Congenital Heart Disease

Introduction

Congenital heart disease is a heart defect that occurs during the formation of the heart in uterus. It could be fatal (i.e. causes intrauterine death, or death at anytime afterwards)
It is an important cause of perinatal morbidity/mortality
Classified as

  1. Cyanotic
  2. Acyanotic

Clinical features

Will depend on the type of the defect.
Mild defects go unnoticed

  1. Stunted growth
  2. Cyanosis
  3. Failure to thrive
  4. Heart murmurs

Differential diagnoses

  • Rheumatic heart disease
  • Endomyocardial fibrosis

Complications

  • Embolic phenomena
  • Cardiac failure

Investigations

  • Full Blood Count and differentials
  • Urea, Electrolytes and Creatinine
  • FChest radiograph
  • Electrocardiograhy
  • Foetal echocardiography.
  • Angiography

Treatment objectives

  • Relieve symptoms
  • Treat the definitive defect(s)

Non-drug treatment

  • Low salt diet

Drug treatment

  • Treatment of cardiac failure if present
  • Digoxin, diuretics and potassium supplements

Supportive measures

  • Oxygen
  • Counselling

Prevention

  • Pre-conception nutrition education
  • Antenatal care
  • Genetic counselling