CONGENITAL DISORDERS
Congenital heart defects complicate approximately 8 of every 1,000 live births. Infants with heart disease often demonstrate poor feeding and failure to thrive. They may exhibit respiratory distress with rapid breathing, heart rates of 160 to 200 beats per minute. They may be ashen or blue in color and perspire excessively. Most of the defects occur during the first trimester of pregnancy, when formation of the heart and blood vessels takes place. Maternal infection with German measles (rubella), or alcohol use, drug use, smoking, exposure to radiation, and genetic disorders have all been implicated as causative factors.
The most common malformation involves a hole between the two muscular pumping chambers of the heart, termed a ventricular septal defect. This results in decreased blood flow to the lungs and mixing between the right and left sides of the heart, a condition termed cyanosis or blue baby syndrome. The baby has a bluish discoloration of the lips and skin, which is often more noticeable with crying and activity. Other common malformations include atrial septal defects, patent ductus arteriosus, and tetrology of Fallot. These defects cause an imbalance in the normally equal amount of blood circulated through the right and left sides of the heart. This requires extra work by the heart, and may eventually lead to heart failure.
The prognosis of infants born with congenital heart disease has markedly improved in recent decades. More than a dozen of the most commonly occurring congenital heart defects can now be totally corrected or significantly improved with surgical procedures. Advances in medical and surgical treatment allow many of these children to lead normal adult lives.