| The exact cause of a congenital heart
defect is not known.Although genetic factors seem to play a part, families
should be aware that medical researchers cannot predict most cases.
Therefore, there's no point in trying to pin down genetic "blame"
or determine which side of the family "caused" the problem.
In addition to genetic factors, certain environmental
and behavioral factors have been identified as interfering with the development
of the fetus's heart during the first 10 weeks of gestation. Some
conditions that alert a physician to the possibility of congenital heart
disease in an infant include:
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Congenital heart
disease in the mother or father.
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Congenital heart
disease in a previous child or other relative.
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Diabetes in the mother.
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Rubella (German measles),
Toxoplasmosis (a protozoal infection transmitted via cat feces)
or HIV infection in the mother.
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The mother's excessive
use of alcohol.
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The mother's use
of cocaine or other drugs.
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The mother's exposure
during pregnancy to certain anticonvulsant and dermatological medications.
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The Fetal Heart
During development inside the uterus, the growing fetus
is fully dependent on the mother's circulatory system and the placenta
for nourishment. The fetus is also dependent on the placenta as its source
of oxygen and its means of removing carbon dioxide.
The fetus doesn't use its own lungs until birth, so
its circulatory pathway is different from that of a newborn infant.
Before birth, the heart doesn't have to pump blood to the lungs to pick
up oxygen. So, instead of having a separate left pulmonary artery
and aorta, in the fetal heart, these two blood vessels are connected via
a blood vessel called the Ductus Arteriosus. In addition, there is an
opening between the right and left atria in the fetal heart, called the
Foramen Ovale, which allows blood to circulate more directly from the
right atrium to the left atrium during fetal development. The ductus arteriosus
and the opening between the two atria exist as parts of the circulatory
system before birth, but that system changes after birth.
These temporary routes naturally close up shortly after
birth, when the baby's lungs and cardiovascular system take over.
And because the fetal heart has a circulatory system different from the
one the baby uses after birth, some heart defects become apparent days
or weeks after birth that weren't spotted earlier.
Types of Congenital Heart Disease
The most common Congenital heart defects are
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Abnormalities that
impede the flow of blood through the vessels.
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Heart valves that
are malformed, missing, or block the flow of blood.
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Problems with the
structure of the heart that allow blood to flow from one side to
the other outside the normal circulatory path.
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Problems with the
connections between the main arteries or veins and the heart.
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More than one congenital problem may be present at the same
time including
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Septal defects (atrial
and ventricular)
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Common atrioventricular
canal defect
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Patent ductus arteriosus
(pulmonary or aortic)
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Ebstein's anomaly
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Co-arctation of the
aorta
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Tetralogy of Fallot
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Transposition of
the great arteries
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Persistent truncus
arteriosus (tricuspid and pulmonary)
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Total anamolous pulmonary
venous connection
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Hypoplastic left
heart syndrome
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High Blood Pressure And Cholesterol
Although hypertension, or high blood pressure, is not
considered a congenital heart disease, it sometimes has a hereditary link.
For that reason, children born in families with a history of high blood
pressure need to have their blood pressure monitored with special care.
Very high levels of LDL ("bad") cholesterol
also sometimes run in families: One inherited condition that affects
1 to 2 percent of children is familial hypercholesterolemia. Very
high levels of LDL cholesterol may contribute to atherosclerosis, which
is the buildup of plaque in the arteries. Therefore, children with familial
hypercholesterolemia need to have their cholesterol levels tested before
they're 5 years old, and regularly thereafter. Treatment for high cholesterol
may involve the child's getting more exercise and eating foods with
low levels of fat and cholesterol. Medication to lower cholesterol levels
may be prescribed for children whose LDL cholesterol after 1 year of
diet therapy remains greater than 190 mg/dL. (5.0 mmol/L), or for children
over 10 who have additional risk factors for heart disease and whose
I.DL cholesterol remains greater than 160 mg/dL
(4.1 mmol/L).
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