What is the health impact of being born with a heart defect on a child?

Some babies are born with heart disease that affects the functioning of their hearts. According to the U.S. Centers for Disease Control and Prevention (CDC), about one in four babies who have a heart defect has a severe heart defect at birth that will require surgery or another procedure during the first year of life. 

It is important to highlight that, on certain occasions, babies born with this condition can look healthy and may be sent home before their disease is detected. However, they face the risk of severe complications in the first days or weeks of life, requiring immediate medical attention (these diseases are among the most frequent and highest mortality congenital anomalies in the world, with a prevalence of 70 - 80 per 10,000 live newborns).

However, less critical congenital heart defects may manifest themselves during childhood: older children may show swelling in their feet, ankles, legs, belly, liver, and neck veins; difficulty breathing during physical activity - they may experience rapid breathing, wheezing or excessive coughing; extreme sweating while eating, playing or exercising; tiredness, weight loss, fainting or chest pain. In all cases, it will be necessary to seek help from experts and/or specialists.

Also, infants and children with congenital heart disease have a high probability of presenting nutritional alterations, which retard their growth and development. The compromise is more severe in those with cardiac insufficiency and cyanosis. Despite advances in treatment, malnutrition continues to be a problem: the reduced caloric intake is related to an increase in energy requirements, a product of the pathology with which they coexist. 

Studies have shown that, despite an adequate caloric intake for age, growth is affected due to the high energy expenditure of patients in this population compared to those of the same age without heart disease. Children with these diseases usually present functional and structural organ impairment due to nutrient deficiency.

In addition, due to the fluid restriction to which they are exposed, they suffer alterations such as reduced gastric capacity, anoxia -which refers to the almost absolute lack of oxygen in the body's tissues or even in the blood, and circulatory congestion. This problem is aggravated at the time of surgery, since the child's organism is not in optimal conditions to be able to face the aggressions to its condition, typical of the intervention, making it vulnerable to situations that increase the risk of morbidity and mortality. 

Likewise, people who have a heart defect from birth may develop other health problems over time: It will depend on the heart defect and its severity. For example, other cardiac problems related to arrhythmias (irregular heartbeats), an increased risk of heart infection (infective endocarditis), or diseases that weaken the heart (cardiomyopathy) may become evident.

Therefore, the prognosis of these diseases depends on their early detection. Some of these defects can be diagnosed during pregnancy by a fetal echocardiogram, which creates images of the unborn baby's heart. If they are not found during pregnancy, they may be detected when the baby is born or as the child grows.

In this way, timely remission to a pediatric cardiologist is necessary for correct diagnosis by ultrasonography and appropriate pharmacological management; coordination with specialists, including pediatric cardiovascular surgeons, to perform one or more surgical interventions at the indicated time; adequate postoperative management, as well as long-term follow-up and medical control. 

Any problems that may occur should be solved in collaboration with the other health professionals, to provide the child with the best conditions for a favorable evolution in his or her treatment and during the years to come.