Causes of congenital heart defects
Causes are thought to include:
Development problems during pregnancy, sometimes as a result of a viral infection such as rubella contracted by the mother
Alcohol, illegal drugs and over-the-counter medicines can also cause defects
Genetic conditions, such as Down’s syndrome
Diagnosing congenital heart defects
Diagnosis can be made by scans taken during pregnancy, but is usually made in the first days or weeks after birth. In some cases, however, diagnosis may not be made until much later in life.
About 30 per cent of children will, at some time, have an innocent heart murmur. But sometimes there are more serious problems with the heart.
What are congenital heart defects?
Congenital heart defects are present in about six out of 1,000 of babies. They take the form of holes between the chambers, blockages in the pathways from the heart to the lungs or the body, or abnormal connections between the chambers and vessels of the heart.
127 heart transplants were undertaken in the UK in 2008, a fifth on children under the age of 16. Heart transplants are usually carried out on people with severe heart failure caused by coronary heart disease or cardiomyopathy. They can also be carried out for patients with:
- Severe abnormalities of the heart valves.
- Congenital heart defects.
- Uncontrollably fast heart rhythm.
A heart transplant may be offered for a number of reasons, when certain conditions are met:
- The heart muscle has become weakened (cardiomyopathy).
- The heart’s blood vessels are blocked and the heart muscle is damaged.
- Apart from heart problems, the individual is in good health.
- Other treatments have been tried or excluded.
- The individual is under 60 (in most cases).
- The individual is able and willing to stick to lifestyle changes necessary after the transplant.
The average wait for a transplant once on the waiting list in the UK is six months. Unfortunately, about 15 per cent per cent of patients die while on the waiting list for a transplant. The heart is stopped and a machine takes over the function of the heart and lungs. The diseased heart is removed and the donor organ sewn in and connected to the main blood vessels.
After a transplant, the individual will need to take immunosuppressive drugs for the rest of their life, to stop their body rejecting the transplant, as well as other drugs to help their body fight infections. The new heart will be monitored at regular intervals for any signs of rejection. After the operation, drugs are given to ensure the body doesn’t try to reject the new heart.
In the past, heart transplants sometimes failed because the person’s immune system rejected the transplanted heart. But as techniques have improved and new immunosuppressive drugs have been introduced to prevent rejection, so heart transplants have become more successful.
The majority of people who have a heart transplant can now expect to live for five years or more. Even so, transplant remains an ‘end-of-the-line’ treatment when all else has failed and the patient is likely to die or have a poor quality of life unless it’s done. Unfortunately, a shortage of donors mean that a significant number of people who are waiting for a heart transplant die before a suitable one is found.