What is congenital heart disease?
Congenital heart disease in a baby or child describes a problem with the heart's structure and function due to abnormal heart development before birth. Congenital means present at birth. This is the main area of expertise for a paediatric cardiologist (childrens heart doctor).
The normal heart
The heart is a pump consisting of four chambers. There are two upper collecting chambers and two bottom-pumping chambers. The left hand-side of the heart receives oxygenated blood from the lungs and then pumps this to the body. The right-hand side of the body collects the deoxygenated (used) blood from the body and then pumps this back around into the lungs for re-oxygenation. There are one-way valves between the upper and lower chambers of the heart and at the beginning of the major arteries to the body and lungs.
There is usually a solid wall of tissue between the walls of the upper and lower chambers. The heart has its own electricity supply causing it to contract and relax (squish), thereby pumping blood to the body.
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.
Even if a complex heart condition is found, we can often help children very sucessfully and allow them to achive their full potemtial.