Wednesday, January 20th 2010, 4:00 AM
In almost all cases, says Dr. Barry Love, congenital heart problems are the result of random chance.
As director of the Congenital Cardiac Catheterization Lab at Mount Sinai, Barry Love is a pediatrician and congenital cardiologist who specializes in performing interventions for inborn heart problems. Last year, he performed more than 350 interventions.
Who’s at risk:
Just under 1% of children are born with some abnormality of the heart structure.
“Congenital heart disease is the general term for inborn problems of the heart,” says Love. “The diagnosis can be made any time from fetal life to adulthood.”
While most congenital heart problems don’t require treatment, about one or two of every 1,000 people have a more serious problem requiring an intervention.
There are many forms of congenital heart disease. “These problems can be anywhere in the heart, including a hole between the pumping chambers, or between the upper chambers of the heart,” says Love. “There can be problems with heart valves or blood vessels, usually when they are too small or narrowed.”
In other cases, blood vessels can arrive in the wrong place. Sometimes these problems are diagnosed in utero through a fetal ultrasound, while some are diagnosed shortly after birth, and still others don’t become apparent until the patient is fully grown.
In the vast majority of cases, congenital heart diseases appear randomly, not as the result of family history or something that happens to the mother during pregnancy. “Most of these problems arise in an isolated fashion — not from heredity or anything we’ve identified,” says Love. “We spend a fair bit of time reassuring parents that really, this isn’t anything they did or didn’t do.”
Signs and symptoms:
Most congenital heart disease is diagnosed in newborns. “Infants can present with poor feeding, breathing difficulties or a blue color that indicates a low oxygen level,” says Love. Another common symptom is a heart murmur, which the doctor often picks up during routine screening when listening to the child’s chest.
“The doctor may hear a noise, a heart murmur, which can be a sign of abnormal blood flow,” says Love. “An experienced doctor can tell the difference between normal and problematic heart murmurs in their sound and other symptoms.”
For the vast majority of patients, a heart murmur is caused by normal blood flow and is nothing to worry about. “But if it’s something that persists over time, the doctor should ask to have it evaluated,” says Love.