Friday, July 18, 2008

How Much Do You Know About Congenital Heart Disease?

Congenital heart disease is a structural heart defects that are present when a baby is born. Such malformations are usually a result of abnormal development during the fetal formation of heart structures. Congenital heart disease is a condition, which affects 8 out of 1,000 live births here in Singapore.

At present, the underlying causes of congenital heart disease are unknown. However, it is believed that certain environmental and genetic factors may play a role. For example, mothers with antenatal infections like rubella may give birth to babies with heart defects. Meanwhile, having poorly managed diabetes during pregnancy might also interfere with the development of the fetus' heart. Babies with chromosomal abnormalities, such as Down's Syndrome, are also genetically predisposed to congenital heart disease.

There are over 30 types of congenital heart defects, and the most common types are simple defects due to holes in the heart chambers or narrowing of the heart valves.

Babies born with congenital heart disease may appear in "blue", breathless and have heart murmurs. Some of these babies may have delays in motor milestones like walking or running. They may also have problems in feeding and gaining weight.

In general, babies with major heart defects are often breathless due to increased workload to the heart or lung congestion. Sucking milk, which requires strength, can tire the baby out. Breast-feeding is the ideal way to feed these babies as breast milk can help protect against infections. Nevertheless, babies who are too breathless from the heart condition, should use tube feeding through a nasogastric or oral gastric tube because this decreases the workload and allows the baby to conserve energy and take enough food to gain weight.

The current technology allows many heart defects to be detected even before the baby is born. Fetal heart scans, called echocardiograms, can locate heart defects in an unborn baby by using sound waves to create a picture of the baby's heart. However, it is impossible to pick up all cases immediately during the pregnancy. For instance, those with small defects may be undetected by the echocardiograms.

Besides highly complex ones, most cases are treatable. Even the major defects can be repaired surgically. Surgery has also made possible for many patients to survive major heart defects and live closed to normal lives in adulthood.

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