Most children are born with a normal, healthy heart which will grow with them. Unfortunately, in some cases children can be born with abnormalities, known as congenital defects and inherited disorders. However, not all the defects that may affect a child are congenital. Rarely, heart diseases such as heart damage or irregular heart beat may occur later in his life. These abnormalities are called acquired heart diseases. They include arrhythmias, cardiomyopathies, Kawasaki disease and consequences given by rheumatic fever, familial hypercholesterolemia and acquired immune deficiency syndrome (AIDS) with myocarditis.

Congenital heart defects

Risk factors

Congenital heart defects affect about 8 -10 out of every 1.000 children*. They occur while the foetus is developing in the uterus and they may produce symptoms at birth, during childhood and sometimes not until adulthood. Usually, the cause of congenital heart disease is unknown. However, there are some factors that are associated with an increased chance of getting congenital heart disease. These risk factors include:

¥ Genetic or chromosomal abnormalities in the child such as Down syndrome.
¥ Taking certain medications or alcohol or drug abuse during pregnancy
¥ Maternal viral infection, such as rubella (German measles) in the first trimester of pregnancy

 
Diseases

The most common congenital heart problems include defects due to an incomplete develop of the different part of the heart. They include:

¥ defects in the walls between the atria and ventricles
¥ heart valve defects
¥ coarctation of the aorta. This is a narrowing of the aorta, typically found just after the vessels are given off from the heart to the left arm
¥ transposition of the great arteries. In this condition, the vessels are reversed with respect to a normally functioning heart: instead of being connected to the left ventricle, the aorta is connected to the right one so that venous (bluish) blood is carried to the body. The pulmonary artery, which is normally attached to the right ventricle, is attached to the left one so that oxygen-rich (red) blood is carried back to the lungs.
¥ tetralogy of Fallot, a type of heart problem which consists of four different heart defects: a hole between the two bottom chambers (ventricles) of the heart; a narrowing at or just below the pulmonary valve; the aorta being is wrongly positioned; the right ventricle is more muscular than normal
¥ heart muscle abnormalities that can lead to heart failure

Treatment

The management of congenital heart defects is based on the severity of the disease. Some mild heart dysfunctions do not require any treatment. However children with moderate-to-severe degrees of defects require treatment, depending on the type of abnormality. They may range from medications to procedures or surgery. In the most severe cases a surgical repair is usually done on an urgent basis following initial stabilization soon after birth.

Most people with congenital heart disease should be monitored by a heart specialist and take precautions to prevent endocarditis (a serious infection of the heart valves) throughout their life. In any case it is very important to diagnose the disease as soon as possible.

* Congenital heart disease statistics, British Heart Foundation

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