Some heart defects are detected or at least suspected during ultrasound examinations during pregnancy. Others are noticed during the first examination immediately after birth. Still others are diagnosed later by symptoms or even by chance – some not until adulthood.
How are congenital heart defects diagnosed?
With the current state of diagnostic technology, more complex functional disorders of the cardiovascular system can be detected with high accuracy by ultrasound during pregnancy. Final confirmation of the diagnosis is made after birth or if symptoms develop, again by cardiac ultrasound or cardiac catheterization.
In this procedure, plastic catheters are advanced through the groin via the vascular system to the heart, where pressure measurements and the use of X-ray contrast agents can precisely define the type and severity of the heart defect.
Complications of congenital heart defects
If the neonatal period is survived, there is a threat of complications depending on the type and severity of the congenital heart defect and the abnormal circulatory conditions that develop:
- Myocardial insufficiency
- Stress on the pulmonary circulation with pulmonary hypertension
- Oxygen deficiency of the organs
- Thickening of the blood as a result of increased red blood cell production.
The increase in red blood cells, which is the response of the organism in the absence of oxygen to ensure increased oxygen-carrying capacity of the blood, in turn means an increased risk of vascular thrombosis and stroke. Even with timely, successful heart surgery in early childhood, the life expectancy of children with at least severe congenital heart defects is significantly reduced.
Treatment of congenital heart defects by cardiac surgery.
The treatment of congenital heart defects is primarily the domain of cardiac surgery. In keeping with the variety of forms of heart defects, a wide range of different surgical techniques also exists. If there is a realistic chance of normalizing blood flow and cardiovascular conditions by cardiac surgery and thus prolonging the child’s life or at least alleviating discomfort, the timing of major cardiac surgery is especially crucial. In individual cases, surgery must be performed immediately after birth as a life-saving emergency measure.
Treating congenital heart defects in children
In other cases, relief surgery may be considered in early infancy, which may not normalize the circulatory conditions but can at least stabilize them sufficiently to attempt definitive correction of the abnormality in one or more follow-up surgeries. Ideally, major corrective heart surgery, if possible, should be performed at the age when the lowest possible risk and best long-term results after surgery can be expected.
In addition to cardiac surgery, an attempt can be made at any stage of the disease to stabilize the cardiovascular conditions by medication, although the chances of success in this regard are rather low. Today, nine out of ten patients reach adulthood. However, they are usually chronically ill and – also due to secondary diseases – usually have a limited ability to perform and work and a shorter life expectancy.
Congenital heart defects: prevention and avoidance
Genetic congenital damage to the heart cannot be prevented. If a child has already been born with a heart defect, the extent to which there is a risk of recurrence for another child can be assessed by hereditary specialists on a case-by-case basis. To prevent damage that may occur in the unborn child during pregnancy due to external influences, all additional risk factors such as medication or infections should be eliminated as far as possible during this period in close consultation with the physician caring for the child.
