Congenital Heart Disease

What is a congenital heart defect?

Congenital means 'from birth'. A congenital heart defect is an abnormality of the heart that has been present from birth.

How common are these defects?

At least 8 out of every 1000 babies born each year have a heart defect. About half of these babies have a minor defect and will not need any treatment but the rest will need medical treatment or surgery.

What caused the defect?

In most cases the cause is unknown, although some defects are found to be genetic. Some abnormalities are as a result of the mother's health during pregnancy, ie diabetes or systemic lupus erythematosus (SLE), an auto immune disease.

Drugs taken in pregnancy - such as some of those prescribed for epilepsy and also illegal drugs or alcohol - are known to cause certain heart defects. Smoking is also thought to be a factor. This does not mean that those suffering from diabetes or epilepsy cannot have healthy children, they just need careful attention during their pregnancies.

How is a congenital heart defect discovered?

Many heart defects are picked up when the mother has a routine ultrasound scan during pregnancy. If there is a suspicion that there may be something wrong with the developing baby's heart, the doctors will recommend the woman has a foetal echocardiogram at about 16-20 weeks of pregnancy. This shows the baby's heart in more detail than in the ultrasound scan. If the woman has already had a baby with a heart defect, or if she or her partner has had a defect, the doctors will advise having a foetal echocardiogram because of the slightly increased risk.

Some defects are not discovered until after birth. Most defects are discovered in early life and treated, if necessary. However, some are not discovered until adulthood.

What happens after a heart defect is found?

A cardiologist will carry out a full medical examination, arrange for an electrocardiogram (ECG), a chest x-ray, an echocardiograrn and possibly blood tests. He will then be in a position to discuss with the patient what sort of treatment, if any, is required.

Some people may need more than one heart operation. If an artificial valve or plastic tube is inserted in the heart as a child, this will need replacing as they outgrow it. This can occur several times. Sometimes just ageing and growth can reduce the effectiveness of the first surgery.

Regular follow-up is needed, even if the patient has had successful surgery and is leading a very normal life, because changes may occur within the heart. Cardiac surgery is relatively new and nobody knows what long-term effects there may be and it is important, for future generations, that records are kept.