How does a healthy heart work?
The heart belongs to the circulatory system, which carries blood throughout the body. The heart is made of muscle and works like a pump to keep the blood moving through the blood vessels (arteries, veins, and blood vessels).
The heart has 4 chambers– the right atrium and the left atrium (plural: atria) on top and the right and left ventricles on the bottom. The heart is divided by a solid wall called the septum into two sides: the right side sends blood to the lungs to get oxygen, while the left side of the heart moves oxygen-rich blood to the remainder of the body through the aorta (the main artery in the heart).
Blood goes into the heart through the right atrium and relocates to the right ventricle, where it then moves through the pulmonary artery to the lungs to get oxygen. The recently oxygenated blood then enters the heart through the left atrium and relocates to the left ventricle, where it is sent through the aorta to the rest of the body.
There are likewise 4 valves in the heart, which open and near allow blood to move through the chambers:
- The aortic valve, located on the left side of the heart, in between the aorta and the left ventricle
- The mitral valve, located in between the left ventricle and the left atrium
- The lung valve, located on the right side of the heart in between the right ventricle and the lung artery (the blood vessel that carries blood to the lungs).
- The tricuspid valve, located on the right side of the heart between the right ventricle and the right atrium.
Capillary– arteries, veins, and capillaries– are likewise associated with helping blood flow:
- The lung artery relocations blood from the heart to the lungs, where it picks up oxygen.
- Pulmonary veins move blood from the lungs to the heart’s left side, where it can be transferred to the remainder of the body.
- The aorta sends newly oxygenated blood from the left side of the heart to the rest of the body.
- The inferior vena cava and exceptional vena cava bring blood back to the heart to get brand-new oxygen.
- The coronary arteries take blood and oxygen from the aorta to the heart muscle itself.
The word congenital means that a condition is present when a baby is born. If a baby is born with a heart defect, the heart is not working appropriately, generally because there is something incorrect (malfunctioning) with the valves or the blood vessels around the heart. The defect can keep blood from flowing normally and can impact heart development. Genetic heart flaws can be easy or complex. There are one million adults and children in the United States who have genetic heart defects.
Congenital heart problems occur since of insufficient or unusual advancement of the fetus’ heart during the extremely early weeks of pregnancy. Some are known to be associated with genetic disorders, such as Down syndrome. However the reason for the majority of hereditary heart defects is unknown. While they can’t be prevented, there are many treatments for the problems and associated health problems.
What are the common types of pediatric congenital heart problems?
A septal defect is a hole in the septum, the wall that divides the heart. There are two types of septal flaws: atrial septal problems (ASDs) are holes in the septum in between the left and the right atria; ventricular septal flaws (VSDs) are holes in the septum between the left and right ventricles. Due to the fact that of this hole, oxygenated blood mixes with non-oxygenated blood.
A septal defect means that blood streams from one chamber of the heart to the other, instead of taking its normal path. For example, with an atrial septal defect, blood streams from one atrium to the other, rather of going to the ventricle.
Similarly, with a VSD, the blood flows from the left ventricle to the right ventricle, rather than through its normal path to the aorta and the rest of the body. As a result, blood that has picked up oxygen from the lungs combines with oxygen-poor blood. This can indicate that parts of the body aren’t getting enough oxygenated blood.
ASDs and VSDs can be small or big. Some ASDs close up by themselves as the child grows older. Others may be repaired utilizing catheters or with open heart surgery.
Although some small VSDs may close on their own, some are so large that the left side of the heart is required to work much harder. If it is not treated, a VSD can cause heart failure. These flaws need to be repaired with open heart surgery.
Another type of problem includes the heart valves. Faulty valves may be brought on by:
- Stenosis (narrowing)– the valve is not able to open completely. As an outcome, the heart needs to work more difficult to pump blood through it.
- Regurgitation– The valve does not close correctly and permits blood to leak backward.
- Atresia– the valve is missing out on a hole for the blood to pass through. This is considered a more complex problem.
- Pulmonary valve stenosis is the most common valve problem. In this defect, the flaps of the pulmonary valve don’t work effectively– they are too thick, or they end up being stiff, or perhaps fuse together, making it hard for the blood to transfer to the lung by means of the lung artery.
Children who have a pulmonary valve stenosis may have a heart whispering, an irregular noise heard during a heart beat. Children who are born with a severe pulmonary valve stenosis may have such symptoms as fatigue, breathing issues, and trouble eating.
Pulmonary valve stenosis may also be accompanied by other problems, such as an ASD or patent ductus arteriosis (PDA). The ductus arteriosis is a blood vessel in the fetus that connects the aorta and the pulmonary artery. The ductus arteriosis usually closes within minutes or days of birth; if it does not close, it is called a patent (open) ductus arteriosis (PDA).
A PDA lets oxygenated blood and deoxygenated blood mix and puts pressure on lung arteries. In case of particular heart flaws, physicians may opt to keep the PDA open up until surgery to fix other blood circulation problems can be done.
Stenosis can likewise affect the aortic valve. If this valve can not open or close properly, blood may leak or pool. This can increase pressure on the heart and cause heart damage. A balloon catheter procedure may be carried out in order to widen the valve and increase the blood circulation.
Other types of congenital heart defects
- Coarctation of the aorta– This problem happens when the aorta narrows and avoids blood from streaming freely to the lower part of the body. Coarctation of the aorta can cause hypertension (high blood pressure) and heart damage. Surgery or balloon catheterization in chosen cases can be used to remedy this issue.
- Total atrioventricular canal defect (CAVC)– The heart has a hole in all four chambers in the spot where the chambers would normally be divided. Symptoms might not appear until the baby is several weeks old; infants might have difficulty breathing, consuming, and growing. This problem can be remedied with surgery.
- D-transposition of the excellent arteries– The positions of the lung artery and the aorta are reversed. The blood flow to either the body or the lungs is cut off. Surgery is had to fix this issue.
- Ebstein’s abnormality– The tricuspid valve does not work as it must and allows blood to leak back into the upper chambers of the heart from the lower pumping chambers. This flaw frequently occurs along with an ASD. Ebstein’s abnormality might be moderate enough to never require surgery. In some cases, however, it may cause cyanosis (the skin turns blue since of a lack of oxygen) or heart failure.
- Single ventricle problems– These include hypoplastic left heart syndrome, lung atresia/intact ventricular septum, and tricuspid atresia:
- In hypoplastic left heart syndrome, the left side of the heart is underdeveloped. Without treatment, the baby will typically pass away. Treatment may include a series of heart operations or a heart transplant.
- In pulmonary atresia, the lung valve has actually ended up being narrowed or blocked. Blood can only get to the lungs through openings that normally close as the baby grows older.
- In tricuspid atresia, there is no tricuspid valve. Blood needs to distribute through an ASD. Surgery is required to fix these problems.
- Tetralogy of Fallot– This flaw combines four issues: a ventricular septal defect; pulmonary stenosis (a blockage in between the heart and the lungs); right ventricular hypertrophy (the muscle around the lower right chamber of the heart is enlarged); and the aorta remains in the incorrect position (over both ventricles, rather of simply the left ventricle). Surgery is had to correct this defect.
- Total anomalous pulmonary venous connection– The veins from the lungs link to the heart in the wrong place and let oxygenated blood into the incorrect heart chamber. This problem needs open heart surgery early in infancy.
- Truncus arteriosis– This defect happens when there is one large artery instead of the normal two different ones to bring blood to the body and the lungs. Surgery is had to close the VSD and to add another tube to act as the second artery.
What are the symptoms of pediatric hereditary heart disease?
Frequently, there are no symptoms connected with these defects. The defects are generally discovered during regular physical exams. In cases where there are symptoms, they might include:
- Problem breathing
- Bluish tones to the skin (cyanosis)
- Poor eating practices
- Fatigue (fatigue)
- Swelling in the abdominal area or around the eyes
- Quick heartbeat
How are pediatric hereditary heart defects detected?
Tests to detect heart problems may consist of:
- Physical exam, including listening to the heart with a stethoscope
- Chest X-ray
- Electrocardiogram to test heart rate patterns
- Echocardiogram (takes images of the heart using acoustic waves)
- Cardiac catheterization (a thin tube is placed through a vein into the heart to acquire details on heart function)
Some flaws can be identified while the baby is still developing in the womb.
What causes pediatric congenital heart defects?
For the most parts, the factors problems happen are not known, but some connections have actually been identified:
- Women who get German measles (rubella) during their first trimester of pregnancy have a higher risk of having a baby with a hereditary heart defect.
- The risk may also be greater if the female has some types of viral infections, is exposed to industrial solvents, takes certain sort of medications, drinks alcohol, or uses cocaine while pregnant.
- Women who have brought to life a child with a hereditary heart defect are at higher risk of bring to life another child with a heart flaw.
Heart flaws can also take place along with other types of abnormality.
What can be done to avoid pediatric hereditary heart flaws?
In most cases, there is no chance to avoid heart defects. However, certain safety measures can be taken:
- A pregnant woman ought to not drink alcohol or take drugs that have not been recommended to her.
- Women with particular chronic conditions (like diabetes, a seizure condition, or phenylketonuria) needs to ask their doctors for recommendations on medications or special diets prior to they become pregnant.
- A woman who is able to conceive should get 400 micrograms of folate or folic acid per day to prevent birth defects.
How are pediatric hereditary heart defects dealt with?
Lots of children who are born with heart defects do not need treatment. In these cases, the problems are moderate or they just fix by themselves (for example, an atrial septal flaw may close on its own).
For children who have a heart defect that need to be dealt with, there are two primary choices: treatment with a catheter, or open heart surgery.
Treatment with a catheter is a lot easier for the child to go through than surgery. Instead of opening the body with a cut as in surgery, the doctor makes a little cut in the skin and inserts a catheter (a thin tube) into the body through an artery or vein.
Catheters are used to treat simple heart flaws, such as an atrial septal defect. In this procedure, the catheter is moved through a vein until it reaches the septum (the wall on the inside of the heart). There, the catheter puts a little device into the septal defect to close it up. The catheter is then gotten rid of.
To treat lung valve stenosis, the catheter is equipped with a little balloon that is pumped up at the pulmonary valve in order to separate the fused leaflets.
Open heart surgery
In cases where the heart flaw can not be treated with a catheter, the child might need open heart surgery. In these circumstances, the pediatric heart surgeon opens the chest and operates straight on the heart to repair the defect. This type of treatment is normally done for more severe heart problems.
What is the prognosis (outlook) for children with genetic heart problems?
The prognosis depends on the problem. In a lot of cases, children with genetic heart problems go on to live typical lives. In many cases, individuals with heart problems are at greater risk for developing infection of the heart and valves. They might need to take antibiotics when having particular dental or surgical procedures in order to avoid endocarditis, an infection of the heart’s lining.
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