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What is meant by the term 'congenital heart disease'? How common are they? Why do they occur? Is a child with a heart condition at increased risk from infection?

Congenital heart defects are anatomical defects that occur at birth. The term congenital means a trait one is born with. There are numerous types of heart abnormalities of varying degrees of severity. More common defects include holes between the chambers of the heart, which can cause flow disturbances and increased heart work. If these holes are large enough, heart failure can ensue. Other defects include an undersized heart, abnormal heart valves, abnormal connections between heart arteries and arteries that supply the lungs with blood, and strictures (narrowing) of the main arteries including the aorta resulting in a condition known as coartation of the aorta. The list of these abnormalities is very long and sometimes children are born with multiple abnormalities resulting in even greater disability and early mortality.

No one is sure why these abnormalities occur but they are more common in individuals who have other developmental abnormalities including Down syndrome. In most instances there is a simply an isolated genetic abnormality which results in one of these problems. They are usually detected at birth but sometimes not until teenage or adult years when heart murmurs become more manifest. Echocardiography has helped identify these problems and define their significance, giving us a great tool to make a simple non-invasive and yet thorough evaluation of most of these individuals.

There is one defect which is gained much attention lately in the medical literature. This defect is called a PFO, or Patent Foramen Ovale. There is an area in the wall separating the two atrial chambers of the heart, which should close at birth. In some individuals this does not happen, setting the stage for possible strokes and infections. Rarely these small defects create heart murmurs and they are poorly seen on routine echocardiography. We now realize that they are much more common that we have ever thought, perhaps effecting about 15-25% of the population. For most individuals, a PFO is a no consequence and can only be diagnosed by placing an echo probe in the esophagus next to the heart. In individuals with unexplained stroke, we now always look for this problem. It also sometimes manifests itself in older individuals and was identified as the cause of the stroke in Ariel Sharon. Also, PFO have been implicated as a cause of migraine headaches.

All congenital heart defects can result in serious infections, heart failure, strokes, arrhythmias, and sudden death. However, for most individuals the severity and type of the lesion has to be evaluated and can often times be managed without any surgical intervention. We are excited that we now have new ways of repairing holes in the heart without surgery by providing safer options to the patients.


Galichia Medical Group, P.A.
2600 N Woodlawn
Wichita, KS 67220

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