Congenital heart defects are abnormalities in the structure or function of a baby’s heart that are present at birth. The main goal of Congenital Heart Defects Awareness Week, Feb. 7-14, is to increase awareness of and education about CHDs.
Congenital heart defects are the most common birth defect affecting about one out of 110 babies. In fact, there are two to three million people in the U.S. right now who are living with a CHD. One out of four babies born with a CHD has what is known as a critical congenital heart defect, which means that this baby will require a lifesaving surgery or procedure right away.
A CHD may affect any part of the heart including one of its four chambers, the heart valves, or blood vessels that enter or exit the heart. The cause of a CHD is most often unknown but may be impacted by genetic factors or environmental factors.
A parent who has a CHD has a 5% chance of having a baby with a CHD. Maternal health issues such as diabetes, lupus, obesity and rubella (or German measles) can also contribute to an increased risk of having a baby with a CHD. Pregnant women who are taking certain over-the-counter or prescription medications, smoking or drinking are also at a higher risk of having a baby affected by a CHD. While marijuana use during pregnancy does not cause heart defects in babies, it should be noted that it has been associated with other birth defects, preterm delivery and developmental problems.
Maximizing maternal health and having pregnant women take a folic acid supplement are protective factors in preventing CHDs in babies. It is vital that women who are considering pregnancy or who are pregnant receive high quality health care.
A CHD may be diagnosed before a baby is born, right after birth or later in life. In fact, one-third of CHDs are diagnosed in utero, one-third are diagnosed after birth, and one-third are not diagnosed until illness or death. Prenatal ultrasounds can detect some CHDs as early as 18-20 weeks.
As of 2011, the CDC recommended uniform screening for all babies and New Mexico started screening all newborns for CCHD starting in 2014. This universal screening was implemented because it was determined that the health benefits of screening outweigh the cost of the screening. The screening is accomplished through checking to see if there is a significant difference in a baby’s blood oxygen level in an arm and a leg to help identify a CCHD.
While this can identify babies who need immediate intervention, it does not pick up babies who are born with a noncritical CHD that does not impact the blood oxygen levels. A congenital heart defect may be diagnosed during a routine office visit, a sick visit or a checkup. It is specifically screened for during a student athlete’s pre-participation sports physical for school as required by the New Mexico Activities Association and is also recommended by the American Academy of Pediatrics.
Some symptoms of a CHD in babies include a heart murmur, blue lips or fingertips, increased respiratory rate, signs of labored breathing, fatigue with feeding or excessive sleepiness. For older kids and teens, the symptoms may also include exercise intolerance or difficulty keeping up with their peers, chest pain with exercise, breathing problems, fainting, or abnormal or skipped heart beats.
If there is reason to believe that your child might have a CHD, it can be diagnosed with an echocardiogram, a special ultrasound of the heart. A heart defect may be repaired surgically, through a noninvasive procedure or may resolve on its own. If you are concerned that your child may have an issue with his or her heart please make an appointment with your pediatrician.
Individuals who have had CHD may also have other health care needs that are important to recognize. They may have developmental delays, learning disabilities, anxiety and depression, among other issues. It is critical to a child’s growth, development, health and well-being to recognize that they may need some extra supports or therapies to ensure that they have what they need to thrive. Additionally, as more kids born with CHD are becoming adults with CHD, it is important that they continue to receive lifelong care with a cardiologist who is knowledgeable in CHD.
More information on congenital heart disease diagnosis, treatment and support may be found on these websites: aap.org, healthychildren.org, iheartchange.org, holeintheheartasd.org and mendedhearts.org.
Melissa Mason is a general pediatrician with Journey Pediatrics in Albuquerque. Please send your questions to melissaemason@gmail.com.
