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Congenital Heart Disease

Also called: Congenital Cardiovascular Disease, Heart Birth Defect, Defects, Heart Defect, Congenital Heart Defect, Congenital Septal Heart Defect

- Summary
- About congenital heart disease
- Potential causes
- Types and differences
- Signs and symptoms
- About fetal heart development
- Diagnosis methods
- Treatment options
- Prospects for recovery
- Pediatric heart transplants
- Questions for your doctor

Reviewed By:
Fred Weiss, M.D., FAAP, FACC
Robert I. Hamby, M.D., FACC, FACP

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About fetal heart development

The fetal heart begins to form shortly after conception. By the end of the second month, the fetal heart is fully formed. Research has shown that congenital heart defects tend to form in this very early stage in pregnancy. Using advanced diagnostic tools, physicians are now able to detect some congenital heart defects before the baby is born.

During pregnancy, the fetal heart differs from the adult heart in some very important ways. Because the fetus does not use its lungs, the right side of the heart, which is responsible for pumping oxygen–poor blood to the lungs in an adult, is bypassed in a fetal heart. Before birth, there are two connections between the right and left sides of the heart. They are:

The ductus arteriosus. An open channel in every fetus that connects the two great arteries (the pulmonary artery and the aorta), allowing blood to bypass the lungs, which are not used by the fetus until it takes its first breath after birth. The ductus arteriosus should permanently close within a few hours to a few days after birth. If the ductus arteriosus remains open after birth (patent ductus arteriosus [PDA]), the heart may be overworked to the point of heart failure. If the baby is very premature this extra blood flow may increase the work of breathing. The neonatologist (newborn specialist) may give a medicine to stimulate the PDA to close. However, in some cases, the physician may need to keep the PDA open and may administer medications to accomplish this. This is often done when other congenital heart defects are preventing the normal flow of blood through the heart.
The foramen ovale. This is an opening between the right and left atria that allows the oxygen–rich blood from the placenta to bypass the right side of the heart and flow directly to the left ventricle (because the blood does not need to go to the lungs to get oxygen). After birth, these channels normally close as the baby breathes and blood flows to the lungs. If the foramen ovale fails to close, the child has a patent foramen ovale (PFO). A very small PFO may persist in about 10 to 15 percent of the general population. Usually this is of no significance, although some medical conditions, such as stroke, may be traced back to the presence of a PFO.