According to Dr. Mark Plunkett, board-certified pediatric heart surgeon, congenital heart disease (CHD) is the most common birth defect in not only the United States, but many other countries as well. Although researchers have taken strides in improving care and treatment for this condition, it is still one of the leading causes of infant death in the United States. More research is necessary to continuing the advancement of treatment options and improving survival rates. To raise awareness of this condition and educate the public, the week of February 7th to 14th was recently designated as CHD Awareness Week by the American Heart Association.
What is Congenital Heart Disease?
Congenital heart disease, also known as congenital heart defects, is an abnormality in the structure and function of the heart, explains Dr. Plunkett. Defects range in severity from very mild to very severe. Those with a mild defect may not immediately be diagnosed as having anything wrong. For babies born with severe defects, treatment is often necessary almost immediately following birth. Many children requiring surgical intervention will have undergone surgery before they turn two years of age.
There are more than 40 different types of defects, and each ranges in severity. Types of defects include:
- Aortic valve stenosis
- Atrial septal defects (ASD)
- Coarctation of the Aorta
- Ebstein’s anomaly
- Hypertrophic cardiomyopathy
- Hypoplastic left heart syndrome
- Pulmonary valve stenosis or atresia
- Tetralogy of Fallot
- Ventricular septal defects (VSD)
- Atrioventricular Canal Defects
These are just a few of the wide spectrum of different abnormalities that may occur. Depending on the type and severity of the defect, a doctor will determine what steps are taken in treatment, asserts Dr. Plunkett. Treatment can range from medication and monitoring to catheterization, surgery, or even a heart transplant.
What are signs and symptoms of CHD?
Some babies are diagnosed with CHD at or before birth. Others are not diagnosed until they are older. Some common signs and symptoms that may indicate a heart problem include: low blood pressure, a blue-ish tinge to the skin, difficulty breathing, trouble feeding, lack of proper weight gain, or the presence of a heart murmur. If any of these things are noticed, the family is typically referred to a pediatric cardiologist. It is important that the issue is addressed as soon as possible to determine the most effective course of action.
How is CHD treated?
Treating CHD is a collaborative effort. It requires the collective effort of a highly trained team of specialists including professionals from surgery, cardiology, intensive care, anesthesia, nursing, perfusion services, and other areas, informs Dr. Mark Plunkett. They often treat patients at facilities with dedicated programs geared toward the specific pre and post-operative care of children with CHD.
Treatment has become more advanced over the past several decades, but more research is still needed. Fifty years ago, the outlook for infants with CHD was rather grim. There was little that doctors could do to help these patients. Even 20 years ago, those with severe or complex heart defects still had a relatively high mortality rate. However, the prognosis is more positive today. An estimated two million Americans are surviving with CHD, and more than 9 out of 10 children are treated successfully and go on to lead relatively healthy lives.
Treatment Options
There are several different options for those with CHD. The medical team will help to guide the family in determining the most effective course of action given the child’s individual situation, says Dr. Mark Plunkett. For those with mild defects that are not causing significant symptoms, the doctors may choose to simply continue to monitor and evaluate the child’s health. They may need additional treatment later on, but it is not necessary immediately.
Medication can help to control symptoms, improve heart function, and prevent additional complications. Depending on the defect and how it is impacting the patient, many different medications are available. The doctor will determine which would prove most beneficial and then carefully monitor their condition once they begin taking it.
Another option is cardiac catheterization. This minimally invasive procedure is used as both a diagnostic tool and a form of treatment. The cardiologist can go in, without having to open up the chest, and patch holes or widen constricted areas in the heart and blood vessels. This can improve the function of the heart and help to decrease symptoms.
In many patients, open heart surgery is necessary to correct defects or improve heart function. Pediatric heart surgeons can replace or repair damaged valves, patch holes, or even relocate structures to their proper location. While open heart surgery was previously the only way to complete these procedures, advancements in treatment have made it possible to use less invasive methods – something Dr. Mark Plunkett says have been very successful. Those with more complex cases, however, may require several open heart surgeries throughout their lifetime.
Finally, for babies born with multiple or complex defects, a heart transplant may be necessary. This is a serious decision; however, as it involves major surgery and lifelong follow-up for continued good health.
Researchers are continuing to look for better ways to treat children with CHD and improve their health and survival rate. Having specialized congenital heart surgery programs that include highly trained surgeons and medical professionals is essential for providing the highest quality of care and treatment. They must have the necessary resources to provide comprehensive care and support for successful outcomes. Dr. Mark Plunkett knows that promoting increased awareness of conditions such as CHD can play an instrumental role in ensuring that research and advancements in the field continue in the future.