Can you cure congenital heart defect? Expert answers 14 common questions about the birth defect

A congenital heart disease or defect is a common type of birth defect that requires medical treatment. The exact cause is unknown, but it may be related to genetic factors or maternal health. If you are a mother who has given birth to a baby with a heart defect, you will have many questions about it. Apart from knowing what it is, you may have questions about its treatment, or how to avoid the complications that come with it, and how it will affect your child’s life. It’s good to know everything about congenital heart defects to take care of your child in the best possible way.

On the day of congenital heart defect awareness, observed on February 14th, cardiologist Dr. Abhijit Bose began answering frequently asked questions about this health issue.

Question 1: What is congenital heart disorder?

Dr. Abhijit Borse: Congenital heart disorder (CHD) is a structural abnormality of the heart that develops before birth. It affects the way blood flows through the heart. Heart defects are the most common type of birth defect. According to the US Centers for Disease Control and Prevention, it affects almost 1% of births each year. The exact cause of CHD is often unknown, but genetic factors and maternal health conditions, such as diabetes and infections during pregnancy, can contribute to its outbreak.

Question 2: What are the seven important congenital heart defects?

Dr. Abhijit Borse: A critical congenital heart defect is a serious condition that requires immediate medical consultation after birth. The seven most important congenital heart defects include:

1. Left elastic left heart syndrome (HLHS)

HLHS is a severe congenital heart disorder in which the left side of the heart is not developed, making it difficult to pump oxygen-rich blood into the body. Babies with HLHS require multiple surgeries or heart transplants to survive.

2. Lung obstruction (PA)

In this condition, the pulmonary valve does not form properly, blocking blood flow from the heart to the lungs. Without treatment, the baby will not be able to get enough oxygen.

3. Farotto’s Tetrology (TOF)

The TOF consists of four cardiac defects, including a heart hole, narrowed pulmonary valve, thickened right ventricle, and an aligned aorta. This condition leads to a lower level of oxygen in the blood, causing cyanosis (bluish skin). Treatment requires surgery.

4. Great Artery Transposition (TGA)

TGA occurs when two major arteries (aorta and pulmonary arteries) are switched into place, leading to inappropriate circulation. Immediate surgery is required to correct this congenital heart defect.

5. Stem artery

This congenital heart defect occurs when a single blood vessel comes out of the heart rather than two separate blood vessels, resulting in a mix of oxygen-rich, oxygen-rich blood. Surgery is required to separate the vessel.

6. Total abnormal pulmonary vein return (TAPVR)

In TAPVR, veins carrying oxygenated blood from the lungs connect to the wrong part of the heart, resulting in insufficient oxygen circulation. Surgery is required to care for this congenital heart defect.

7. Aorta reduction (COA)

COA is a stenosis of the aorta, the main artery that transports blood from the heart to the body. This condition forces the heart to work harder, leading to high blood pressure and potential heart failure without treatment.

Question 3: Can I live a normal life with congenital heart failure?

Dr. Abhijit Bose: The outlook for people with congenital heart defects has been greatly improved with advances in medical, surgical and medication. Some CHDs can be managed with minimal lifestyle adjustments, but critical CHDs require lifelong surveillance and medical intervention. With proper treatment, many people with congenital heart disease can lead an active and fulfilling life. A cardiologist, a healthy heart diet, exercise (recommended by a doctor), avoiding smoking and excessive alcohol consumption can help you effectively manage your condition.

Question 4. Will the congenital heart defects be eliminated?

Dr. Abhijit Borse: The outcome of congenital heart defects depends on the type of condition and severity. Several mild defects, such as microventricular septal defects (VSD) and atrial septal defects (ASD), can close themselves as the child grows. However, more complicated conditions such as Fallot (TOF) tetology and platelet left heart syndrome (HLHS) often require surgery. If CHD is not fully cured, lifelong surveillance and medical care may be required.

Question 5: Can congenital heart disease cause death?

Dr. Abhijit Borse: Yes, congenital heart disease can be life-threatening, especially if it is severe and untreated. A study published in Lancet Child & Adolescent Health in 2020 found that 2,61,247 deaths occurred worldwide in 2017.

Question 6: What is a CHD blood test?

Dr. Abhijit Bose: Although blood tests alone cannot diagnose congenital heart disease, they can help assess heart function and detect complications. Commonly used tests include:

• Pulse oximetry to measure oxygen levels in the blood is often used as a screening tool for newborns.
• The B type natriuretic peptide (BNP) test can help assess the risk of heart failure in people with CHD.
• Genetic testing identifies genetic conditions associated with cardiac defects.
• Complete blood cell count (CBC) checks for anemia, infections, or other conditions that can affect heart health.
  These tests, combined with imaging studies, provide a more clear picture of the child’s heart health.

Question 7: How do you know if your baby has heart problems?

Dr. Abhijit Bose: Signs of CHD may appear at birth or soon after, but defects may not be detected until later. Parents should be careful:

• Bluish skin (cyanosis) due to low oxygen levels.
• Quick or work breathing.
• Insufficient feeding leads to slower weight gain.
• Swelling around the legs, abdomen, or eyes.
• Heart murmurs (abnormal heart sounds) detected during a medical checkup.
  If any of these symptoms of congenital heart failure develop, further testing is required.

Question 8: How to prevent a baby’s heart defect?

Dr. Abhijit Bose: Not all congenital heart defects can be prevented, but certain lifestyles and medical precautions can reduce the risk.

• Regular examinations and ultrasound can help you detect potential problems early.
• Taking 500 mcg of folic acid every day before and after pregnancy reduces the risk of birth defects.
• Pregnant women should avoid alcohol and smoking as they may affect the development of the fetal heart.
• Conditions such as diabetes, obesity, and hypertension should be well controlled before and during pregnancy.
• Several viral infections, such as rubella, can cause CHD. Getting vaccinated before pregnancy can reduce this risk.

Question 9: How do you deal with a baby’s heart hole?

Dr. Abhijit BoseHeart holes are one of the most common congenital heart defects. Treatment depends on the size and location of the defect.

• Small holes (e.g., small ventricular septal defects or atrial septal defects): Many of these will be closed independently within the first few years of life and only require regular monitoring by a cardiologist.
• Medium to large holes: These may require intervention if they cause symptoms such as poor growth, difficulty breathing, or recurrent infections. Treatment options include:
• Medicine: Drugs such as diuretics can help reduce fluid buildup and relieve symptoms.
• Catheter-based procedure: A minimal invasive approach to inserting the device through the blood vessel to close the hole.
• Surgery: In severe cases, heart surgery is required to patch the hole and restore normal blood flow.

Question 10: Can I cure congenital heart disease?

Dr. Abhijit Bose: There is no universal “treatment” for congenital heart disease, but many treatments effectively manage or correct defects. The approach depends on specific conditions.

• Mild CHD: Some small flaws are naturally healed without intervention.
• Moderate to severe CHD: These require treatment, surgical, or catheter-based intervention. Complex heart defects require multiple surgeries or lifetime management.
• Heart transplant: Children may undergo a heart transplant if they cannot be corrected by surgery or if the heart fails after surgery and have a serious congenital heart defect, according to the National Heart, Lung and Blood Institute.

Question 11. Do ultrasound help to detect fetal heart defects?

Dr. Abhijit BoseYes, fetal echocardiography (special ultrasound of the baby’s heart) can be used to detect many congenital heart defects before birth. This test is usually performed between 18 and 24 weeks of pregnancy. In particular, if the following risks are high:

• Family history of CHD.
• Maternal health conditions such as diabetes and lupus.
• Anomaly detected by daily prenatal ultrasound.
• Genetic syndromes like Down syndrome.

Question 12. What is the best medicine for congenital heart disorders?

Dr. Abhijit Bose: There is no single “best” medication for CHD, but some medications can help manage symptoms and prevent complications.

• Diuretics (such as furosemide) can help reduce fluid accumulation and relieve symptoms of heart failure.
• Beta blockers (such as propranolol) are used in some CHD cases to control abnormal heart rhythms.
• ACE inhibitors (eg, Enalapril) help to relax blood vessels and improve heart function.
• Prostaglandins are administered in neonates with certain serious cardiac defects to keep the duct open for blood flow before surgery.
• Anticoagulants (e.g., aspirin, warfarin) are used in patients with CHD who are at high risk of artificial valves or thrombosis.

Although medication alone cannot cure CHD, it plays an important role in managing symptoms, improving heart function, and preparing surgical interventions where necessary. You should also always check with your doctor about the appropriate treatment course for your condition.

Question 13: What should you avoid when you have congenital heart disease?

Dr. Abhijit Bose: People with CHD, especially those with moderate to severe defects, should avoid certain activities and lifestyle choices that can strain the heart or worsen the condition.

• Intense activity and high-intensity sports: Some people with congenital heart defects can exercise safely, but high-intensity sports such as weightlifting, marathon running and competitive contact sports can be intense on the heart.
• Smoking and Alcohol: Smoking damages blood vessels and increases the risk of heart failure and complications. Excess alcohol can lead to heart rhythm problems, especially in people with heart defects repaired.
• Unregulated Drugs and Supplements: Some over-the-counter medications (such as urinating substances) contain stimulants that can increase blood pressure and heart rate. Certain supplements that contain high doses of caffeine or herbal stimulants should be avoided.
• Uncontrolled stress: Chronic stress can put extra strain on the heart. Practice of relaxation techniques such as meditation and deep breathing can help maintain heart health.
• Poor dietary choice: People with congenital heart disorders should limit high sodium, high fat, and ultra processed foods to prevent cardiac complications.

Question 14: How to care for a child with congenital heart disease?

Dr. Abhijit Bose: Caregiving for children with CHD requires medical surveillance, lifestyle adjustment, and emotional support. Here are the important steps:

• Follow up with a pediatric cardiologist to monitor your child’s heart health. Make sure all necessary medications, treatments, or surgeries are followed as prescribed.
• Encourage a heart-healthy diet with nutrient-rich foods. Monitor sodium and sugar intake to prevent additional heart tension.
• While some sports may be limited, many children with CHD benefit from light and moderate exercise, such as walking and swimming. However, check with your doctor before you let your child begin physical activity.
• Children with CHD are at increased risk for infections such as endocarditis (cardiac infection). Good hygiene, flu vaccinations, pneumonia, and regular dental treatments can help reduce this risk.
• Children with CHD may feel different from their peers. We encourage emotional well-being by providing support, connecting with the CHD support group and developing confidence.