children s health issues
Overview of Heart Defects
Symptoms of Heart Defects
Sometimes heart defects cause few or no symptoms and are not detectable even during a physical examination of the child. Some mild defects cause symptoms only later in life. Fortunately, most serious heart defects in children are detectable based on symptoms noticed by parents and by abnormalities noticed during a doctor's examination. Because normal circulation of oxygen-rich blood is necessary for normal growth, development, and activity, infants and children with heart defects may fail to grow or gain weight normally. They may have difficulty feeding or may tire quickly during physical activities. In more severe cases, breathing may be labored or a bluish color of the skin (cyanosis) may develop. Older children with heart defects may not be able to keep up with their peers during exercise or may experience shortness of breath, fainting, or chest pain, particularly during exercise. Abnormal blood flow through the heart usually causes an abnormal sound (heart murmur) that can be heard using a stethoscope. Serious heart murmurs are often easy for a doctor to hear. However, the vast majority of heart murmurs that occur during childhood are not caused by heart defects and are not a sign of a problem. Murmurs that are not caused by a heart disorder are usually called innocent or functional murmurs. Heart failure makes the heart beat rapidly and often causes fluid to collect in the lungs or liver. Fluid build up can lead to trouble breathing while eating, rapid breathing, grunting during breathing, crackling sounds in the lungs, an enlarged liver, and swelling of the legs. Some heart defects (such as a hole in the atrium) increase the risk that a blood clot will form on the right side of the heart and pass across the defect, into the left side of the heart and then out to the body where it may block an artery in the brain, leading to a Overview of Stroke . However, such blood clots are rare in childhood. The vast majority of heart murmurs that occur during childhood are not caused by heart defects and do not indicate any problems. Eisenmenger syndrome occurs when a large Shunting of blood flow that is not corrected early in life leads to irreversible damage to the blood vessels of the lungs. This damage eventually leads to reversal of the shunt to one that is right-to-left. involves oxygen-rich blood, which is pumped from the left side of the heart, mixing with oxygen-poor blood being pumped through the pulmonary artery to the lungs. Left-to-right shunting makes the circulation inefficient and increases the amount of blood flowing to the lungs. Over time, this extra blood flow damages the lung blood vessels, causing the walls of the blood vessels to thicken abnormally. This may happen slowly, over many decades such as with an Atrial and Ventricular Septal Defects or rapidly as occurs in Eventually, the resistance to flow from the damaged and thickened lung arteries in the lungs can becomes so high that there is a reversal of blood flow from the right side of the heart to the left side. This reversal of blood flow is called Eisenmenger syndrome. Eisenmenger syndrome can overwork the right side of the heart, causing heart failure. Other complications include increasing bluish discoloration (cyanosis), abnormally increased thickness of the blood, bleeding from the lungs, and strokes. Disorders that may lead to Eisenmenger syndrome include Atrial and Ventricular Septal Defects None Atrioventricular Septal Defects None Aortopulmonary Window None Patent Ductus Arteriosus None Persistent Truncus Arteriosus None Because birth defects of the heart are usually diagnosed and treated promptly, Eisenmenger syndrome is becoming less common. Symptoms include a bluish color of the skin (cyanosis), widening and swelling of the fingernails or toenails (clubbing), fainting, shortness of breath during activity, fatigue, and chest pain. Other symptoms may develop, depending on which birth defect causes Eisenmenger syndrome. If doctors suspect Eisenmenger syndrome, electrocardiography, echocardiography, and cardiac catheterization are done to provide more information about how the heart is functioning. Doctors also do laboratory tests to identify abnormalities caused by the lack of oxygen. Although there are some interventions or medications that can delay the natural progression of this condition, Lung and Heart-Lung Transplantation is the only definitive treatment for Eisenmenger syndrome. Therefore, it is important that heart birth defects are identified and corrected as soon as possible. 