Congenital Heart Disease

 

Congenital Heart Disease is a defect within the heart structure and more commonly present at birth. The severity of the disease varies from mild defects to severe and life-theatening conditions. According the the birth defect registry it was reported from 1994 till the year 2000, congenital heart disease was a factor in 0.81% of total live births.  

According to Health Indicator 2007 by the Malaysian Department of Statistics, there were about 500,000 child deliveries in Malaysia in a year. Incidences of congenital heart disease is estimated at about 5,000 per year, of which two thirds will require surgical interventions in the first year of life. About 400 children under the age of 5, with congenital heart disease died in the year 2016. In addition, over 25,000 youth are reported to be suffering from this disease.  

There are many types of Congenital Heart Disease such as: 

- Atrial Septal Defect (hole in the wall separating the two upper, right and left, atriums of the heart)

- Coarctation of the aorta

- Fallot's Tetralogy

- Hold in the heart

- Mitral Valve Prolapse

- Patent Ductus Arteriosus

- Pulmonary Artesia

- Pulmonary / Aortic Stenosis

- Transposition of the great vessels

- Ventricular Septal Defect (hole in the wall separating the right and left ventricles)

 

Causes

The cause for Congenital Heart Disease is yet to be fully understood, however they might include:

Chromosomal or genetic conditions, which can be inherited or might occur once in a while during early pregnancy:

- Down Syndrome, DiGeorge Syndrome, Marfan Syndrome and Turner Syndrome 

- Environmental factors can lead to congenital heart disease:

- Excessive drug or alcohol consumption during pregnancy, acne medications, exposure to chemicals, viral infections (e.g. rubella), and other diseases including diabetes

Symptoms

Many congenital heart defects show no signs or symptoms.If multiple heart defects are detected in newborns, certain symptoms might appear: 

- Blue skin, lips, and fingernails

- Chest pain

- Fainting

- Heart murmur

- Palpitation

- Poor blood circulation

- Rapid breathing 

- Tiredness

Treatment

Transcatheter Procedures might be used where it is essentially a small invasive procedure that is more commonly done using a catheter (small tube). This includes the delivery of an intravascular device such as a balloon, a coil, or a stent to help expand or close (device closure) existing cardiovascular defects. 

Types of transcatheter procedures include: 

Balloon Angioplasty or Balloon Dilation is a procedure that aids in enlarging narrow blood vessels to improve blood flow in the heart. 
Balloon Atrial Septostomy is used to treat certain congenital heart defects and can be performed in foetuses or in infants. Essentially, a technique that helps in enlarging the hold between the right and left side of the heart. 
Balloon Valvuloplasty, this procedure is to aid patients with narrow valves and to widen it's opening with a tiny balloon catheter that inflates and deflate the affected valve.
Device closure of a condition called Patent Ductus Arteriosus (PDA) is used when a baby's Ductus Arteriosus, usually an artery that exists in all foetuses at birth but is not completely closed after birth. A device is carefully inserted through the bloob vessels in the groin area to close this gap. 
Device closure of Atrial Septic Defect (ASD), a congenital heart defect between the upper two chambers of the heart. Device closure is performed with an occluder (separator) that is inserted to divide the two chambers, so the heart can then go back to functioning well.

Surgery

Cavo-pulmonary shunt (CPS)

Fontan procedure

Ligation of patent ductus arteriosus

Modified blalock taussig shunt (BTS)

Norwood procedure

Pulmonary artery band (PAB)

Rastelli operation

Ross procedure

Complications and related diseases
Complications related pregnancies, use of contraception and risk to offspring
Inflammation of the inner layers within the heart (Endocarditis)
Managing of resulting non-cardiac medical problems
Social, emotional, financial, employment and educational problems
Surgical procedure complication and life-long follow-up

Our Specialists

Dr. Ahmad Ashraf Zaini Anwar
Specialty
Internal Medicine
Interventional Cardiology
Location
Gleneagles Hospital Kota Kinabalu
Dr. Chu Chong Mow
Specialty
Internal Medicine
Interventional Cardiology
Location
Gleneagles Hospital Kota Kinabalu

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