Why Do Babies Have Heart Attacks in the Womb

KEY POINTS

• Congenital center defects (also chosen CHDs) are heart conditions that a baby is born with. They're the most common types of nativity defects.

• The most serious congenital center defects are chosen critical congenital middle defects (also called critical CHDs).

• Babies with critical CHDs need surgery or other handling within the first twelvemonth of life. Without treatment, disquisitional CHDs can be deadly.

• Nigh every state requires babies to be checked for critical CHDs at nascency as office of newborn screening.

• If you're significant or trying to get pregnant, don't smoke or drink booze. Doing these things can increase the chances of your baby having a CHD.

What are congenital heart defects?

Congenital means present at birth. Congenital heart defects (also called CHDs) are middle conditions that a baby is born with. These weather condition can affect the heart'south shape or how it works or both. CHDs can exist mild or serious.

CHDs are the most common types of birth defects. Birth defects are structural changes nowadays at nascency that can touch almost any part of the trunk. They may affect how the body looks, works or both. Birth defects can cause problems in overall health, how the body develops or how the body works.

Critical congenital heart defects (besides called disquisitional CHDs or critical congenital heart illness) are the most serious congenital middle defects. Babies with critical CHDs demand surgery or other treatment within the first year of life. Without treatment, critical CHDs tin can crusade serious health bug and death.

Well-nigh 1 in 100 babies (nigh i percent or 40,000 babies) is born with a heart defect in the U.s.a. each year. About 1 in 4 babies born with a heart defect (about 25 pct) has a critical CHD. Some center defects don't need treatment or can be treated easily. But others, like some critical CHDs, may need surgeries over several years.

How can centre defects bear on your baby?

Heart defects tin can affect different parts of your baby's heart, including:

• Heart chambers. The heart has iv chambers. The 2 upper chambers (also chosen atria) receive blood. The ii lower chambers (likewise called ventricles) pump blood out of the heart to other parts of the body.
• Septum. This is a wall that separates the right and left sides of the centre. There is a wall between the two atria, and a wall betwixt the two ventricles.
• Heart valves. These valves open and shut to control blood flow through the heart. They help blood move in the correct direction as information technology's pumped to other parts of the trunk.
• Arteries and veins well-nigh the heart. Arteries are claret vessels that carry blood away from the middle to the body. The aorta is the main avenue that carries blood away from the heart to the balance of the body. Veins are blood vessels that carry blood from the body to the heart.

Eye defects tin touch claret flow, causing your baby'southward blood to:

• Slow downwardly
• Become in the wrong management or to the wrong identify
• Exist blocked
• Non have plenty oxygen to deport throughout the body

Some of these blood period problems can cause fluid buildup in the lungs (also called lung congestion or pulmonary edema). Fluid in the lungs can make it harder for your baby to breathe. Babies with serious heart defects may develop heart failure (too called congestive heart failure). This is when the heart can't pump blood likewise every bit it should.

What are examples of critical CHDs?

Critical CHDs include:

Coarctation of the aorta (as well called COA). In this condition, function of the aorta is likewise narrow. This can reduce or block the menses of claret to the trunk. The heart muscles demand to work harder to get blood out of the middle. This extra stress on the middle can weaken the heart musculus and cause other centre bug. Babies with COA are treated with surgery or a procedure called airship angioplasty. In this procedure, a provider uses a catheter (a thin, flexible tube) with a tiny airship that he expands to stretch open the aorta. He may put in a stent, which is a small mesh-covered tube used to keep the blood vessel open. Many children with COA need to take medicine to lower their blood force per unit area. Blood force per unit area is the forcefulness of claret against the walls of the arteries.

Dextro-Transposition of the Great Arteries (too called d-TGA). Babies with this status accept the positions of two of import arteries switched. This means the blood that'southward pumped to the torso may non have enough oxygen. Babies with d-TGA need middle surgery before long later on birth to help go oxygen-rich blood from the middle to the rest of the body. They may need medicines to make their heart pump better, lower their claret pressure, assist the body go rid of extra fluid or deadening down the middle if information technology's beating also fast. If the centre is beating too slowly, they may demand a pacemaker. A pacemaker is a small device placed under the skin in the chest to help control the heartbeat.

Interrupted aortic arch (likewise called IAA). In this condition, a role of the aorta is missing. This means that the eye tin can't ship blood through the aorta to the rest of the body. Babies with IAA demand surgery soon after nativity to repair the aorta.

Pulmonary atresia (likewise called PA). In this condition, the centre'due south pulmonary valve doesn't course properly or at all. The pulmonary valve controls blood flow from the right ventricle of the middle to the lungs. If a babe has PA, claret can't catamenia from the eye to the lungs to pick up oxygen for the trunk. Babies with PA commonly demand medicine to improve blood menstruation until they tin can be treated with cardiac catheterization or surgery. During cardiac catheterization, your baby'southward provider moves a catheter into a blood vessel and guides it to his centre. Then he can use a tiny balloon to expand the valve. Or he may put in a stent to keep a blood vessel open. But nearly babies with PA need surgery soon afterward nativity to widen or replace the pulmonary valve.

Single ventricle defects. In this grouping of weather, a infant's heart has one ventricle that works well enough to pump claret instead of two ventricles. Single ventricle defects include:

• Ebstein anomaly. In this status, the heart'due south tricuspid valve (the valve between the two correct chambers of the heart) doesn't work properly. This means blood can leak dorsum into the wrong part of the center. Babies with this status may demand surgery to repair or replace the tricuspid valve. They too may need medicines to control their center rate, better blood flow or treat whatever signs of heart failure.
• Hypoplastic left middle syndrome (as well called HLHS). In this condition, the left side of the center doesn't class correctly, and the eye can't pump blood to the body properly. A infant with HLHS needs several dissimilar types of surgery starting soon after birth to help increase blood catamenia to her trunk. Some babies likewise demand medicines to brand their heart muscle stronger, lower their blood pressure or help the body get rid of extra fluid. If the condition is very severe or if surgeries weaken the heart, the baby may need a heart transplant. A middle transplant is surgery in which a damaged heart is removed and replaced with a healthy heart from another person.
• Tricuspid atresia. In this condition, the center'south tricuspid valve (the valve between the two right chambers of the heart) isn't formed. This means that blood tin't flow correctly through the heart or to the balance of the body. Babies with tricuspid atresia may need i or more surgeries starting presently after birth to increase blood catamenia to the lungs and bypass (get around) the part of the heart that's not working properly. Some babies need medicines to make the heart muscle stronger, lower their blood pressure, or help the body get rid of extra fluid.
• Double-outlet right ventricle (also chosen DORV). In this condition, the aorta connects to the eye's right ventricle instead of the left ventricle. There's also a pigsty betwixt the two ventricles. This means that the blood being pumped to the trunk may not have enough oxygen. Babies with DORV need surgery to repair the heart.

Tetralogy of Fallot (also called TOF). Babies with this condition have a combination of four heart defects that limits oxygen in blood that's pumped to the body. Babies with TOF need heart surgery soon after nativity to improve blood flow to the lungs and the residuum of the body.

Total anomalous pulmonary venous return (also called TAPVR). In this status, the veins that take blood from the lungs to the centre don't connect to the eye the correct way, so the body doesn't get enough oxygen. Babies with this condition need surgery so that claret can flow better through the middle.

Truncus arteriosus (likewise called common truncus). Babies with this condition take merely one artery that leaves the heart instead of ii arteries. They also have only one valve that controls the blood that leaves the middle instead of 2 valves. This means that claret with oxygen mixes with claret that doesn't accept oxygen. So likewise much blood goes to the lungs, and the heart has to piece of work harder to pump blood to the rest of the body. Babies with this condition need surgery to repair the heart and claret vessels. Some babies may need medicines to make the middle muscle stronger, lower their blood pressure level or help the torso get rid of extra fluid.

Every bit they grow older, most babies with critical CHDs demand regular checkups with a pediatric cardiologist to check the heart and look for whatever other health problems.

What are mutual congenital heart defects and how are they treated?

Common CHDs include:

Patent ductus arteriosus (also chosen PDA). This condition happens in the connection (called the ductus arteriosus) between two major blood vessels leading from the heart: the pulmonary avenue and the aorta. The ductus arteriosus is open when a babe is in the womb. If it doesn't close properly afterward nativity, claret that doesn't accept enough oxygen can flow in the incorrect direction. This can weaken the eye muscle and lead to eye failure. Sometimes a PDA may shut on its own. But some babies need medicine, procedures with catheters or middle surgery.

Septal defects. These conditions leave a hole in the septum. This can cause blood to go in the wrong direction or to the wrong place, or it can cause extra claret to be pumped to the lungs. Types of septal defects include:

• Atrial septal defect (also called ASD). This is when the hole is in the wall that separates the right and left atria.
• Ventricular septal defect (also chosen VSD). This is when the hole is in the wall that separates the right and left ventricles. VSDs are the about common type of heart defect.
• Atrioventricular septal defect (AVSD). This is when at that place are holes between the chambers of the correct and left side of the eye, and the valves between these chambers may non course correctly.

Some small-scale septal defects close on their own. Heart surgery or procedures with catheters can fix larger septal defects. Babies with AVSD usually need heart surgery.

What causes congenital heart defects?

Eye defects can begin to develop in the kickoff six weeks of pregnancy when the heart is forming, often earlier yous know y'all're meaning. We're not sure what causes about congenital heart defects, just these things may play a role:

Changes in genes or chromosomes

Some babies accept center defects considering of changes in their chromosomes or genes. Chromosomes are the structures that concord genes. Genes are part of your body's cells that store instructions for the way your body grows and works. Genes are passed from parents to children. Sure gene changes (also called mutations) are linked to heart defects. At least 15 in 100 (15 percent) of CHDs are linked to genetic or chromosomal weather condition. For example, about one-half of babies with Down syndrome have heart defects.

If you, your partner or one of your other children has a built heart defect, your side by side babe may be more likely to have one, too. So yous may want to meet with a genetic counselor. This is a person who is trained to assistance you understand genes, birth defects and other medical conditions that run in families, and how they can affect your health and your baby's health.

Health atmospheric condition in mom

Having one of these conditions may increase your risk of having a infant with a CHD:

• Lupus (also called systemic lupus erythematosus or SLE). Lupus is an autoimmune disease. This is a health condition that happen when antibodies (cells in the body that fight off infections) attack healthy tissue by fault. Lupus can damage the joints, skin, kidneys, centre, lungs and other body parts.
• Maternal phenylketonuria (also called PKU). PKU is a condition in which your body can't break downwardly an amino acid chosen phenylalanine. Amnio acids help build protein in your body. Without handling, phenylalanine builds up in the claret and causes wellness problems. Near pregnant women with PKU tin can have healthy babies if they follow a special mean plan that'due south low in phenylalanine.
• Obesity (being very overweight). If you're obese, you have an excess amount of trunk fatty, and your body mass alphabetize (BMI) is xxx or higher. To discover out your BMI, get to www.cdc.gov/bmi.
• Preexisting diabetes (also chosen type ane or type 2 diabetes). This is a medical status in which your body has too much sugar (called glucose) in your claret. Preexisting means you had diabetes before yous got pregnant. Diabetes tin can damage organs in your torso, including claret vessels, nerves, eyes and kidneys.
• Rubella (likewise chosen German language measles). This is an infection that causes mild influenza-like symptoms and rash on the skin. Having rubella during pregnancy may increment your baby's chance for a CHD.

Medicines you accept

Taking certain medicines may increase your baby's risk of having a CHD. Tell your provider nearly whatever medicine y'all have before you lot attempt to get pregnant. This includes prescription medicines, over-the counter medicine, herbal products and supplements.

If the medicine you take may be harmful to your babe, y'all may be able to alter to one that'south safer. Simply some medicines may be critical to your ain health, fifty-fifty if they may bear on your infant. You lot and your provider can counterbalance the benefits and risks of medicine you lot take to give you the healthiest possible pregnancy. Don't kickoff or terminate taking any prescription medicine earlier, during or after pregnancy without talking to your wellness care provider beginning. Starting, stopping or changing medicines may cause serious health problems for yous or your baby.

These are examples of medicines that may increase your baby's risk of having a CHD:

• ACE inhibitors. These medicines are used to treat loftier blood pressure level and other conditions. High blood pressure level is when the force of blood against the walls of the blood vessels is besides loftier. Information technology tin stress your heart and crusade issues during pregnancy.
• Isotretinoin. This medicine is used to treat acne.
• Lithium. This medicine is used to care for low. Depression (likewise called depressive disorder, major depression and clinical depression) is a medical condition that causes feelings of sadness and a loss of interest in things you like to do. Information technology can affect how you feel, think and deed and tin can interfere with your daily life. It needs treatment to become better.
• Statins. These medicines are used to care for loftier cholesterol. Cholesterol is a substance in your blood. Too much cholesterol can increase your adventure of heart disease.
• Thalidomide. This medicine is used to treat certain pare conditions, infections, certain types of cancer and complications from HIV (stands for man immunodeficiency virus). HIV attacks the body's immune system and is the virus that causes AIDS. In a healthy person, the allowed organization protects the body from infections, cancers and some diseases.

Conditions in your everyday life (lifestyle and surround)

Some things in your life and environment (where and how you lot live) may increase your chances of having a baby with a CHD. These include:

• Drinking booze during pregnancy. If you're pregnant, trying to go pregnant or call back y'all may exist significant, don't drinkable alcohol.
• Smoking before or during pregnancy. Women who smoke anytime during the month before pregnancy or during the first iii months of pregnancy are more likely to have a baby with a CHD than women who don't smoke.

If you smoke or drinkable alcohol, ask your health care provider about getting help to quit.

How practise yous know if your babe has a congenital heart defect?

If your wellness care provider doesn't find a severe congenital eye defect in your infant during pregnancy, information technology's normally diagnosed soon subsequently birth or during the first few months of life. Less severe heart defects may not exist found until children are older.

During pregnancy

Your provider may use a examination called fetal echocardiogram (also called fetal repeat) to check your babe's middle. This test uses ultrasound to make a picture show of your babe's heart while still in the uterus (womb). You lot can have this test at about 18 to 24 weeks of pregnancy.

You may demand a fetal echocardiogram if:

• Your provider finds a possible trouble, like an abnormal heart rhythm in your baby, during an ultrasound.
• Your babe has a genetic or chromosomal status, like Downwardly syndrome, that may be linked to CHDs.
• Yous have a family history of heart problems. This means that you lot, your partner or someone in your families has centre problems.
• You accept a health status, like diabetes, that may play a role in CHDs.
• Yous're taking a medicine that can increase the risk of your baby having a CHD.

After birth

Your baby is tested for critical CHDs equally part of newborn screening before she leaves the infirmary after nascency. Newborn screening checks for serious but rare and more often than not treatable conditions. It includes blood, hearing and middle screening. All states require newborn screening, and all states except California require screening for critical CHDs. California requires that providers offer screening for disquisitional CHDs.

Babies are screened for critical CHDs with a simple exam called pulse oximetry (also chosen pulse ox). This test checks the amount of oxygen in your infant'south blood. Low levels of oxygen tin can exist a sign of a heart defect. Pulse oximetry uses a pulse oximeter car with sensors that are placed on your baby's peel. The test is painless and only takes a few minutes. Pulse oximetry can find many merely non all critical CHDs. Your baby's provider also may detect a heart defect by doing a concrete exam.

If tests find that your baby has a critical CHD, she can get early care and treatment to prevent more serious health problems. Your baby'south provider can refer your infant to a pediatric cardiologist for treatment. This is a doctor who treats babies and children with middle atmospheric condition.

What are signs and symptoms of congenital center defects?

Signs of a condition are things someone else tin can meet or know virtually y'all, like y'all have a rash or y'all're cough. Some CHDs have no signs, and so you may not know that your infant has a CHD until he's older.

Signs of heart defects include:

• A heart murmur. This is a blowing, whooshing or rasping sound heard during a heartbeat. Information technology'southward caused past crude claret menstruum through the heart valves or near the center.   Your infant's provider may hear a murmur when she checks your infant's heartbeat using a stethoscope.
• A pounding heart
• A weak pulse
• Gray or blue color of the pare, lips or fingernails
• Sleepiness while feeding or being very sleepy at other times
• Swollen abdomen or legs or puffiness around the optics
• Problem animate or fast breathing. Breathing problems while feeding can lead to slow weight gain.

If your baby has any of these signs, phone call his provider correct away. Your infant's provider may use these tests to cheque for center defects:

• Physical examination. Your babe'due south provider listens to your baby'south center and lungs with a stethoscope and looks for other signs of a heart defect.
• Echocardiogram (too called an echo or cardiac ultrasound). This is an ultrasound of the heart. Your baby's provider tin see the heart beating and cheque the heart'south valves and other parts.
• Electrocardiogram (as well called EKG or ECG). This test records the heart's electric activeness. It shows how fast the heart is beating and if its rhythm is steady or not. It also shows the size and position of the centre's chambers.
• Breast Ten-ray. This test makes pictures of your baby'south chest and organs, similar the heart and lungs. Information technology can evidence if the heart is enlarged. It as well can show if the lungs have extra blood or other fluid in them. An enlarged eye or extra fluid in the lungs tin can be signs of centre failure.
• Pulse oximetry
• Cardiac catheterization

Last reviewed: June, 2019

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Source: https://www.marchofdimes.org/complications/congenital-heart-defects.aspx

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