Most of us have personally experienced loss from heart disease or know of someone who has lost a loved one to a heart attack or heart problem. As a pediatric cardiologist specializing in heart failure and transplants, my goal is to raise awareness of a disease you might not have heard of before, congenital heart disease, which can affect the tiniest heart before a child is even born.
Basics of Congenital Heart Defects
According to the Centers for Disease Control and Prevention, 40,000 infants born in the United States each year will have a congenital heart defect or heart disease, meaning that a heart abnormality is present at birth. Heart defects are the most common type of birth defect.
As I explain to parents, the defects fall into three main categories: defects that don’t allow enough blood to flow to the lungs (not enough pulmonary blood flow), defects that cause too much blood flow to the lungs (pulmonary overcirculation) and defects that don’t allow enough blood to flow throughout the body (not enough systemic blood flow). They can include the underdevelopment of the heart’s chambers, abnormalities of the heart muscle, blockages in the blood vessels and many others.
Some defects need to be treated immediately, but others can be monitored over time, so it’s important for families affected by these conditions to maintain routine contact with their doctors.
Causes of CHD
Moms-to-be often wonder if they did something wrong during pregnancy to cause the defect, but in most cases, the answer is no. Some heart defects stem from genetics, but there is no known cause for the vast majority of cases. There are, however, some things that women who are pregnant or are planning to become pregnant should do, including:
Avoid tobacco, drugs and alcohol, as they might increase risk of heart defects.
Seek ongoing prenatal care and tell your doctor if you have a family history of CHD.
–Maintain good blood sugar control, especially if you have diabetes.
–Tell your doctor if you are considering beginning a new medication to check for side effects.
How Technology is Making a Difference in Diagnosis and Treatment
While hearing the words heart defect is scary, the good news is that doctors can develop a treatment plan for your child before he or she is even born, and children with CHD are living longer and healthier lives. Many complex forms of CHD can be found through a procedure called a fetal echocardiogram. This is a special type of imaging that sends ultrasonic sound waves through a mother’s abdomen that bounce, or echo, off structures in the fetus’s heart to detect abnormalities.
Once the child is born, we also can use 3-D printing to create accurate replicas of tiny hearts. These exact models allow the cardiologist and cardiac surgeon to visualize the heart defect and plan the appropriate intervention. If surgery is necessary, the models also allow physicians to see the precise formation of the defect and even practice the procedure ahead of time.
Tips to Keep Growing Hearts Healthy
The CDC cautions that more than one-third of U.S. adults are obese, a common condition linked to heart disease. But what frightens me even more as a pediatrician is that these numbers are expected to rise as obesity plagues children at younger and younger ages. Consider these tips to keep your family heart healthy:
Maintain your child’s weight as he or she grows. If a child’s weight already has surpassed doctors’ recommendations, work to maintain this weight as he or she grows. Taking proactive steps to balance the height to weight ratio is much easier than losing weight once they’ve reached their full growth potential.
Don’t single out your child; make healthy changes as a family. It might be easier to tell a child to go outside and exercise more or cut back on unhealthy snacks or drinks, but you are likely to be more successful in creating healthy habits if your whole family participates. For example, plan a trip to a local park to ride bikes together or encourage everyone to participate in healthy meal preparation.
Schedule regular pediatrician visits. This is important even if your child does not have a heart condition. These visits are about more than staying up to date on vaccines. Pediatricians ask many questions to screen for harmful habits so that you can intervene earlier for better outcomes.
Dr. Sairah Kahn is a cardiologist at Children’s National Hospital.
