2. Definition
• These are Cardiac Anomalies Arising as a result of a defect in the
structure or function of the heart and great vessels which is present.
• These lesions either obstruct blood flow in the heart or vessels near
it, or alter the Pathway of blood circulating through the heart.
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4. Clinical Symptoms
• Cyanosis: Bluish discoloration of the skin, lips, and nails due to
inadequate oxygenation of the blood. This can be a sign of
serious heart defects like Tetralogy of Fallot or transposition of
the great arteries.
• Difficulty in feeding: Babies with congenital heart defects may
have trouble feeding or may get tired easily while feeding due to
the increased workload on the heart.
• Poor weight gain: Inadequate feeding and increased energy
expenditure due to the heart defect can lead to poor weight gain
or failure to thrive.
5. • Rapid breathing (tachypnea): The heart's inability to pump
blood efficiently can cause the body to compensate by
increasing the respiratory rate.
• Poor growth: Children with congenital heart defects may have
delayed growth and development due to inadequate oxygen
supply to the tissues.
• Fatigue and weakness: Children with significant heart defects
may tire easily during physical activity due to the heart's
decreased ability to pump blood effectively.
6. • Recurrent respiratory infections: Some congenital heart
defects can predispose children to recurrent respiratory
infections due to the abnormal circulation of blood through the
lungs.
• Heart murmur: A heart murmur, which is an abnormal sound
heard during a heartbeat, may be present and can indicate the
presence of a congenital heart defect. However, not all heart
murmurs are associated with congenital heart disease.
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9. Diagnostics
• Physical examination: A thorough physical examination we
can often reveal signs of congenital heart disease, such as
abnormal heart sounds (murmurs), cyanosis, or abnormal
breathing patterns.
• Echocardiography: This is the primary imaging modality used
to diagnose congenital heart defects. It uses sound waves to
create images of the heart's structure and function, allowing
doctors to identify abnormalities in the heart chambers, valves,
and blood vessels.
• Electrocardiogram (ECG or EKG): An ECG records the
electrical activity of the heart and can help identify abnormal
heart rhythms or patterns that may suggest the presence of
congenital heart disease.
10. • Chest X-ray: A chest X-ray can provide additional information
about the size and shape of the heart and the presence of any
lung abnormalities that may be associated with congenital heart
disease.
• Fetal echocardiography: In some cases, congenital heart
defects can be detected before birth using fetal
echocardiography, which is an ultrasound examination of the
fetal heart performed during pregnancy.
11. Tactics of Handling pregnancy
• Preconception counseling: If there is a known risk of congenital
heart disease in a family or if a previous child has been diagnosed,
preconception counseling with a maternal-fetal medicine specialist
and a genetic counselor can provide valuable information about the
risks and potential outcomes of pregnancy.
• Prenatal care: Close monitoring by an obstetrician specializing in
high-risk pregnancies is essential throughout the pregnancy. Regular
prenatal visits allow for monitoring of the mother's health and the
baby's growth and development.
• Fetal echocardiography: In cases where there is a known risk of
congenital heart disease, fetal echocardiography can be performed
to evaluate the baby's heart structure and function before birth. This
can help in planning for appropriate medical care and interventions
after delivery.
12. • Postnatal care: Close monitoring of the baby's health and
cardiac function is essential after birth. This may include
additional imaging studies, such as echocardiography, and
consultation with pediatric cardiologists to determine the best
course of treatment.
• Breastfeeding and nutrition: In most cases, breastfeeding is
encouraged for babies with congenital heart disease, as it
provides important nutrients and helps strengthen the bond
between mother and baby. However, the specific feeding plan
may need to be tailored to the baby's individual needs and
ability to feed effectively.
13. Estimation of Labor risk
• Type and severity of congenital heart disease: Some heart
defects pose a higher risk during labor and delivery than others.
For example, infants with complex cyanotic heart defects may
be more susceptible to oxygen desaturation and hemodynamic
instability during the stress of labor.
• Maternal health: The mother's health plays a significant role in
determining the risk of labor and delivery complications.
Conditions such as hypertension, diabetes, and pulmonary
hypertension can increase the risk for both the mother and the
baby.
14. • Emergency preparedness: In some cases, like Fetal distress,
uterine Rupture emergency interventions such as cesarean
section or immediate neonatal resuscitation may be necessary
to mitigate risks during labor and delivery.
• Postnatal care: Close monitoring of the baby's cardiac function
and overall health is crucial in the immediate postnatal period.
