When your little one was born, did the doctor say that he had a heart murmur? Or as he got older, did he get tired more quickly than other children when running and playing? These things can sometimes be signs of a congenital heart disease. But don't panic. Not all congenital heart diseases are serious. Today we're talking about a type of heart disease that is common, but doesn't cause blue eyes.
What is Acyanotic Heart Disease?
Simply put, congenital heart disease (CHD) is a condition that occurs when a baby's heart develops during pregnancy. This means that there are small defects in the shape or function of the heart. These can be divided into two main types.
1. Cyanotic Congenital Heart Disease: In this type, due to a defect in the heart, the amount of oxygen in the blood going to the body decreases. Then , areas like the lips, tongue, and fingertips start to turn blue . This blue color is called 'cyanosis'.
2. Acyanotic Congenital Heart Disease: In this type of heart disease, there is no deficiency in the amount of oxygen in the blood going to the body, even though there is a defect in the heart. Therefore, the body does not turn blue. However, due to the defect in the heart, there is some abnormality in the pattern of blood flowing throughout the body.
That means, in non-cyanotic heart disease, even though there is plenty of oxygen in the blood, there is a problem with the way the blood flows through the heart. This can put extra strain on the heart.
How common is this condition?
About 8 out of every 1,000 newborns in the world have some form of congenital heart disease. Of these , 75%, or about three-quarters, are the acyanotic type of heart disease we're talking about. So you can see that this is not a very rare condition.
What are the most common types of non-cyanotic heart disease?
There are several types of heart disease identified under this. Let's understand each one in simple terms. Take a look at this table.
| Name of the disease (Medical Term) | Simply put, this is what happens. |
|---|---|
| Ventricular Septal Defect (VSD) | A hole in the wall separating the two lower chambers (ventricles) of the heart. This is the most common congenital heart defect. In most cases, small holes close on their own over time. |
| Atrial Septal Defect (ASD) | A hole in the wall that separates the two upper chambers of the heart (atria). These holes rarely close on their own, like a VSD. Larger holes may need to be closed with surgery. |
| Patent Ductus Arteriosus (PDA) | When a baby is in the womb, there is a connection between two major arteries that prevents blood from flowing to the lungs. This connection should close after birth. If it doesn't, it is called a PDA. This is common in premature babies. |
| Aortic Stenosis | Narrowing of the aortic valve, where blood enters the aorta, the main artery that carries blood from the heart to the entire body. This causes the heart to work harder to pump blood. |
| Pulmonary Stenosis | Narrowing of the pulmonary artery valve that carries blood from the heart to the lungs. |
| Coarctation of the Aorta | A blockage or narrowing of the main artery (aorta) that carries blood to the body. |
What are the symptoms of this disease?
Some babies with this condition may not show any symptoms at birth. The only sign may be an extra heart sound (heart murmur) that the doctor hears with a stethoscope.
However, over time, as the heart continues to work harder to pump blood, certain problems can arise. High blood pressure (hypertension) can develop because the heart has to work harder to pump blood. Sometimes, blood pressure in the lungs (pulmonary hypertension) can also increase. Eventually, heart failure can develop, a condition in which the heart can no longer pump blood efficiently. The following symptoms may occur with these conditions:
- Shortness of breath: Especially when exercising or straining.
- Dizziness: A sudden feeling of spinning.
- Feeling tired easily: Feeling very tired even after doing normal work (Fatigue).
- Syncope: You may suddenly lose consciousness and fall.
What causes this situation?
Scientists still can't say with 100% certainty why these congenital heart defects occur, but they have found that certain factors may contribute to this.
- Abnormal chromosomes: There is an increased risk of these heart defects with certain genetic conditions.
- Genetics: If someone in the family has had congenital heart disease, the risk of a child developing it is slightly higher.
- Some medical conditions that the mother may develop during pregnancy can affect the fetus, such as diabetes, viral infections such as rubella, the use of certain medications, and drug use.
How to diagnose the disease?
If your doctor hears an extra heart sound in your child or shows the above symptoms, he or she will order several tests to confirm the diagnosis.
- Chest X-ray: This can check the size and shape of the heart and the condition of the lungs.
- Electrocardiogram (ECG/EKG): A simple test that measures the electrical activity of the heart.
- Echocardiogram (Echo): This is the most important test. It is like an ultrasound scan of the heart. It can clearly see everything in the heart, including the chambers, valves, and holes in the walls.
- Heart Catheterization: In this, a thin tube (catheter) is passed through a blood vessel in the arm or leg into the heart to measure things like the pressure inside the heart, oxygen levels, etc. Sometimes a dye is injected to look at the blood flow.
How is it treated?
The treatment method depends on factors such as the type of heart defect, its severity, and the patient's age.
Sometimes no treatment is needed. For example, a small hole in a VSD may close on its own as the child grows.
But if symptoms appear or the doctor determines that there may be damage to the heart, treatment will be required.
- Medications: Medications are given to help the heart work more easily, control blood pressure, or remove excess fluid from the heart.
- Catheter procedures: Non-surgical procedures, similar to cardiac catheterization, involve passing a thin tube into the heart and inserting a small plug/device to close a hole, such as an ASD or VSD.
- Surgery: Open-heart surgery may be necessary to correct some defects.
How to live healthily with this condition?
Many people with non-cardiac heart disease live normal, full lives. However, it is important to understand your condition and follow your doctor's advice.
If you or your child has this condition, it is essential to have regular checkups with an adult congenital cardiologist . He or she will guide you on the following:
- Decide what level of exercise is appropriate and safe for you.
- Follow a heart-healthy diet.
- Regularly check how your heart condition changes as you age.
- If necessary, take medications, such as blood pressure medications, to reduce the strain on the heart.
- If you decide to get pregnant, it is essential to discuss it with a specialist beforehand, as it places an additional burden on the heart.
- Make an accurate decision about when surgery or other treatment is needed.
Take-Home Message
- Acyanotic heart disease is a congenital heart defect. However, in this case, the body does not turn blue because there is no lack of oxygen in the blood.
- VSD, ASD, and PDA are the most common conditions under this category.
- Some children may not show any symptoms at first, but later they may develop symptoms such as difficulty breathing and fatigue.
- Many of these conditions have effective treatments, and some resolve spontaneously.
- If you or your child has this condition, it is very important to have regular checkups with a specialist cardiologist. Don't worry, with proper management, you can live a healthy life.
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