Primary Aldosteronism

Primary aldosteronism (al-DOS-tuh-ro-niz-um) is a type of hormonal disorder that leads to high blood pressure. Your adrenal glands produce a number of essential hormones. One of these is aldosterone, which balances sodium and potassium in your blood.

In primary aldosteronism, your adrenal glands produce too much aldosterone, causing you to lose potassium and retain sodium. The excess sodium, in turn, holds on to water, increasing your blood volume and blood pressure. Diagnosis and treatment of primary aldosteronism are important because people with this form of high blood pressure have a higher risk of heart disease and stroke. Also, the high blood pressure associated with primary aldosteronism may be curable. Options for people with primary aldosteronism include medications, lifestyle modifications, and surgery.

Symptoms

The main signs of primary aldosteronism are:

• Moderate to severe high blood pressure
• High blood pressure that takes several medications to control (resistant hypertension)
• High blood pressure along with a low potassium level (hypokalemia)

Complications

Primary aldosteronism can lead to high blood pressure and low potassium levels. These complications, in turn, can lead to other problems.

Problems related to high blood pressure

Persistently elevated blood pressure can lead to problems with your heart and kidneys, including:

• Heart attack
• Heart failure
• Left ventricular hypertrophy — enlargement of the muscle that makes up the wall of the left ventricle, one of your heart's pumping chambers
• Stroke
• Kidney disease or kidney failure
• Premature death

High blood pressure caused by primary aldosteronism carries a higher risk of cardiovascular complications than do other types of high blood pressure. This excess risk is due to the high aldosterone levels, which can cause heart and blood vessel damage independent of complications related to high blood pressure.

Problems related to low potassium levels

Some, but not all, people with primary aldosteronism have low potassium levels (hypokalemia). Mild hypokalemia may not cause any symptoms, but very low levels of potassium can lead to:

• Weakness
• Cardiac arrhythmias
• Muscle cramps
• Excess thirst or urination

Aldosteronism

Aldosteronism is a hormonal disorder that leads to hypertension. The excessive secretion of the hormone aldosterone disturbs the balance of sodium, potassium, and water in the blood. The production of excess secretion of aldosterone in the adrenal gland causes the loss of potassium and retaining of sodium alone. The excess sodium takes in water which increases blood volume and blood pressure. This can be cured by taking proper medications, change of lifestyles and surgery when required. The decrease in potassium level leads to weakness in the body, excess secretion of the urine and also muscle cramps. The important cause for aldosteronism is Conn’s syndrome. In children and young adults, there is a type of primary aldosteronism called glucocorticoid-remediable aldosteronism which causes high blood pressure. It is confirmed as aldosteronism if the High blood pressure is associated with low potassium levels in the screening.  

• Track 1-1 Cause and Occurrence of Aldosteronism
• Track 2-2 Signs and Symptoms
• Track 3-3 Types and Classification
• Track 4-4 Treatment Aids

TOD - Brain Diseases

Hypertension is a circulatory disease. Many patients with high blood pressure develop coronary artery disease or heart failure, and many die as a result. But all parts of the body depend on the circulation, and many organs suffer from the impact of untreated hypertension. One of the organs at greatest risk is the brain.

Damage to your brain

Just like your heart, your brain depends on a nourishing blood supply to work properly and survive. But high blood pressure can cause several problems, including:

Transient ischemic attack (TIA):

Sometimes called a ministroke, a transient ischemic (is-KEE-mik) attack is a brief, temporary disruption of blood supply to your brain. It's often caused by atherosclerosis or a blood clot — both of which can arise from high blood pressure. A transient ischemic attack is often a warning that you're at risk of a full-blown stroke.

Stroke: 

A stroke occurs when part of your brain is deprived of oxygen and nutrients, causing brain cells to die. Uncontrolled high blood pressure can lead to stroke by damaging and weakening your brain's blood vessels, causing them to narrow, rupture or leak. High blood pressure can also cause blood clots to form in the arteries leading to your brain, blocking blood flow and potentially causing a stroke.

Dementia: 

Dementia is a brain disease resulting in problems with thinking, speaking, reasoning, memory, vision, and movement. There are a number of causes of dementia. One cause, vascular dementia, can result from narrowing and blockage of the arteries that supply blood to the brain. It can also result from strokes caused by an interruption of blood flow to the brain. In either case, high blood pressure may be the culprit.

Mild cognitive impairment: 

Mild cognitive impairment is a transition stage between the changes in understanding and memory that come with aging and the more serious problems caused by Alzheimer's disease. Like dementia, it can result from blocked blood flow to the brain when high blood pressure damages arteries.

TOD - Renal Hypertension

Renal Hypertension is also called renovascular hypertension is elevated blood pressure caused by Kidney Diseases. It can usually be controlled by Blood Pressure Drugs. Some people with Renal Hypertension can be controlled by angioplasty, stenting or surgery on the blood vessels of the Kidney.

Causes:

• Renal Artery Stenosis
• Atherosclerosis
• Fibromuscular dysplasia

Symptoms:

No particular symptom for Renal Hypertension. Thus, the doctor suspects Renal Hypertension if he has elevated blood pressure. Elevated Blood Pressure symptoms include:

• Headache
• Confusion
• Blurry or double vision
• Bloody (pink-colored) urine
• Nosebleed

Treatment:

• ACE Inhibitors
• ARBs

If the condition is too serious then treatment methods like the follows becomes must:

• Angioplasty
• Stenting
• Surgery 

TOD - Eyes: Hypertensive Retinopathy

When high blood pressure is not treated it causes damage to various body organs. One of the important organs is eyes. When hypertension is not treated it affects the veins that supply blood to the eye and causes eye disease. This is known as Hypertensive Retinopathy. Hypertension causes damage to the retina, back of the eye where the image focus. If untreated this leads to serious problems. 

Symptoms:

There is no particular symptom to identify Hypertensive Retinopathy only on regular examination it can be found. General symptoms can be headache and vision problem. 

Diagnosis: 

Eye care professional diagnosis hypertensive retinopathy using an Ophthalmoscope, which is an instrument that projects light to the back of the eyeball, the doctor will look for the signs of retinopathy as: 

• Narrowing of the blood vessels
• Spots on the retinal known as cotton wool spots and exudates
• Swelling of macula (the central area of the retina) and optic nerve
• Bleeding in the back of the eye

Treatment:

The best way to treat Hypertensive Retinopathy is to control the blood pressure.

Target Organ Damage

Target Organ Damage refers to the damage caused in organs fed by the circulatory system as heart, kidney, brain, eyes, etc., which are caused by sustained Hypertension.

Hypertensive damage on the organs can be like:

• Heart: Thick wall lining up the heart muscles, results can be seen in electrocardiogram screening 
• Kidney: Leakage of protein into urine or reduced renal function. 
• Eye: This can be tested on fundoscopic evidence of hypertensive retinopathy. 
• Skin: Paller or mottled appearance. 
• Brain: Orientation to time, person, and place. 

Hypertension, as we think, doesn't affect just one or two organs but instead, it affects each and every organ in the human body. Thus, keeping the blood pressure in control is highly essential to stay healthy.

CVD - TIA

Transient ischemic attack (TIA):

A transient ischemic attack (TIA) — sometimes known as a ministroke — is a temporary period of symptoms similar to that of had a stroke. A temporary decrease in blood supply to part of our brain causes TIAs, which may last as little as five minutes.

Like an ischemic stroke, a TIA occurs when a clot or debris blocks blood flow to part of your nervous system — but there is no permanent tissue damage and no lasting symptoms.

Seek emergency care even if the symptoms seem to clear up. Having a TIA puts anyone at greater risk of having a full-blown stroke, causing permanent damage later. If had a TIA, it means there's likely a partially blocked or narrowed artery leading to your brain or a clot source in the heart.

It's not possible to tell whether you are having a stroke or a TIA based only on your symptoms. Even when symptoms last for under an hour, there is still a risk of permanent tissue damage.

CVD - Stenosis

Intracranial stenosis is a narrowing of the arteries inside the brain. Similar to carotid stenosis in the neck, it is caused by a buildup of plaque in the inner wall of the blood vessels. This narrowing of the blood vessels causes decreased blood flow to the area of the brain that the affected vessels supply. There are three ways in which intracranial artery stenosis can result in a stroke:

• Plaque can grow larger and larger, severely narrowing the artery and reducing blood flow to the brain. Plaque can eventually completely block (occlude) the artery.
• Plaque can roughen and deform the artery wall, causing blood clots to form and blocking blood flow to the brain.
• Plaque can rupture and break away, traveling downstream to lodge in a smaller artery and blocking blood flow to the brain.

Causes:

Atherosclerosis is a major cause of intracranial artery stenosis. It can begin in early adulthood, but symptoms may not appear for several decades. Some people have rapidly progressing atherosclerosis during their thirties, others during their fifties or sixties. Atherosclerosis begins with damage to the inner wall of the artery caused by high blood pressure, diabetes, smoking, and elevated “bad” cholesterol. Other risk factors include obesity, heart disease, family history, and advanced age. Intracranial stenosis is associated with several conditions, including Moya Moya disease, radiation-induced vessel damage (vasculopathy), high blood pressure, high cholesterol, and diabetes.

Diagnosis:

• Computed Tomography Angiography
• Magnetic Resonance Angiography
• Angiogram
• Transcranial Doppler Ultrasound
• Computed Tomography Perfusion
• Positron Emission Tomography 

Treatment Methods:

Medications

• Blood thinner 
• Cholesterol-lowering
• Blood Pressure

Surgery

• Balloon Angioplasty / Stenting
• Cerebral Artery Bypass

Clinical Trials

Ref:  http://www.mayfieldclinic.com/PE-IntracranialStenosis.htm

CVD - Aneurysm

Aneurysm refers to the weakening of an artery wall that creates a bulge or distention of the artery. Most aneurysms do not show any symptoms but when it ruptures it leads to fatal complications.

• Aneurysms affect a variety of arteries. The most significant aneurysms affect the arteries supplying the brain and the heart. An aortic aneurysm affects the body's main artery.
• The rupture of an aneurysm causes internal bleeding.
• The risk of an aneurysm developing and rupturing varies between individuals. Smoking and high blood pressure are major risk factors for the development of an aneurysm.
• Some types of aneurysm may need surgical treatment to prevent rupture. Doctors will only operate on others if they are life-threatening.

Types of Aneurysm:

Aneurysms are classified by the location in the body. The arteries of brain and heart are two main types of serious aneurysm. The bulging takes place in two main forms as

• Fusiform aneurysms bulge all sides
• Sacclar aneurysm bulges only on one side  

The risk of rupture depends on the size of the bulge. 

Aortic Aneurysm:

The aorta is the large artery that begins at the left ventricle of the heart and passes through the chest and abdominal cavities. The normal diameter of the aorta is between 2 and 3 centimeters (cm) but can bulge to beyond 5 cm with an aneurysm. The most common type of Aortic aneurysm is Abdominal Aortic Aneurysm (AAA) and less common type of Aortic aneurysm is Thoracic Aortic Aneurysm (TAA). 

Cerebral Aneurysm:

Aneurysms of the arteries that supply the brain with blood are known as intracranial aneurysms. Due to their appearance, they are also known as "berry" aneurysms. Ruptured cerebral aneurysms are the most common cause of a type of stroke known as subarachnoid hemorrhage (SAH).

Peripheral Aneurysm: 

Aneurysm also occurs in the periphery. There are different types of Peripheral aneurysm as:

• Popliteal aneurysm: This happens behind the knee. It is the most common peripheral aneurysm.
• Splenic artery aneurysm: This type of aneurysm occurs near the spleen.
• Mesenteric artery aneurysm: This affects the artery that transports blood to the intestines.
• Femoral artery aneurysm: The femoral artery is in the groin.
• Carotid artery aneurysm: This occurs in the neck.
• Visceral aneurysm: This is a bulge of the arteries that supply blood to the bowel or kidneys.

Peripheral aneurysms are less likely to rupture than aortic aneurysms.

Ref: https://www.medicalnewstoday.com/articles/156993.php

CVD - Atherosclerosis

Atherosclerosis is the narrowing of arteries due to plaque buildup on the artery walls. Arteries carry blood from the heart to the rest of the body. They are lined with a thin layer of cells that keeps them smooth and allows blood to flow easily. This is called the endothelium. Atherosclerosis starts when the endothelium becomes damaged, allowing the harmful type of cholesterol to build up in the artery wall. The body sends a type of white blood cell to clean up this cholesterol, but, sometimes, the cells get stuck at the affected site. Over time, plaque can build up, made of cholesterol, macrophages, calcium, and other substances from the blood.

Sometimes, the plaque grows to a certain size and stops growing, causing the individual no problems. However, sometimes, the plaque clogs up the artery, disrupting the flow of blood around the body. This makes blood clots more likely, which can result in life-threatening conditions.

In some cases, the plaque eventually, breaks open. If this happens, platelets gather in the affected area and can stick together, forming blood clots. This can block the artery, leading to life-threatening complications, such as stroke and heart attack. The condition can affect the entire artery tree, but mainly affects the larger, high-pressure arteries.

Symptoms

The first signs of atherosclerosis can begin to develop during adolescence, with streaks of white blood cells appearing on the artery wall. Most often, there are no symptoms until a plaque ruptures, or the blood flow is very restricted. This typically takes many years to occur. The symptoms depend on which arteries are affected.

Carotid arteries

Carotid arteries provide blood to the brain. A limited blood supply can lead to a stroke, and a person may experience a range of symptoms as a result of atherosclerosis in this area, including:

• weakness
• difficulty breathing
• headache
• facial numbness
• paralysis

Coronary arteries

Chest pain can be a symptom of atherosclerosis affecting the coronary articles. Coronary arteries provide blood to the heart. When the blood supply to the heart is limited, it can cause angina and heart attack.

• Symptoms include:
• vomiting
• extreme anxiety
• chest pain
• coughing
• feeling faint

Renal arteries

Renal arteries supply blood to the kidneys. If the blood supply becomes limited, there is a serious risk of developing chronic kidney disease. The person with renal artery blockage may experience:

• loss of appetite
• swelling of the hands and feet
• difficulty concentrating

Treatment

Treating atherosclerosis is important for preventing complications.

Treatment options include lifestyle changes, various medications, and surgical interventions. However, it is important that a doctor correctly diagnoses atherosclerosis to make sure that the arteries are returned to full capability.

Diagnosis

Those who are at risk of developing atherosclerosis should be tested because the symptoms do not show until cardiovascular disease develops. A diagnosis will be based on medical history, test results, and a physical exam.

Treatment options

The range of treatments for atherosclerosis include:

Lifestyle changes: These focus on weight management, physical activity, and a healthy diet. A doctor may recommend eating foods high in soluble fiber and limiting intake of saturated fats, sodium, and alcohol.

Medication: Antiplatelet medications can prevent the build-up of plaque or help prevent blood clots. Others, such as statins, might be prescribed to lower cholesterol, and angiotensin-converting enzyme (ACE) inhibitors can help lower blood pressure.

Surgery: Severe cases of atherosclerosis may be treated by surgical procedures, such as angioplasty or coronary artery bypass grafting (CABG).

Angioplasty involves expanding the artery and opening the blockage so that the blood can flow through properly again. CABG is another form of surgery that can improve blood flow to the heart by using arteries from other parts of the body to bypass a narrowed coronary artery.

Prevention

Preventing the development of atherosclerosis is one of the best ways to treat the condition.

Steps to limit the risk of plaque buildup include:

Diet: Try to avoid saturated fats, they increase levels of bad cholesterol. The following foods are high in unsaturated fats and can help keep bad cholesterol levels down:

• olive oil
• avocados
• walnuts
• oily fish
• nuts
• seeds

Exercise: Exercise will improve fitness levels, lower blood pressure, and help weight loss.

Not smoking: Smoking is one of the major risk factors for atherosclerosis, and it also raises blood pressure. Smokers should quit as soon as possible and arrange a meeting with their doctor about ways to give up and manage withdrawal symptoms.

Causes

Certain factors can damage the inner area of the artery and lead to atherosclerosis.

These factors include:

• high blood pressure
• high levels of cholesterol
• smoking
• high levels of sugar in the blood

Complications

Atherosclerosis can lead to serious and long-lasting complications.

These can lead to a range of dangerous complications, including:

• Heart disease and heart failure: The heart may not be able to pump enough blood around the body, or may not fill with sufficient levels of blood.
• Heart attack: This is a medical emergency in which the supply of blood becomes blocked. It can be life-threatening.
• Kidney failure: The kidneys can stop functioning if they do not receive enough blood.
• Aneurysm: This is a serious condition in which the walls of an artery bulge, sometimes bursting and causing potentially fatal internal bleeding.
• Stroke: A stroke is a medical emergency in which the blood supply to the brain is blocked, starving the brain of oxygen. This can kill brain cells.
• Arrhythmia: Atherosclerosis can lead to abnormal heart rhythms and palpitations.

Risk factors

Certain people have a higher risk of developing the condition. These include

• Diabetes: Individuals with poorly controlled diabetes and frequently high blood glucose levels are more likely to develop atherosclerosis.
• Genetics: People who have a parent or sibling with atherosclerosis and cardiovascular disease have a much higher risk of developing atherosclerosis than others.
• Air pollution: Exposure to air pollution appears to increase the risk of cholesterol build-up in the coronary arteries.

CVD - Stroke

A stroke occurs when the blood supply to part of your brain is interrupted or reduced, depriving brain tissue of oxygen and nutrients. Within minutes, brain cells begin to die. A stroke is a medical emergency. Prompt treatment is crucial. Early action can minimize brain damage and potential complications. The good news is that strokes can be treated and prevented.

Symptoms

Watch for these signs and symptoms if you think you or someone else may be having a stroke. Pay attention to when the signs and symptoms begin. The length of time they have been present can affect your treatment options:

Trouble with speaking and understanding: 

You may experience confusion. You may slur your words or have difficulty understanding speech.

Paralysis or numbness of the face, arm or leg: 

You may develop sudden numbness, weakness or paralysis in your face, arm or leg. This often happens just on one side of your body. Try to raise both your arms over your head at the same time. If one arm begins to fall, you may be having a stroke. Also, one side of your mouth may droop when you try to smile.

Trouble with seeing in one or both eyes: 

You may suddenly have blurred or blackened vision in one or both eyes, or you may see double.

Headache: 

A sudden, severe headache, which may be accompanied by vomiting, dizziness or altered consciousness, may indicate you're having a stroke.

Trouble with walking: 

You may stumble or experience sudden dizziness, loss of balance or loss of coordination.

Causes

A stroke may be caused by a blocked artery (ischemic stroke) or the leaking or bursting of a blood vessel (hemorrhagic stroke). Some people may experience only a temporary disruption of blood flow to the brain (transient ischemic attack, or TIA) that doesn't cause permanent damage.

Ischemic stroke

About 80 percent of strokes are ischemic strokes. Ischemic strokes occur when the arteries to your brain become narrowed or blocked, causing severely reduced blood flow (ischemia). The most common ischemic strokes include:

Thrombotic stroke: 

A thrombotic stroke occurs when a blood clot (thrombus) forms in one of the arteries that supply blood to your brain. A clot may be caused by fatty deposits (plaque) that build up in arteries and cause reduced blood flow (atherosclerosis) or other artery conditions.

Embolic stroke: 

An embolic stroke occurs when a blood clot or other debris forms away from your brain — commonly in your heart — and is swept through your bloodstream to lodge in narrower brain arteries. This type of blood clot is called an embolus.

Hemorrhagic stroke

Hemorrhagic stroke occurs when a blood vessel in your brain leaks or ruptures. Brain hemorrhages can result from many conditions that affect your blood vessels. These include:

• Uncontrolled high blood pressure (hypertension)

• Overtreatment with anticoagulants (blood thinners)

• Weak spots in your blood vessel walls (aneurysms)

A less common cause of hemorrhage is the rupture of an abnormal tangle of thin-walled blood vessels (arteriovenous malformation). Types of hemorrhagic stroke include:

Intracerebral hemorrhage: 

In an intracerebral hemorrhage, a blood vessel in the brain bursts and spills into the surrounding brain tissue, damaging brain cells. Brain cells beyond the leak are deprived of blood and are also damaged. High blood pressure, trauma, vascular malformations, use of blood-thinning medications and other conditions may cause an intracerebral hemorrhage.

Subarachnoid hemorrhage: 

In a subarachnoid hemorrhage, an artery on or near the surface of your brain bursts and spills into the space between the surface of your brain and your skull. This bleeding is often signaled by a sudden, severe headache. A subarachnoid hemorrhage is commonly caused by the bursting of a small sack-shaped or berry-shaped aneurysm. After the hemorrhage, the blood vessels in your brain may widen and narrow erratically (vasospasm), causing brain cell damage by further limiting blood flow.

Cerebrovascular Diseases

Cerebro refers to the brain and vascular refers to arteries and veins. Cerebrovascular means blood flow to the brain. Cerebrovascular disease is a combination of defects in two places as brain and blood. Cerebrovascular diseases include all disorders that affect the brain temporarily or permanently. Cerebrovascular diseases include stroke, stenosis, deep vein thrombosis, atherosclerosis, transient ischemic attack (TIA) and aneurysm. A stroke occurs commonly with little or no warning. The most common form of stroke is ischemic stroke and the dreadful stroke is known as hemorrhagic stroke. TIA is a temporary event and it doesn’t cause any permanent damage to the body. When there is a build-up of fat and cholesterol in the arteries it leads to plaque formation. This plague is known as atherosclerosis and when this blockage is severe it is known as stenosis. An aneurysm is an effect which develops because of HTN or atherosclerosis in which the blood vessel to the brain weakens which causes bulging up of the blood vessel in that area.

Cardiovascular Diseases - IHD

The heart disease that is the consequence of an inflammation is called inflammatory heart disease. There could be many causes of inflammation, Inflammatory heart disease may occur due to an infection that develops from a bacteria or virus. It could also develop due to inflammation due to some internal milieu. Inflammation of heart is caused by known infectious agents, viruses, bacteria, fungi or parasites, and by toxic materials from the environment, water, food, air, toxic gases, smoke, and pollution, or by an unknown origin. Myocarditis is induced by infection of heart muscle by virus like sarcoidosis and immune diseases.

A heart has following three layers

• Pericardium – Outer sac of the heart
• Myocardium – Inner muscle core of the heart
• Endocardium – Innermost lining of the heart

Depending upon the layer of heart involved it could be pericarditis, myocarditis or endocarditis.

Myocarditis

Myocarditis describes any inflammation that occurs within the heart muscle. It is induced by viral infections, diseases like sarcoidosis, and immune disorders. It is not unusual for the disease to be completely asymptomatic. Pain in the chest is the most likely sign of myocarditis. The disease may progress into degeneration of the heart muscle and cause heart failure. If treated early a fair portion of individuals achieve total recovery. Others may progress to chronic heart failure. Rarely a fulminant heart failure may develop.

Pericarditis

Pericarditis is inflammation of the pericardium, the fluid sac that envelopes the heart.

The cause of pericarditis

• Infection
• Malignancy
• Metabolic disorders like hypothyroidism and uremia
• Connective tissue disease
• Drug reaction

Pericarditis presents as chest pain or angina pectoris that is generally expressed as a cutting, intense pain that migrates from the chest area to the shoulder blades, back, and neck that become significantly worse on inhalation and becomes better by leaning forward. Analgesics and the treatment of the offending factor is the accepted line of treatment.

Endocarditis

Endocarditis is inflammation of the endocardium or inner lining of the heart. It usually affects individuals who have an artificial heart valve in place or have suffered degeneration of a heart valve.

Groups most at risk

•  Individuals who currently have an artificial valve(s).
•  Congenital birth defect
•  Any previous injury to the heart
•  Intravenous drug users

The main treatments are antibiotics and surgery where damage is significantly compromising.

Cardiovascular Diseases - Congenital Heart Disease

Congenital heart disease, or a congenital heart defect, is a heart abnormality present at birth. The problem can affect:

• the heart walls
• the heart valves
• the blood vessels

There are numerous types of congenital heart defects. They can range from simple conditions that don’t cause symptoms to complex problems that cause severe, life-threatening symptoms.

Types of Congenital Heart Disease

Though there are many different types of congenital heart defects, they can be divided into three main categories:

• In heart valve defects, the valves inside the heart that direct blood flow may close up or leak. This interferes with the heart’s ability to pump blood correctly.
• In heart wall defects, the natural walls that exist between the left and right sides and the upper and lower chambers of the heart may not develop correctly, causing blood to back up into the heart or to build up in places where it doesn’t belong. The defect puts pressure on the heart to work harder, which may result in high blood pressure.
• In blood vessel defects, the arteries and veins that carry blood to the heart and back out to the body may not function correctly. This can reduce or block blood flow, leading to various health complications.

Cyanotic and Acyanotic Congenital Heart Disease

Many doctors classify congenital heart disease as either cyanotic congenital heart disease or acyanotic congenital heart disease. In both types, the heart isn’t pumping blood as efficiently as it should. The main difference is that cyanotic congenital heart disease causes low levels of oxygen in the blood, and acyanotic congenital heart disease doesn’t. Babies with reduced oxygen levels may experience breathlessness and a bluish tint to their skin. Babies who have enough oxygen in their blood don’t display these symptoms, but they may still develop complications later in life, such as high blood pressure.

Symptoms of Congenital Heart Disease

A congenital heart defect is often detected during a pregnancy ultrasound. If your doctor hears an abnormal heartbeat, for instance, they may further investigate the issue by performing certain tests. These may include an echocardiogram, a chest X-ray, or an MRI scan. If a diagnosis is made, your doctor will make sure the appropriate specialists are available during delivery.

In some cases, the symptoms of a congenital heart defect may not appear until shortly after birth. Newborns with heart defects may experience:

• bluish lips, skin, fingers, and toes
• breathlessness or trouble breathing
• feeding difficulties
• low birth weight
• chest pain
• delayed growth

In other cases, the symptoms of a congenital heart defect may not appear until many years after birth. Once symptoms do develop, they may include:

• abnormal heart rhythms
• dizziness
• trouble breathing
• fainting
• swelling
• fatigue

Congenital Heart Disease Causes

Congenital heart disease occurs as a result of an early developmental problem in the heart’s structure. The defect typically interferes with the normal flow of blood through the heart, which may affect breathing. Although researchers aren’t exactly sure why the heart fails to develop correctly, suspected causes include the following:

• The heart defect may run in families.
• Taking certain prescription drugs during pregnancy puts a child at a higher risk for a heart defect.
• Using alcohol or illegal drugs during pregnancy can increase a child’s risk of having a heart defect.
• Mothers who had a viral infection during the first trimester of pregnancy are more likely to give birth to a child with a heart defect.
• Increased blood sugar levels, such as occurs with diabetes, may affect childhood development.

Congenital Heart Disease Treatment

The treatment for a congenital heart defect depends on the type and severity of the defect. Some babies have mild heart defects that heal on their own with time. Others may have severe defects that require extensive treatment. In these cases, treatment may include the following:

Medications

There are various medications that can help the heart work more efficiently. Some can also be used to prevent blood clots from forming or to control an irregular heartbeat.

Implantable Heart Devices

Some of the complications associated with congenital heart defects can be prevented with the use of certain devices, including pacemakers and implantable cardioverter defibrillators (ICDs). A pacemaker can help regulate an abnormal heart rate, and an ICD may correct life-threatening irregular heartbeats.

Catheter Procedures

Catheterization techniques allow doctors to repair certain congenital heart defects without surgically opening the chest and heart. During these procedures, the doctor will insert a thin tube into a vein in the leg and guide it up to the heart. Once the catheter is in the correct position, the doctor will use small tools threaded through the catheter to correct the defect.

Open-Heart Surgery

This type of surgery may be needed if catheter procedures aren't enough to repair a congenital heart defect. A surgeon may perform open-heart surgery to close holes in the heart, repair heart valves, or widen blood vessels.

Heart Transplant

In the rare cases in which a congenital heart defect is too complex to fix, a heart transplant may be needed. During this procedure, the child's heart is replaced with a healthy heart from a donor.

Congenital Heart Disease in Adults

Depending on the defect, diagnosis and treatment may begin shortly after birth, during childhood, or in adulthood. Some defects don’t cause any symptoms until the child becomes an adult so diagnosis and treatment may be delayed. In these cases, the symptoms of a newly discovered congenital heart defect may include:

• shortness of breath
• chest pain
• a reduced ability to exercise
• being easily fatigued

The treatment for congenital heart disease in adults can also vary depending on the severity of the heart defect. Some people may only need to monitor their condition closely, and others may require medications and surgeries. In some cases, defects that may have been treated in childhood can present problems again in adulthood. The original repair may no longer be effective or the initial defect may have become worse over time. Scar tissue that developed around the original repair may also end up causing problems, such as heart arrhythmias. Regardless of your situation, it’s important to continue seeing your doctor for follow-up care. Treatment may not cure your condition, but it can help you maintain an active, productive life. It will also reduce your risk for serious complications, such as heart infections, heart failure, and stroke.

Congenital Heart Disease Be Prevention

• Women who are pregnant or plan on becoming pregnant can take certain precautions to lower their risk of giving birth to a baby with a congenital heart defect:
• If you’re planning on becoming pregnant, talk to your doctor about any prescription or over-the-counter medications you’re taking.
• If you have diabetes, make sure your blood sugar levels are under control before becoming pregnant. It’s also important to work with your doctor to manage the disease while pregnant.
• If you weren’t vaccinated against rubella or German measles, avoid exposure to the disease and speak with your doctor about prevention options.
• If you have a family history of congenital heart defects, ask your doctor about genetic screening. Certain genes may contribute to abnormal heart development.
• Avoid drinking alcohol and using illegal drugs during pregnancy.