I'm Dr. Jonathan Johnson,
a pediatric cardiologist at Mayo Clinic.
In this video, we'll cover
the basics of
congenital heart disease in children.
Whether you're looking for answers about
your own child's health
or that of someone you love,
we're here to provide you with
the best information available.
Congenital heart disease,
also called a defect,
refers to one or more problems with
the heart structure that
are present at birth.
These abnormalities occur when
the heart or blood vessels
don't form correctly in utero.
At least eight out of
every 1000 infants born in the US
each year have a heart defect.
That's 40,000 infants
every year in this country.
Congenital means that the problem was
existing or present at birth.
But sometimes defects can be
identified even before birth.
Sometimes they don't show signs
until children are older
or even into adulthood.
Congenital heart disease can involve
abnormalities in any of these structures,
including the arteries, valves,
chambers or the wall
separating the chambers of the heart.
These defects, depending
on the severity and type,
can affect the proper flow of blood and
oxygen to the lungs and the body.
There may be associated heart rhythm problems
or the defects may cause
the heart to work harder than it should.
Some, like a small hole in the heart,
can be very simple
and cause very few problems
with the child's development and health.
But other cases, like
when babies are born with parts
of their hearts missing,
require immediate care.
Some congenital heart defects
cause no signs or symptoms.
Sometimes indications may only
appear later in life.
And symptoms can also return
years after treatments.
Symptoms for more serious forms of
congenital heart defects may become
evident in the first few days
or months after birth.
You may notice a pale gray or blue skin color
called cyanosis.
Babies use a lot of calories
and effort when they're eating.
Thus, eating often brings
out symptoms of heart failure,
such as rapid breathing
or shortness of breath.
Poor weight gain caused by the heart defect
or by difficulty feeding due to symptoms
while feeding, can be
a sign of congenital heart disease.
Some less serious conditions may not be
diagnosed until later in childhood.
Signs in older children can include
becoming easily short of breath,
easily tiring, or fainting
during exercise or activity.
They may also have swelling in
the hands, the ankles and the feet.
Your pediatrician may also
hear an abnormal heartbeat
or abnormal heart sound called
a murmur during a checkup.
Most of these murmurs are actually innocent,
but it's important to check them out.
Some congenital heart defects can be seen on
an ultrasound while the
baby is still in the womb.
In certain extreme cases,
treatment may be advised
before a baby is even born.
This may be done to correct the problem or
reduce complications as
the child continues to develop.
In order to determine if
your child has congenital heart disease,
your doctor will do a physical exam
and listen to their heart with a stethoscope.
They'll ask about the child's symptoms and
their medical history and
any history of
heart problems in their families.
Then, if needed, they may advise other tests.
A pulse oximetry measurement may be
performed to estimate the amount
of oxygen in the blood.
This is a simple test
done with a finger sensor.
An electrocardiogram, or ECG,
can be conducted to record
the electrical signals in their heart.
This is non-invasive and painless.
Your doctor might want to schedule
an echocardiogram, which uses
sound waves to create an image of the heart.
An echocardiogram allows the doctor
to see the heart muscle and valves
in motion and diagnosis
most forms of congenital heart disease.
They might be given a chest x-ray,
which could reveal issues in the size and
the shape of the heart. In some conditions,
your doctor may order a cardiac MRI,
which uses large magnets to
take images of the heart in motion.
Your doctor may ask
for a cardiac catheterization.
For this, a catheter or
a small plastic tube placed via
a needle into an artery or vein in your leg,
arm or neck, and advanced
into the different chambers of your heart.
This way, doctors can
check the blood flow and
the pressure inside
the heart chambers themselves.
Today, doctors use
cardiac catheterization methods to close
certain kinds of holes in
the heart or to place expandable valves.
If your child has congenital heart disease,
they will need care throughout their life.
However, not every child
with congenital heart disease requires
active treatment and the defect
may pose no harm to their health.
Some defects, like a small hole in the heart,
may resolve on their own.
Some conditions can be
treated with medications.
These can include blood pressure medications,
heart rhythm medications, and
medications to help you get rid of
excess water in your body.
More serious forms of
congenital heart diseases
may require surgery or
other procedures. This may be
open-heart or a less invasive type of surgery.
And, in cases where repairs aren't an option,
a heart transplant may be needed.
Doctors try to limit
these interventions as much as
possible and only recommend
them if absolutely needed.
It is important to familiarize
yourself with your child's condition.
Keep an eye out for
worsening or new symptoms,
and be aware of any lifestyle adjustments
recommended by your cardiologist.
As patients get older, it is crucial
that they continue care with
an adult-focused cardiologist
with training in congenital heart disease.
Finding out your child has a heart defect is
scary and can be for them
too, if they're old enough to understand it.
But no matter when the diagnosis is made,
progress in research and treatment have
greatly increased not only survival rates,
but overall quality of
life for patients living with
congenital heart disease.
There's a great deal of hope for
children with congenital heart disease.
And we expect all
to have happy childhoods that
lead to long, full, productive lives.
If you want to learn even more
about congenital heart disease in children,
watch our other related videos
or visit mayoclinic.org.
We wish you well.