Pediatric Congenital Heart Disease

Congenital heart disease, also called a congenital heart defect, is the most common birth defect. These heart conditions develop before a baby is born and affect the way a child’s heart looks and works. Some children with congenital heart disease need only monitoring or medications. But about 1 in 3 infants have life-threatening heart defects that require surgery.

Each type of congenital heart disease affects the heart differently. There may be problems with the heart valves, heart walls, heart chambers, nearby blood vessels or a combination of these issues. As a result, a baby’s blood might not have enough oxygen. The blood may move in the wrong direction or sometimes not at all. At Children's Health℠, we treat all types, from the common to the rare and complex.

Some congenital heart defects cause mild issues that may not be noticed until later in childhood or even adulthood, while others can bring serious challenges.

Signs of congenital heart disease may include:

• Blue skin tones (cyanosis) due to lack of oxygen
• Excessive sweating
• Extreme fatigue or sleepiness
• Lack of appetite or stunted growth
• Puffiness in the legs, feet or face
• Rapid breathing or shortness of breath
• Inability to keep up with peers during play or physical activity
• Weak pulse or pounding heart

Experts at our Fetal Heart Program perform ultrasounds, called fetal echocardiograms or fetal “echoes,” that can diagnose congenital heart disease while a baby is still in the womb. Fetal echoes are safe for mom and baby.

Many heart defects aren’t noticeable until after a baby is born or even later in life. Before a newborn leaves the hospital, most states, including Texas, require screenings for certain congenital heart diseases that are considered critical. These more serious heart defects can be life-threatening if not detected and treated early.

To detect a critical heart problem in a newborn, doctors measure the baby’s oxygen level. This painless test involves placing sensors on a newborn’s skin (pulse oximetry test). A low oxygen level may indicate a heart problem. Your child will also get a physical exam so the doctor can listen to the heart and lungs and check for heart murmurs (unusual heart sounds) or abnormal pulses.

Diagnostic tests for congenital heart disease include:

• Chest X-rays to check for an enlarged heart and excess fluid in the lungs
• Echocardiogram to examine heart valves and structure
• Electrocardiogram (EKG) to test heart rhythm
• Heart catheterization to measure oxygen levels and pressure inside heart chambers and blood vessels
• Cardiac MRI to examine heart structure and look for unusual changes to the heart

Experts are still trying to determine why some children develop heart defects. Potential causes may include:

• Chromosome changes. Certain chromosomal conditions, such as Down syndrome, increase a child’s chances of having congenital heart disease.
• Environmental exposures. Taking certain medications, drinking alcohol, smoking or abusing substances during pregnancy may affect an unborn baby’s heart development.
• Genetics. Heart disease sometimes runs in families (a genetic condition). A child may be more likely to have a heart problem if a parent or sibling has one, too.
• Maternal health. Moms-to-be who have certain health conditions, such as Type 1 diabetes or lupus, may have a higher risk of having a baby with a heart defect.

Depending on the specific type of congenital heart disease, treatments range from medication to surgery to a heart transplant. Our team has the expertise to match your child’s condition with the treatment that offers the best results.

Should your child need surgery, you can feel confident knowing that our doctors successfully perform hundreds of complex cardiothoracic surgeries on the tiniest hearts every year. Plus, your child is in the skilled hands of our dedicated cardiac anesthesia team. Our team safely sedates more than 1,000 children each year for heart procedures.

Other treatments for congenital heart disease include:

• Electrophysiology. Specialists in our electrophysiology program treat heart rhythm problems (arrhythmias) through catheter-based procedures or by placing heart devices such as pacemakers.
• Heart catheterizations. We have one of the nation’s largest and most experienced pediatric heart catheterization programs. Our doctors perform minimally invasive procedures using catheters (thin, flexible tubes) inserted through blood vessels to access the heart. Children recover faster with less pain and scarring and may not need more complex open-heart procedures.
• Medications. Some children need medicines to treat heart rhythm problems, regulate blood pressure or get rid of excess fluid. Our pharmacists, who specialize in heart medications, help families manage medication treatments and side effects.
• Ventricular assist devices (VADs). These surgically implanted devices help weakened hearts to pump blood. We have one of the largest and most experienced VAD programs for children in the world.
• Heart transplants. We offer life-saving pediatric heart transplants and have performed more transplants than almost any other center in the country.

After heart surgery, your child recovers in the region’s most comprehensive pediatric cardiac intensive care unit (CICU). Here, our team of pediatric heart specialists carefully monitors your child’s recovery. As much as possible, we make sure you get all the time you need with your baby in the CICU. Some parents choose to stay overnight in one of our family rooms.