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CARE FOR BABIES WITH BIRTH DEFECT DISABILITIES

Congenital Heart Defects

Congenital heart disease: A malformation of the heart, aorta, or other large blood vessels that is the most frequent form of major birth defect in newborns. Abbreviated CHD. There are many types of CHD, including atrial septal defect (ASD), ventricular septal defect (VSD), pulmonary (valvular) stenosis, aortic stenosis, coarctation of the aorta, Tetralogy of Fallot, and transposition of the great arteries. Much of the practice of pediatric cardiology consists of the diagnosis and treatment of CHD. Also known as congenital heart defect, congenital heart malformation, congenital cardiovascular disease, congenital cardiovascular defect, and congenital cardiovascular malformation. Continue Reading

 

 

Demographics

If you’re living with a congenital heart disease (CHD) you’re not alone. About 1 million adults in the U.S. are living with a congenital heart disease (CHD), according to the Adult Congenital Heart Association (ACHA).

 

 

Causes and symptoms

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Congenital heart DEFECT

  • Identify What is a Birth Defect and how it effects children
  • Educate individuals on the types of Birth Defect (structural, functional abnormalities)
  • environmental factors that lead to birth defects
  • community awareness of social, physical and psychological needs of children with birth defects
  •  Improving access to care for people with birth defects

Diagnosis

Many congenital heart defects or conditions can cause congenital heart disease. Some of the most common include:

 

Atrial Septal Defects (ASDs) – An ASD is a hole in the wall that separates the two upper chambers of the heart. There are many different kinds of ASDs. Some ASDs only need follow-up observation, but many require surgical repair. In some cases, ASDs can be repaired with a minimally invasive procedure using catheters to place small closure devices within the heart.

 

Bicuspid Aortic Valve Disease – The aortic valve typically consists of three leaflets (tiny flaps of tissue that open and close). In bicuspid valve disease, only two leaflets are functional. This can lead to aortic valve stenosis (stiffening) and regurgitation (reverse blood flow). Many cases require valve replacement or replacement of part of the aorta.

 

Coartacation Of the Aorta – This is obstruction or narrowing of the aorta, usually beyond the left subclavian artery (the artery that supplies blood to the left arm). This condition can lead to high blood pressure and is often related to a bicuspid aortic valve. Even if your condition was repaired in childhood, you need ongoing follow-up to check for abnormal growth or re-narrowing of the aorta, or heart valve disease that requires surgery.

 

Ebstein’s Abnormality – This term refers to any of a number of defects of the tricuspid valve, which separates the upper right and lower right chambers of the heart. Ebstein’s anomaly can result in severe regurgitation (reverse blood flow), heart rhythm disorders and atrial septal defects. Some people with Ebstein’s anomaly require heart valve replacement, while others may only develop a mild heart rhythm disorder. Even if the defect has been repaired, lifelong monitoring and care is critical.

 

Single Ventricle Defects – A single ventricle defect means that only one chamber of the heart is large or strong enough to pump effectively. Children with single ventricle defects are often treated with the Fontan procedure, which allows oxygen-poor blood to bypass the heart and flow directly to the lungs. If you had the Fontan procedure as a child, you’ll need ongoing evaluation and care to check for heart rhythm disorders, reverse blood flow and other complications.

 

Tetralogy Of Fallot – One of the most common congenital heart defects in children, this complex condition results in low levels of oxygen in the blood. The low oxygen level can cause the skin to appear blue (cyanosis). Tetralogy of Fallot is often repaired in early childhood. In adults, it can lead to severe regurgitation (reverse blood flow) in the pulmonary valve, heart rhythm disorders and other complications. It’s important to have regular evaluations by an experienced team.

 

Transposition Of The Great Arteries – In this condition, the positions of the aorta and pulmonary artery are reversed, causing oxygen-rich blood to flow to the lungs and oxygen-poor blood to flow to the body. Transposition of the great arteries requires corrective surgery in the first weeks of life. Your needs as an adult depend on the type of repair you had in childhood. You’ll need regular screening for to make sure your blood is flowing correctly, to check for irregular heart rhythms and to assess left and right heart function.

 

Ventricular Septal Defects (VSDs) – A VSD is a hole in the wall that separates the two lower chambers of the heart. Some kinds of VSDs must be repaired in childhood. If you have a VSD that has not been repaired, you might be at risk for complications, such as low oxygen levels in the blood. You need regular screening

 

 

 

 

 

 

 

Severe congenital heart defects generally are diagnosed during pregnancy or soon after birth. Less severe defects often aren't diagnosed until children are older. Minor defects often have no signs or symptoms. Doctors may diagnose them based on results from a physical exam and tests done for another reason.

Treatment

A child born with a cleft lip and/or palate can begin early treatment to enable the restoration of as normal an appearance as possible before the child begins peer interaction. The early treatment minimizes the social discomfort a child born with a facial deformity may feel as the child grows.

 

In addition to correction of lip, palate, nose and facial structures, the team will work to prevent hearing and speech difficulties that may accompany such anomalies. The specialized approach to correcting deformities of the lip and palate is unique in the care and attention given to enhancing a child's quality of life as soon as possible.

 

While it is known how cleft lip and palate deformities occur before birth, it is not known why they occur. Yet, one in 500 births results in a deformity of the lip and/or palate. As the cause and possible preventative treatment for this facial deformity is sought, the team at Medical City Children's Hospital of Dallas is ready to provide the best possible treatment for your child and to make possible the smile he or she was meant to have.

 

Children with a cleft palate are particularly prone to ear infections because the cleft can interfere with the function of the middle ear. To permit proper drainage and air circulation, the ear-nose-and-throat surgeon on the Cleft Palate Team may recommend that a small plastic ventilation tube be inserted in the eardrum. This relatively minor operation may be done at the same time of the cleft repair.

Prevention

Eat properly and take prenatal vitamins before and during pregnancy. Also take folic acid supplements as instructed by your doctor. Reduce your risks for infections during pregnancy. Some infections can increase the risk that a fetus will develop Congenital heart defect.

 

 

 

Treatment

Echocardiography (echo) is a painless test that uses sound waves to create a moving picture of the heart. During the test, the sound waves (called ultrasound) bounce off the structures of the heart. A computer converts the sound waves into pictures on a screen.

 

Echo allows the doctor to clearly see any problem with the way the heart is formed or the way it's working.

 

Echo is an important test for both diagnosing a heart problem and following the problem over time. The test can show problems with the heart's structure and how the heart is reacting to those problems. Echo will help your child's cardiologist decide if and when treatment is needed.

 

During pregnancy, if your doctor suspects that your baby has a congenital heart defect, fetal echo can be done. This test uses sound waves to create a picture of the baby's heart while the baby is still in the womb.

 

Fetal echo usually is done at about 18 to 22 weeks of pregnancy. If your child is diagnosed with a congenital heart defect before birth, your doctor can plan treatment before the baby is born.

 

Resources

 

 

Emory Healthcare, London, Web site: http://www.emoryhealthcare.org/

 

National Heart, Lung, and Blood Institute  (National Library of Medicine)

 

 

 

 

 

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