Congenital heart disease in adults
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Congenital heart disease refers to a variety of structural problems with the heart that have existed since birth. Congenital refers to a condition that you are born with. Both adults and children with congenital heart disease may experience altered blood flow via the heart.
There are several milder forms of congenital heart disease. However, complicated defects could result in potentially fatal issues. Improvements in diagnosis and care are extending the lives of those with congenital heart disease.
Congenital heart disease patients require lifetime medical treatment. Regular checkups, medicine, or surgery are all possible options of treatment. If you have adult congenital heart disease, inquire with your doctor how frequently you should undergo follow-up checkups.
Symptoms
Some people don’t experience the warning signs or symptoms of congenital heart disease until they are adults. Years after a congenital heart disease has been treated, symptoms may come back again.
Typical adult congenital heart disease signs and symptoms include:
- Breathing difficulty
- Heart arrhythmias (irregular heart rhythms)
- Body organ or tissue swelling (edema)
- Bluish discoloration of the fingernails, lips and skin (cyanosis)
- Experiencing fatigue after activities
Seek immediate medical treatment if you experience any unsettling symptoms, such as chest pain or breathing difficulties.
Make an appointment to see your doctor if you have any of the signs or symptoms of congenital heart disease or if you had treatment for a congenital heart problem as a child.
Causes
The majority of congenital cardiac diseases have unknown causes. Some of these diseases are inherited from parents to children.
Understanding how the heart generally functions will help you better comprehend congenital heart disease.
- Two top chambers (atria) and two lower chambers (ventricles) make up the heart’s chamber structure.
- The right side of the heart transport blood to the lungs via the pulmonary arteries.
- Blood absorbs oxygen in the lungs before returning to the left side of your heart via the pulmonary veins.
- The blood is then pumped from the left side of the heart to the rest of the body via the aorta.
All of these cardiac structures, including the arteries, valves, chambers, and septum are susceptible to congenital heart disease.
Risk factors
Congenital cardiac disease may be influenced by a number of environmental and genetic risk factors, such as:
- Genetics. Congenital heart disease is inherited in families and is linked to numerous genetic disorders. For example, congenital heart abnormalities are common in children with Down syndrome. While an unborn child is still in the mother’s womb, genetic testing can identify Down syndrome and several other genetic disorders.
- Rubella (German measles). Rubella infection during pregnancy may have an impact on how the unborn child’s heart develops.
- Diabetes. Women who have type 1 or type 2 diabetes during pregnancy may have an impact on how the baby’s heart develops. The risk of congenital heart disease is typically not increased by gestational diabetes.
- Medications. Congenital heart disease and other birth problems might result from taking some drugs while expecting. Lithium, which is used to treat bipolar disorder, and isotretinoin, which is used to treat acne, are two drugs that have been related to cardiac problems. Inform your doctor of all the medications you take at all times.
- Alcohol. Alcohol consumption during pregnancy has been associated with an increased risk of fetal heart abnormalities.
- Smoking. Smoking during pregnancy raises the chance that the baby will be born with congenital cardiac abnormalities.
Diagnosis
Your doctor will do a physical examination and use a stethoscope to listen to your heart in order to identify congenital heart disease. Questions regarding your symptoms, medical history, and family history will be asked.
The state of the heart can be examined by tests, which can also screen for other diseases that might present with similar symptoms.
Tests
The following tests are used to identify or confirm congenital cardiac disease in both adults and children:
- Electrocardiogram (ECG). A painless procedure which captures the electrical cardiac signals and the rate of the heartbeat. An ECG can be used to detect heartbeats that are irregular (arrhythmias).
- Chest X-ray. Changes in the heart’s and lungs’ size and shape can be seen on a chest X-ray.
- Pulse oximetry. The amount of oxygen in the blood can be estimated using a tiny sensor that is affixed to the finger.
- Echocardiogram. Ultrasound produces images of the beating heart. An echocardiography can display the heart’s blood flow and its valves. You could also get an echocardiogram while working out, usually on a treadmill or bike.
- Transesophageal echocardiogram. A transesophageal echocardiography may be used if the doctor feels that more precise images of the heart are required. In this test, a flexible tube with a transducer is inserted through the throat then down into the esophagus.
- Exercise tests or stress tests. These tests frequently involve walking or cycling on a treadmill while the heart is being tracked by an ECG. Exercise testing can show how the heart reacts to exertion.
- Heart Computed Tomography (CT) scan and heart Magnetic Resonance Imaging (MRI). Images of the heart and chest are produced by these tests. X-rays are used in cardiac CT scans. A magnetic field and radio waves are used in cardiac MRI. You lie on a table that normally slides into a long, tube-shaped machine for both tests.
- Cardiac catheterization. This test can be used to measure the heart’s blood pressure and blood flow. A catheter is delicately inserted into a blood vessel by a doctor, typically in the groin and up to the heart. To direct the catheter to the proper location, X-rays are done. Sometimes a catheter is used to administer dye. The dye improves the visibility of blood vessels on the photographs.
Treatment
Childhood congenital heart disease is frequently effectively treated. Some congenital heart conditions, however, might not be severe enough to be fixed during childhood, yet they nevertheless pose a risk to adults.
The degree of congenital heart disease in adults will determine how it is treated. Only occasional medical examinations may be necessary for those with relatively small congenital cardiac abnormalities to prevent the progression of the disease.
Adults with congenital heart disease may also have surgery and other medical procedures.
Medications
Medications that improve heart function can be used to treat some mild congenital heart defects. Additionally, drugs may be administered to manage an erratic heartbeat or avoid blood clots.
Surgeries and other procedures
Adults with congenital heart disease can receive treatment through a variety of surgeries and treatments.
- Implantable heart devices. The complications that are related to congenital heart disease in adults may be prevented through devices such as a pacemaker that controls the heart rate or an implantable cardioverter-defibrillator or ICD which corrects irregular heartbeats that could be life-threatening.
- Catheter-based treatments. Adults with some forms of congenital heart disease may be treated with catheters, which are small, flexible tubes making a repair possible without requiring open heart surgery. A catheter is inserted by the doctor through a blood vessel, typically in the groin, and directed to the heart. Multiple catheters may occasionally be utilized. Once the catheter is in position, the doctor inserts tiny tools through it to fix the congenital heart abnormality.
- Open-heart surgery. An open-heart surgery can be required to correct a congenital cardiac abnormality if catheter treatments are ineffective.
- Heart transplant. A heart transplant may be a possibility if a major cardiac problem cannot be fixed.
