Cause of congenital heart defects often unknown
A cousin posted a photo on Facebook of a healthy looking, roughly three-year-old boy holding a sign saying that he was about to undergo his third open heart surgery and wanted 1,000 likes. I would have thought he’d want to get well, receive a lot of toys and start a GoFundMe page to pay for it all.
Some congenital heart defects are simple and don’t need treatment. This boy, named Ryan, isn’t that lucky. He was born with a Critical Congenital Heart Defect of which there are several conditions to choose from. According to KidsHealth.com, about one in one hundred infants are born with a heart defect. Of those about 7,200 will be critical.
“Congenital heart defects happen because of incomplete or abnormal development of the fetus’ heart during the very early weeks of pregnancy. Some are known to be associated with genetic disorders, such as Down syndrome. But the cause of most congenital heart defects is unknown. While they can’t be prevented, there are many treatments for the defects and related health problems,” Kids Health says.
Some heart defects are diagnosed during pregnancy. A fetal echocardiogram which is a special ultrasound can create pictures of the fetus’ developing heart. However, not all defects can be detected during pregnancy, and are either detected after the baby’s birth or as the child ages.
To understand heart defects it helps to know how the heart works. The Mayo Clinic explains: “The heart is divided into four hollow chambers, two on the right and two on the left. In performing its basic job — pumping blood throughout the body — the heart uses its left and right sides for different tasks.
“The right side of the heart moves blood to the lungs through vessels called pulmonary arteries. In the lungs, blood picks up oxygen then returns to the heart’s left side through the pulmonary veins. The left side of the heart then pumps the blood through the aorta and out to the rest of the body.”
An infant’s heart begins to take shape and starts beating during the first six weeks of pregnancy. This is when the major blood vessels that run to and from the heart begin to form and, in some cases, develop heart defects. Studies have been inconclusive as to why these defects occur, but researchers believe that genetics, certain medical conditions, some medications and factors such as smoking and drinking alcohol play a role.
“Having rubella (German measles) during pregnancy can cause problems in your baby’s heart development. Your doctor can test you for immunity to this viral disease before pregnancy and vaccinate you against it if you aren’t immune,” Mayo says.
If you have diabetes it’s crucial to have it under control before conception as the disease may interfere with the development of the baby’s heart. However, gestational diabetes typically does not increase risk of heart defects.
Before you decide to get pregnant, meet with your primary healthcare professional and talk about all the drugs and supplements you’re taking. Some medications, thalidomide (Thalomid), the acne medication isotretinoin (Amnesteem, Claravis, Sotret), lithium and anti-seizure medications containing valproate are known to increase heart defects.
Your PCP will most likely advise you to take a multivitamin with at least 400 mgs of folic acid which has been proven to reduce birth defects in the brain and spinal cord and may do so for heart defects as well.
Signs and symptoms usually become evident soon after birth. “Because congenital defects often compromise the heart’s ability to pump blood and to deliver oxygen to the tissues of the body, they often produce telltale signs such as a bluish tinge or color (cyanosis) to the lips, tongue, and/or nailbeds,” KidsHealth explains.
Other indications could include rapid breathing, flared nostrils, grunting when breathing, swelling in the legs, abdomen or areas around the eyes, shortness of breath during feedings and poor weight gain.
Children like Ryan will have to be mindful of their heart problems for the rest of their lives. He may have some emotional issues because of his limitations and will always have risks for heart tissue infections, heart failure or heart valve problems.
Kathy Hubbard is a member of Bonner General Health Foundation Advisory Council. She can be reached at 264-4029 or firstname.lastname@example.org.