Congenital heart defects are the most common type of birth defect, affecting approximately 1 in every 100 babies born in the U.S. Out of the about 40,000 babies born with a heart defect each year, approximately 7,200 have a critical congenital heart defect which requires surgery or a procedure in their first year of life. However, as detection and treatments of congenital heart disease rapidly advance, outcomes for children with congenital heart defects are improving.
"Survival for children with congenital heart disease has improved incredibly," says Michael Day, M.D., a pediatric cardiologist at Pediatric Heart Specialists, The Heart Center at Children's Health℠. "It is a real success story in medicine over the last quarter-century. There are so many opportunities for these kids to live a full and healthy life."
What is congenital heart disease?
Congenital heart disease is an abnormality or structural problem of the heart or circulatory system that an infant is born with. Congenital heart defects can involve the walls of the heart, the valves and the arteries, or veins near the heart. These defects occur during fetal development, and some can be detected while fetuses are still in the womb with ultrasound and fetal echocardiogram. Other types of heart defects are detected at birth if a baby is born with symptoms like blue coloring or through a simple screening.
"By measuring oxygen saturation in a baby's blood, we can get another vital sign that a baby has a congenital heart disease that is not immediately obvious," explains Dr. Day.
When prenatal or early screenings catch a congenital heart defect, physicians can act quickly to keep the baby safe and healthy.
How common is congenital heart disease?
Congenital heart defects affect close to 1% of births each year in the U.S. – that's close to 40,000 children born with a congenital heart defect annually.
"While congenital heart defects are not common, they're not that rare either," says Dr. Day. "Of all the congenital defects and disorders that children are both with, congenital heart disease is the most common."
Because diagnostics and treatments for heart defects have greatly improved over the years, more and more children are growing up to live a long, healthy life. There are approximately 3 million children and adults living with congenital heart disease.
How many types of congenital heart defects are there?
There are many different types of congenital heart defects. Congenital heart defects can be broken down into common categories, such as: cyanotic congenital heart disease, ductal dependent congenital heart disease, critical congenital heart disease, and other acyanotic or less acute congenital heart defects.
Cyanotic congenital heart disease
These types of congenital heart defects cause a baby to appear blue at birth (called cyanosis). The blue color occurs because deoxygenated blood flows out into the body. Common cyanotic heart defects include:
- Tetralogy of Fallot
- Transposition of great arteries
- Tricuspid atresia
- Total anomalous pulmonary venous return
- Truncus arteriosus
- Hypoplastic left heart syndrome
All of these conditions require surgery within the first year of life. They may even require multiple surgeries to allow for healthy heart function.
Ductal dependent congenital heart disease
All babies are born with a small hole in the heart called ductus arteriosus. During the first few days of life, the hole usually closes on its own. However, in some children the hole doesn't close on its own (called patent ductus arteriosus, or PDA). Children with a ductal dependent congenital heart defect will experience cardiovascular collapse when the PDA closes. Prostaglandins, a type of medicine, help keep the ductus arteriosus open until children can undergo surgery or catheterization to fix their congenital heart defect.
Critical congenital heart disease
About 25% of all congenital heart defects are considered critical, meaning they will require surgery or a procedure within a baby's first year of life.
Hypoplastic left heart syndrome is the most involved and complex of all congenital heart diseases. "It is among the most severe but treatable congenital heart defects," says Dr. Day.
Acyanotic or less acute congenital heart defects
These heart defects may be less dangerous, though they can still affect a child's health. They can include ventricular septal defects, atrial septal defects and minor valve defects like bicuspid aortic valves. These types of defects may heal on their own or with limited interventions, and require no surgery within a baby's first year of life.
What are the most common congenital heart defects?
The most common congenital heart defect is a bicuspid aortic valve (BAV). The aortic valve opens and shuts to allow blood flow from the heart to the aorta. The aorta is the major blood vessel bringing oxygen-rich blood to the body. This defect occurs when there are only two leaflets instead of three within the valve. About 2% of all people have a bicuspid aortic valve, but they may not know it.
"It varies widely how severe this defect can be," says Dr. Day. "For some, it doesn't leak or block blood flow, and the patient may never know they have this type of defect. In others, the valve can be really thick and doesn't open well. In those cases, a baby may need catheterization on the first day of life."
Other common heart defects in infants include:
- Ventricular septal defects (VSD): Occurs when a hole is present in the heart's lower septum (the divide between the left and right side)
- Atrial septal defects (ASD): Occur when a hole is present in the heart's upper septum (the divide between the left and right sides of the heart)
Thanks to advances in detection and treatment, there is hope for a healthy childhood for almost all children with a congenital heart defect.
"I tell parents they are raising a child, not a condition," says Dr. Day. "My job is to remove any obstacles between their child and living as healthy and normal a life as possible. Children really can thrive and live a very healthy life with congenital heart disease."
Congenital heart defects are the most common type of birth defect, affecting about 1 in 100 babies in the U.S. Thanks to advances to treatment, the future for children living with CHD is encouraging. Learn more from @Childrens.
The Heart Center at Children's Health, including Pediatric Heart Specialists, provides expert diagnosis and effective treatment for the full spectrum of pediatric heart conditions so that children can have healthy childhoods. Learn more about how we care for congenital heart defects at the Heart Center.
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