According to the National Institutes of Health, congenital heart defects are responsible for more deaths in the first year of life than any other birth defect.
In the United States more than 25,000 babies, or 1 in 115 to 150 births, are born each year with a congenital heart defect.
Heather Barlett, MD, pediatric cardiologist at University of Iowa Children's Hospital, talks about congenital heart defects:
Are there varying degrees of congenital heart defects?
Yes, there's a wide range of heart defects. Most of the children we see have minor problems, such as a hole between two chambers of the heart that will close on its own. But some children have significant underdevelopment of parts of their heart that causes severe disease which requires a lot of care and followup with cardiology.
What are some of the causes of congenital heart defects?
Most of them are unknown. We feel that, based on research, the cause is the genes they inherited versus exposure. Some defects are seen when there are chromosomal abnormalities such as with Down syndrome, where you inherit an extra chromosome. Those children are at a significant risk of having congenital heart disease. Other things are maternal illnesses that can increase the risk, such as if the mom has diabetes or drinks alcohol. Those increase the risk.
During pregnancy, can a woman take steps to prevent congenital heart defects in her baby?
The easiest thing a woman can do is get good prenatal care. They get good counseling about what medications are safe and are not; get counseling about avoiding alcohol and other exposures that could put the baby at risk. Taking prenatal vitamins with folic acid may temper some benefit to the baby.
Are some women more at risk to have a child that has a heart defect?
Yes, there are certain illnesses that put them at risk. One of them is diabetes. Other associations are if you have had the flu during pregnancy or other febrile illnesses. The one I have particular interest in is when the mothers have congenital heart disease themselves. Certain kinds of congenital heart disease put the baby at risk for inheriting similar or other congenital heart diseases.
How is a heart defect diagnosed in a child?
Most of the time it is first picked up by the pediatrician or the family doctor. They pick up something unusual in the exam and refer them to cardiology. We learn most through our exam, but we also have technical tools—like an electrocardiogram or a echocardiogram—that help us and increase the sophistication of our studies to diagnose as needed.
What is the range of treatment for babies born with congenital heart defects?
Hopefully we can follow them and make sure they're doing well. The more significant diseases—some that are really severe—require surgery in the first week of life. There's that range in between of doing a procedure in the cath lab to closing off an extra connection; to mapping out an extra circuit that causes arrhythmias and making that extra circuit go away.
Why is it important to have a child with a heart defect evaluated at a center like UI Children's Hospital?
It goes along with that range of what they need. At UI Children's Hospital we have all the subspecialties in cardiology represented. So if your child needs evaluation by electrophysiology or intervention with sophisticated electrocardiography—those are represented. Within pediatrics, if we need input from our colleagues in gastroenterology or intensivists, whatever's needed is here and allows a multidisciplinary approach to provide care for those kids.
Are children born with heart defects inhibited from activities as they grow?
It depends on the severity of the lesions. With the minor lesions, hopefully some will spontaneously close on their own and the kids can live normal lives and not be bothered by a cardiologist in the future. Some who have severe disease will require ongoing care into adulthood by providers who are familiar in specializing in general heart disease.
Can some heart defects be cured, or will the child become an adult with a heart condition?
It depends on how you define it. There are some of the more straightforward lesions we can cure. We can close off an extra connection and it's closed, it's never going to bother the child. But some of the more severe diseases will limit what they can do and will be a chronic disease that requires management lifelong. |
