Congenital Heart Disease (CHD) is a leading cause of deaths across the world. CHD is an inborn defect of the heart in which it fails to function properly due to its structure. The condition is becoming a major burden in healthcare because approximately 85% to 90% of the children can survive to adulthood. This has been as a result of improved medication and treatment. Discussed in this report are the different causes of CHDs, signs and symptoms, risk factors, diagnosis, treatment, prevention measures and resultant complications in case of improper treatment. The significant groundbreaking discoveries have been as a result of major past and present trends in research. While the future of CHD is unknown, there is need to find a way on how to sustain the growing population of CHD adults. Collaboration, partnerships, use of big data, the involvement of patients in the research process and use of precision in therapies are some of the expected future inclinations in research.
Congenital Heart Disease in Pediatrics
Congenital Heart Disease (CHD) is a heart defect present at birth, and it is characterized by an abnormality in the structure of the heart (MedlinePlus, 2018). Due to this, the regular flow of blood is considerably disrupted. For instance, its flow rate can either reduce, flow in the wrong direction or can completely be blocked. CHD is a unique defect because sometimes causes no problems while in other times, it can result in life-threatening complications.
There are various types of CHDs with different levels of severity: simple, complex or critical. Regardless of their seriousness, they are all caused by the following factors:
• Holes in the heart: when a hole forms between the atria, ventricular walls or between the major blood vessels from which blood leaves the heart causing mixing of oxygenated blood with a deoxygenated one (Mayo Clinic, 2018a). Examples of such defects are atrial and ventricular septal defects respectively and patent discus arteriosus.
• Obstructed blood flow: narrowing of blood vessels and valves causing the heart to overwork in pumping blood through them leading to its enlargement and thickening of its muscles. Pulmonary or aortic stenosis are instances of resultant defects.
• Abnormal blood vessels: incorrect formation or positioning of blood vessels going into or out of the heart. Examples include arterial transposition, aortic coarctation and anomalous pulmonary venous connection (Mayo Clinic, 2018a).
• Heart valve abnormalities: the inability of the heart to close and open correctly leading to an improper flow of blood. Common defects from this anomaly are Ebstein’s anomaly and pulmonary atresia.
• An underdeveloped heart: it occurs when a portion of the heart fails to develop well, for instance, the hypoplastic left heart syndrome in which the heart is underdeveloped in its left part. Consequently, it fails to pump sufficient blood across the body organs.
• Multiple defects: when one is born with a couple of heart defects for instance Tetralogy of Fallout which is as a result of four defects: ventricular hole, narrowing of blood vessels, thickening of muscles and overriding of the aorta.
Signs and symptoms depend on the seriousness of the defect. Serious symptoms immediately manifest after a child is born and include cyanosis (change in skin color to either blue or pale gray), increased breathing rates, inflammation around the eyes and abdomen and breathing difficulties during feeding (Mayo Clinic, 2018a). Symptoms from minor CHDs usually manifests after the child has grown since they may be unnoticeable when a child is born. They include running out of breath, fainting occasionally, and excessive tiring after an activity/exercise or inflammation of the hands or feet (Mayo Clinic, 2018a).
The leading cause of CHDs remains a mystery. However, a parent can take some measures to reduce the probability of a child’s risk of acquiring congenital disabilities. First, vaccination against rubella infection while expectant. Rubella (German measles) is known to affect the proper development of a baby’s heart before it is conceived (Mayo Clinic, 2018a). Secondly, a pregnant mother should ensure that she is healthy and in perfect control of any chronic medical conditions like diabetes, epilepsy among others. Thirdly, stop consumption of toxic substances like smoking, drinking alcohol or take drugs without a doctor’s prescription (Lui, Fernandes, & McElhinney, 2014). Finally, the pregnant mother is strongly recommended to at least take multivitamin tablets containing 400µg of folic acid every day.
Identification of CHDs require examination of one’s medical history and through a couple of tests like an electrocardiogram, chest x-ray, echocardiogram, pulse oximetry, exercise stress test, cardiac CT or cardiac catheterization (Mayo Clinic, 2018b). All these measures are designed to evaluate the functioning of the heart and body to detect any abnormalities as a result in heart malfunction like heartbeat rate, heart’s electrical activity, the oxygen level in blood or level of blood pressure.
Treatment is usually done to correct the defect or secondary complications and may include regular checkups to keep the condition in check especially for mild cases. For mind cases, medication is usually recommended to maintain regular heartbeats and prevent clotting of blood (Mayo Clinic, 2018b). Moreover, heart devices that help regulate heart rate can be implanted in someone. Finally, in case the following fails to work, open-heart surgery is recommended while heart transplant is usually considered the last option.
Research by Lui et al. (2014) highlights chronic diseases like diabetes and obesity and lack of physical activities as some of the risk factors for CHD. Additionally, medication, rubella during pregnancy, smoking and alcohol consumption before conception and heredity are other instances of risk factors (Mayo Clinic, 2018a). Without proper medication, CHDs can lead to complications like stroke, cyanosis, retarded growth and development, emotional issues or congestive heart failure.
Despite the significant advancement in medical breakthroughs, the cause of CHDs has not been identified with precision. It remains a common congenital disability with approximately 0.8% born with it (Gurvitz, Burns, Brindis, Broberg, Daniels, Fuller, & Mahle, 2016). However, due to advanced diagnosis, treatment, and prevention, 85% to 90% of these children survive to adulthood resulting into a population of men and women with CHDs (Gurvitz et al., 2016). Notable past and present research trends, as highlighted by Kaltman, Burns, and Pearson (2017), are a multidisciplinary approach where different experts work together to deal with CHD cases and utilization of big data to investigate variations, track patients and outcomes among other factors. While the future research remains speculative, identifiable trends include increased research efficiency, growing need for collaboration and partnerships, use of precise therapies and engaging patients as active participants in the diagnosis process.