A congenital heart defect (CHD) is a malformation of the heart existing at birth.
Results from the failure of the heart or major blood vessel to mature normally during gestation.
There are many different types of CHD. Common congenital defects can be divided into following categories:
Obstruction to blood flow - any structure of heart valves or major blood vessels that are abnormal can block the flow of blood e.g.
congenital aortic stenosis, mitral valve stenosis, pulmonary valve atresia/stenosis, Absent Pulmonary Valve Syndrome, Coarctation of aorta, interrupted aortic arch, etc.
Left to right shunt - blood flows from left side of heart into right side of heart, resulting in overloading of right side of heart and therefore too much blood flowing into lungs e.g.
Right to left shunts (cyanotic defects with decreased flow to lung)
Tetralogy of Fallot, Pulmonary Atresia with intact VSD, Pulmonary atresia with VSD, Tricuspid Atresia, Ebstein's Anomaly
Complex Cyanotic Defects ("mixing defects")
Double Outlet Right Ventricle, Univentricular heart, Total Anomalous Pulmonary venous connection, Truncus Arteriosus, Hypoplastic Left Heart Syndrome
Medical and surgical treatments now offer these children an opportunity to grow and mature into adult life, an option that once was not available in the past.
How is it diagnosed?
Accurate diagnosis is necessary for the doctor to give appropriate treatment.
Antenatal (before a child is born) diagnosis: a fetal cardiologist detects CHD during regular check-ups before the child is born.
If this is the case, plan of management and appropriate treatment can be fully discussed and planned with the parents before labour
Some of the conditions are diagnosed soon after birth due to abnormality in routine tests (e.g. oxygen saturation measurement, heart murmurs)
Other defects may only be diagnosed later on in the child's life.
Common tests used for diagnosis of CHD:
Electrocardiogram (ECG)
2D ECHO Cardiogram
Cardiac Catherisation
Cardiac Magnetic Resonance Imaging (CMR)
What is the treatment?
In some cases, CHD may be life-threatening and must be surgically corrected
hours after birth - Total Anomalous Pulmonary Venous Drainage
within a few days - Transposition of Great Arteries
In other cases, the operation can be carried out after a few months or years. Sometimes, it is necessary to repair the defect in stages.
Putting in a temporary shunt to redirect the blood flow so that your child can grow bigger and stronger before carrying out a definitive procedure.
