|Heart conditions in newborn babies||469.000000000000||Heart conditions in newborn babies||Heart conditions in newborn babies||H||English||Neonatology||Newborn (0-28 days)||Heart||Cardiovascular system||Conditions and diseases||Adult (19+)||NA||2009-10-28T04:00:00Z||Patrick McNamara, MB, BCh, BAO, FRCPCAndrew James, MBChB, MBI, FRACP, FRCPC||10.0000000000000||49.0000000000000||1945.00000000000||Flat Content||Health A-Z||<p>Read about types of heart conditions that can occur in a newborn baby. Heart failure, patent ductus arteriosus, and congenital heart defects are discussed.</p>||<p>Some babies are born with congenital heart conditions. The severity of these conditions ranges; children with simple conditions may lead completely normal lives while those with more complex conditions will usually face more challenges. Most children with heart conditions reach adulthood.</p>||<h2>Key points</h2>
<ul><li>Heart failure occurs when not enough oxygen is delivered to the body as a result of low cardiac output syndrome.</li>
<li>Heart failure is treated with medications called intropes, which encourage the heart to beat more strongly.</li>
<li>There are 35 known types of congenital heart defects ranging from simple to complex.
</li><li>Treatment of heart defects will depend on the area of the heart affected and how severe the defect is.</li></ul>||<h2>Low cardiac output syndrome and heart failure</h2><p>In some newborn babies, the myocardium, or heart muscle, may be injured due to asphyxia and may not pump forcefully enough. Medically, this is described as a low cardiac output syndrome. The result of this heart weakness is that not enough oxygen is delivered to the body. This condition is usually called heart failure. This name sounds alarming, but in most cases the condition is treatable, though serious. </p><p>Whenever the cardiac output is low, a newborn baby’s body will try to compensate in various ways, including:</p><ul><li>a faster heartbeat </li><li>modified blood flow favouring the vital organs </li><li>faster breathing </li><li>enlargement of the chambers of the heart to increase the volume of blood pumped with each beat </li></ul><h3>Treatment of heart failure</h3><p>The most common treatment for heart failure is use of medications called inotropes, which encourage the heart to beat more strongly. Inotropes, which include dopamine, dobutamine, milrinone, epinephrine, and norepinephrine, are administered intravenously. </p><p>Dopamine and dobutamine help the body create more norepinephrine, a natural substance that stimulates the heart to beat more strongly. The body can become tolerant to both of these drugs, reducing their effectiveness over time. Additionally, higher blood pressure may be a consequence of the medication. At low doses, dopamine works on the heart to make it pump better and increase heart rate. Higher doses cause heart vessels to constrict, increasing blood pressure. </p><p>Milrinone also encourages the heart to beat more strongly. However, unlike dopamine, rather than producing a higher blood pressure and increasing oxygen demands on the heart as additional effects, the medication relaxes the blood vessels. </p><h3>Complications of drug therapy</h3><p>Any inotropic agent can make the heart beat too fast, causing the muscle tissue to start to tire. Inotropes can also cause an irregular heart rhythm, although this complication is rare. To avoid these complications, appropriate doses will be given and the newborn baby’s heart rate will be monitored. </p><h2>Congenital heart defects</h2><p>Congenital heart defects, or lesions, are parts of the heart that have not formed properly. They occur very early in pregnancy, often before a woman even knows she is pregnant. These defects can include "holes" in parts of the heart, or missing or malformed parts of the heart. </p><p>The causes of heart defects are not quite clear. One factor that seems to increase the risk of a defect is family history. If someone in your family has a defect, it is slightly more likely that your child will too. </p><p>Congenital heart defects are the most common birth defect. Symptoms can be very subtle or quite severe, resulting in serious illness. Some defects may become apparent later in life. Congenital heart defects are more common in people with certain syndromes, like Down syndrome, Turner syndrome, Williams syndrome, and velocardiofacial syndrome. </p><p>Defects generally affect the heart in two ways: they block or slow down blood flow in the heart or the blood vessels near the heart, or they make the blood flow through the heart in abnormal patterns, forcing the heart to work harder. </p><h3>Types of heart defects</h3><p>There are about 35 known types of congenital heart defects. They range from the simple to the complex. Some are more common than others. There are many varieties of any given type of defect and a large potential for combination defects. The more common ones include ventricular septal defect, tetralogy of Fallot, transposition of the great arteries, atrioventricular septal defect, and coarctation of the aorta. A number of defects occur in combination. </p><p>The most common kind of congenital heart defects are what are referred to as flow defects, since they affect how blood flows through the heart. These include the atrial and ventricular septal defects. With these conditions, blood flows from the left side of the heart to the right side, meaning that too much blood flows into the lungs. These defects are also referred to as left-to-right shunts. </p><p>Heart conditions are often divided into two groups: cyanotic and acyanotic. A cyanotic condition has cyanosis as a symptom. Cyanosis is a bluish discoloration of the skin, caused by the circulation of blood that doesn’t have enough oxygen. In contrast, someone with an acyanotic condition does not show symptoms of cyanosis. </p><p>Cyanotic conditions include transposition of the great arteries, tetralogy of Fallot, truncus arteriosus, and tricuspid atresia. Acyanotic conditions include patent ductus arteriosus, atrial septal defect, ventricular septal defect, and coarctation of the aorta. </p><h3>Symptoms of heart defects</h3><p>Babies and children with heart defects may have difficulties eating or gaining weight, breathe faster than normal, or sweat when eating or sleeping. These symptoms are referred to as congestive heart failure. Some children turn blue, a condition called cyanosis, or have abnormal blood pressure. Not all children have symptoms, while some have a combination. Sometimes the existence of a heart murmur may indicate a problem. </p><h3>Diagnosis of heart defects</h3><p>Sometimes doctors can diagnose a heart defect even before the baby is born, using a fetal echocardiogram, which provides a picture of the baby’s heart. However, defects are usually identified days or even months after birth, when symptoms become obvious.</p><p>To diagnose a heart defect after birth, the cardiologist will usually do a history and physical exam. A chest X-ray will give the doctor information about your baby’s lungs, as well as the size, shape, and position of the heart. An electrocardiogram shows heartbeat rhythms, while an echocardiogram shows the structure of the heart and how well it’s working. An echocardiogram is a lot like an ultrasound that a pregnant woman may have to measure the baby’s progress during her pregnancy. </p><h3>Treatment of heart defects<br></h3><p>Treatment depends on which part of the heart is affected. Some children will not need treatment if the effect on blood flow is minor, while others will require medication or intervention such as cardiac catheterization or surgery. Many heart defects can be successfully managed, often in early infancy and sometimes even in the womb, before the baby is born. Some defects aren’t treated right away, but can wait until the child is older. And some defects are treated in stages. While heart defects generally are not curable, they can be managed well enough to enable the child to function well. </p><p>With advances in our understanding of heart defects and technology, the outlook for most children is positive. The risk of serious side effects and complications from treatment is much lower than it used to be. The majority of children will reach adulthood. Children with simple conditions may lead completely normal lives. Children with more complex conditions usually face more challenges. </p>||Heart conditions in newborn babies|