Congenital heart problems are heart defects that have been present since birth. They are usually caused by a disturbance in the formation of the heart during the first 12 weeks of pregnancy. Treatment can be complex, involving delicate surgery and this is available at several private paediatric units within the UK. If you have access to private care, it may be possible to obtain local treatment, or to travel to a major centre or to London.
The most common of all congenital heart problems is hole in the heart, which links the left and right sides of the heart. Other congenital heart problems may be related to blood flow caused by abnormal development of the blood vessels or valves within the heart. Rarer types of congenital heart problems may involve the child having the wrong number of heart chambers, with problems affecting the ventricles or atria.
What causes congenital heart problems?
The causes of congenital heart problems are not fully understood, but they appear to happen more often in the children of women infected with rubella (German measles) during early pregnancy or women with poorly controlled diabetes during early pregnancy. Rarely, congenital heart problems may be inherited, linked to chromosomal abnormalities such as Down’s syndrome, or caused by exposure to drugs or X-rays during pregnancy.
How are congenital heart problems detected?
During pregnancy, a detailed ultrasound scan can be used to screen for congenital heart problems if similar problems have been detected in an older sibling or previous pregnancy. The 4D scans available privately are particularly good at showing up congenital heart problems before birth. Once born, babies with previously unrecognised congenital heart problems fail to gain sufficient weight and appear bluish around the lips and tongue due to lack of oxygen. In older children, symptoms may include shortness of breath, and in severe cases the lower legs may appear swollen.
If a congenital heart problem is suspected, your child may need to undergo specific tests such as blood tests, X-rays, electrocardiogram (ECG) or ultrasound. If the problem is complex, cardiac catheterisation – where a thin wire is inserted through the blood vessels from the groin to the heart for detailed examination and sampling – may be used.
What treatments are available for congenital heart problems?
Very minor congenital heart problems may not need treatment and may resolve themselves as your child grows. Some children have a tiny hole in the heart that seals before they reach adolescence. More severe problems can affect your child’s general health, growth and development, so effective and timely treatment becomes necessary.
Treatment for congenital heart problems usually involves surgery and/or drug treatment. Drug treatment is usually needed in children who are suffering symptoms, and may include diuretics (drugs that promote urine formation) to clear any build up of fluid within the body and reduce the strain on the heart. Oxygen may also be given. In small babies, feeding assistance may be given via a tube through the nose and into the stomach.
Surgery is the only way to permanently and immediately cure congenital heart problems such as hole in the heart or a narrow blood vessel that needs widening. This type of heart surgery is relatively common with high success rates and low risk. More complex or larger congenital heart problems may be improved but may not always be curable with surgery. Several operations may be needed. If the problem cannot be corrected with surgery, a heart and lung transplant may be considered as a last resort.