

Treatment depends on the type and severity of the condition. Some children, such as those with an innocent murmur or mild valve stenosis will not require any treatment, while others may need medicines or interventional procedures involving cardiac catheterisation or child heart surgery.

What happens next?

All children with congenital heart disease (even when corrected) will need regular check-ups, usually continuing into adulthood.

These will usually involve repeat Echo and ECG scans and sometimes cardiac magnetic resonance imaging (MRI) scans. The aim of these check-ups is to monitor your child’s heart function so that any future heart problems are diagnosed and treated quickly.