On an episode of the Healthful Woman podcast titled “Congenital Heart Disease in Newborns,” Dr. Nathan Fox sat down with Dr. Miwa Geiger, the director of the Fetal Heart Program at Mount Sinai. Congenital heart disease can be difficult to diagnose and treat since each case varies. It can also be frightening for parents to hear that their child may have a birth defect.
We will be discussing some of the key takeaways from this podcast episode to give you a better understanding of congenital heart disease and the steps that can be taken to treat it.
What is Congenital Heart Disease?
Congenital heart disease refers to a variety of heart defects that a baby might be born with. Common heart defects include a hole in the heart, which is one of the more minor defects a fetus might have. ASDs (Atrial Septal Defect) are holes in the top chambers and VSDs (Ventricular Septal Defect) are holes in the bottom chambers. Dr. Geiger explains that “ASDs are very hard to diagnose prenatally because there’s supposed to be an opening there. VSDs are holes between the bottom chambers of the heart that are not supposed to be there, but sometimes we cannot see them, and sometimes we can see them.” Sometimes these holes can get smaller and close over time, so surgery is not always required.
More severe cases are when one of the pumping chambers is not the correct size or the valves have formed in a way that prevents the blood flow from going to the correct chamber. Those patients can undergo a single ventricle pathway which is a surgery that redirects blood flow to move passively into the lungs while one pumping chamber does all the work. Although most of these children can live relatively normal lives, they often have some limitations and may need heart transplants in their teenage or early adult years.
How Are Children Affected by Congenital Heart Disease?
It can be difficult to learn that your unborn child has a congenital heart disease. Many parents are concerned about the quality of life their child will have and how many treatments will be needed after they are born. This concern and uncertainty is normal, especially since it can be difficult to tell how severe the condition is through an ultrasonic image. As the fetus grows, the heart can also change rapidly so appointments are recommended every 4 weeks to see how the condition is progressing.
Even after birth, the range of side effects and how severely children are impacted by their heart defects can vary. As Dr. Geiger says, “we do have patients who have fairly complex congenital heart defects who…go on to college, having normal jobs. You would never know unless you saw them without a shirt on that they had anything wrong. And then you see patients that need a lot of help with school. You know, something that’s fairly common is ADHD and depression in cases of significant heart disease.”
Treatment for Congenital Heart Disease
Scientific and medical advances like catheter procedures such as aortic stenosis or pulmonary valve stenosis and pulmonary valve replacements have made a significant impact on the ability to treat heart defects. There are even medications that can be given intravenously to maintain normal fetal circulation.
What’s important to remember is that although congenital heart disease can cause limitations, most adults living with congenital heart disease live relatively normal lives. “You could have some babies who have a certain condition and they do perfectly fine and they will or will not need surgery and they’ll be healthy and live long, you know, productive, happy lives” (Dr. Fox).
Consulting a Fetal Specialist
Every doctor and patient is different, so it is important that you find a doctor who fits your personality and that you feel comfortable with. Although other doctors may conduct their consultations differently, Dr. Geiger explains the steps she takes when speaking with parents about the possibility of their baby’s heart defect. One of the most important things is to tell the parents what the diagnosis is and the severity of the condition. Dr. Geiger then makes an illustration of the heart to that parents can visualize a normal heart compared to the one their fetus is developing. She explains possible steps of what might happen after birth, such as how the baby will look and the surgeries that may be necessary.
Compassion and understanding of each parent’s needs is an important part of these consultations with Dr. Geiger. She asks many questions about whether the parents would like to hear about each of the surgeries in detail and their background in science so that they do not feel overwhelmed with information. A coordinator is also present to write notes about what is discussed so that parents do not have to worry about forgetting any important information.
Ultrasonic Testing at Carnegie Imaging
An ultrasound is one of the first ways a heart defect can be detected. Schedule a consultation at Carnegie Imaging and our expert team will help you guide you and your baby through pregnancy with an effective treatment plan.
Carnegie Imaging for Women blogs are intended for educational purposes only and do not replace certified professional care. Medical conditions vary and change frequently. Please ask your doctor any questions you may have regarding your condition to receive a proper diagnosis or risk analysis. Thank you!