Congenital heart defect

What is it?

Congenital heart defects are the result of a disturbance in the development of the heart during the earliest embryonic period (2 to 12 weeks after conception). Some congenital heart defects can be hidden by the body for a long time and therefore only cause symptoms later in life.

Congenital heart defects can occur with a syndrome (e.g. Down syndrome), but can also occur on their own.

The following congenital heart defects are the most common:

Bicuspid aortic valve

This is a valve between the heart and large body artery or aorta that has two valve flap instead of three. This increases the risk of rapid wear and tear, valve leaks and/or valve constriction. There is also an increased risk of an aortic aneurysm.

Patent foramen ovale

This is a remaining tunnel that connects the right and left atria. This passage is crucial in the baby's developmental phase and closes after birth. This closureis incomplete in approximately 25% of people. On rare occasions, this passage can allow a clot to pass through, which can lead to a stroke.

• Atrium septum defect

This is a gap between the two atria. See figure.

• Ventricular septum defect

This is a gap between the two chambers (ventricles). This abnormal connection causes overtaxation of the heart and can weaken it. This is how heart failure develops.

• Coarctatio

Coarctation refers to the narrowing or constriction of the body’s main artery (the aorta).

Symptoms

Usually, congenital heart diseases are detected and treated during childhood. At a later age, the only symptom a physician can hear is a heart 'murmur'.

Other common symptoms include:

• fatigue
• shortness of breath
• heart palpitations
• fainting
• heart rhythm disturbances

How is the diagnosis determined?

• Electrocardiogram
• Ultrasound via the chest (transthoracic ultrasound)
• Ultrasound through the oesophagus (transoesophageal ultrasound)
• CT or MRI of the heart
• Diagnostic cardiac catheterisation

Treatment

There are both surgical and non-surgical techniques for the treatment of a congenital heart defect. Because congenital defects are different in almost every patient, individual treatment is always ‘customised'. It is obviously best for you to be guided by the attending cardiologist.

A commonly used non-surgical technique for closing 'holes' is the placement of an 'umbrella'. The defect is approached with a catheter, after which a split disc can be unfolded to close the hole.

Latest publication date: 14/05/2024
Supervising author: Dr Provenier Frank