Congenital heart disease and acquired: causes, symptoms, treatment

Medically reviewed: 1, February 2024

Congenital and acquired heart disease: what is the difference?

Congenital heart disease: definition

Congenital heart disease typically refers to intrauterine anatomical defects (before the birth of the child) of the heart, its valve apparatus or its vessels. These defects can occur in isolation or in combination with each other. In contrast, acquired heart disease, also known as non-congenital heart disease, refers to conditions affecting the heart that develop after birth due to various factors such as lifestyle choices, infections, or aging. It contrasts with congenital heart diseases, which are present at birth due to abnormalities in heart structure or function.

Congenital heart disease can occur immediately after the child’s birth or leak secretly. Congenital heart defects meet with a frequency of 6-8 cases per thousand births, which is 30% of all malformations. They occupy the first place in the mortality of newborns and children of the first year of life.

After the first year of life, mortality decreases sharply, and within a period of 1 to 15 years, no more than 5% of children die. It is clear that this is a big and serious problem.

Treatment of congenital heart anomalies is possible only surgically. Thanks to the success of cardiac surgery, complex reconstructive surgery has become possible with previously inoperable AMS. In these conditions, the main task in organizing care for children with CHD is timely diagnosis and provision of qualified care in a surgical clinic.

The heart is made up of four chambers, it is like an internal pump consisting of muscles, which constantly pumps blood through a complex network of vessels in our body.

These four chambers are known as the atria and ventricles.

The atria are situated at the top, while the ventricles are positioned at the bottom. It is a continuous process where blood is constantly moving from the atria to the ventricles, and subsequently pumped into the arteries via the four heart valves.

The primary form of treatment for acquired heart disease is typically surgical in nature. It is crucial for patients suffering from this condition to promptly seek consultation with a cardiac surgeon. Doing so ensures that the possibility of undergoing a highly effective surgical treatment is not overlooked or delayed.

Therefore, the correct and reliable work of the heart is due to the correct structure.

Causes of congenital heart disease

In a small part of cases, congenital malformations are of a genetic nature, the main reasons for their development are external influences on the formation of the child’s organism mainly in the first trimester of pregnancy (viral, eg rubella, and other maternal diseases, alcoholism, drug addiction, use of certain medicines, ionizing radiation – radiation, etc.).

One of the important factors is also the health of the father.

There are also risk factors for the birth of a child with CHD. These include:

• the age of the mother,
• endocrine diseases of the spouses,
• toxicosis and the threat of interruption of the first trimester of pregnancy,
• stillborn in history,
• the presence of children with congenital malformations in the immediate family.

To quantify the risk of childbirth with a UPU in the family can only a geneticist, but each doctor can give a preliminary prognosis and send parents to a medical and biological consultation.

Manifestations and symptoms of congenital heart defects

Among the numerous types of AMS, there are seven that are frequently encountered. The defect of the interventricular septum (DMV) accounts for approximately 20% of all instances of congenital heart disease.

Additionally, the atrial septal defect (ASD), the open arterial duct (AAP), coarctation of the aorta, aortic stenosis, stenosis of the pulmonary artery, and transposition of large main vessels (TCR) each make up around 10-15% of cases. There exists an extensive range of over 100 distinct types of congenital heart defects.

These defects are often categorized and classified based on various criteria, with the most recent classification in the United States aligning with the International Classification of Diseases.

A common method of classifying these defects involves dividing them into two groups: blue and white.

• Blue-type defects are characterized by cyanotic skin, while white-type defects exhibit pale skin. Examples of blue-type defects include tetralogy of Fallot, transposition of the main vessels, and atresia of the pulmonary artery.
• On the other hand, white-type defects encompass conditions such as atrial septal defect, interventricular septal defect, and several others.

Identifying congenital heart disease at an early stage provides a greater chance for timely treatment, thereby increasing the hope for a positive outcome.

Congenital Heart Disease in children

Doctors have multiple reasons to suspect the presence of heart disease in children:

• A child at birth or shortly after birth has a blue or cyanotic skin color, lips, auricles. Or cyanosis appears when breastfeeding, crying baby. With white heart defects, skin blemishes and cold extremities may occur.
• The doctor, when listening to the heart, detects noises. Noise in a child is not an obligatory sign of a heart defect, however, it forces us to examine the heart in more detail.
• The child shows signs of heart failure. This is usually a very unfavorable situation.
• Changes are detected on the electrocardiogram, X-ray images, during echocardiography.

Even having an inborn heart disease, for some time after birth, the child can look outwardly quite healthy during the first ten years of life.

As time goes on, the symptoms of heart disease start to become more apparent in the child. They begin to fall behind in their physical development compared to their peers, experiencing difficulties with breathing when engaging in physical activities. Additionally, their skin may appear pale or even exhibit a bluish tint, indicating a lack of oxygen in the body.

To establish a true diagnosis, a complex examination of the heart with the use of modern high-tech expensive equipment is necessary.

Complications of congenital heart defects

Congenital malformations can be complicated by heart failure, bacterial endocarditis, early protracted pneumonia due to stagnation in the small circulation, high pulmonary hypertension, syncope (short-term loss of consciousness), stenocardic syndrome and myocardial infarction (most typical for aortic stenosis, abnormal left coronary artery), dyspnea-cyanotic attacks.

Prevention of congenital heart disease

Since the causes of congenital heart disease are still poorly understood, it is difficult to determine the necessary preventive measures that would guarantee the prevention of congenital heart disease.
The risk of congenital diseases in children can be greatly reduced if parents prioritize and take proper care of their own health.

Thanks to early detection and the availability of innovative treatment options, individuals have a greater chance of successfully managing their condition, the outlook is relatively favorable. In the absence of such an opportunity, it is doubtful or unfavorable.

Congenital Heart Disease treatment

Treatment of CHD can in principle be divided into surgical (in most cases it is the only radical) and therapeutic (more often it is ancillary).

Most often, the question of surgical treatment is put before the birth of the child, if it concerns the “blue defects”. Therefore, in such cases, the birth should take place in the maternity homes of cardiosurgical hospitals.

Therapeutic treatment is necessary if the timing of the operation can be postponed to a later date.

If the question concerns “pale vices”, the treatment will depend on how the defect behaves when the child grows up. Most likely, all treatment will be therapeutic.

It is necessary to pay utmost attention to your health and the health of your unborn child. Come deliberately to the question of the continuation of the family.

If you know that there are relatives with heart defects in your family or family, there is a possibility that a child with a heart defect can be born.

In order not to miss such moments, a pregnant woman should warn her doctor about it, go through all the ultrasound during pregnancy.

Acquired heart diseases: what is it?

Acquired heart disease refers to a structural alteration in the heart valve that occurs due to various diseases or traumatic injuries to the heart over the course of a person’s lifetime. The heart, being a vital organ, is comprised of four chambers: the left atrium and ventricle, separated by the mitral valve, and the right atrium and ventricle, separated by the tricuspid valve.

The aortic valve is located at the point where the aorta exits the heart, while the valve of the pulmonary artery can be found at the spot where the pulmonary artery leaves the heart.

The mitral valve is the most commonly affected by defects, accounting for approximately 50-70% of cases, while defects in the aortic valve occur slightly less frequently, ranging from 8-27% of cases.

Isolated defects of the tricuspid valve are rare, in less than 1% of cases, but in combination with the vices of other valves, the tricuspid valve infection occurs in half of the patients.

Some common types of acquired heart diseases include:

• Coronary artery disease (CAD): Plaque builds up inside the coronary arteries supplying blood to the heart muscle, leading to narrowed or blocked vessels. This can result in chest pain (angina), shortness of breath, or a heart attack.
• Heart failure: Weakened or damaged heart muscles struggle to pump sufficient blood throughout the body, causing fluid accumulation in lungs or other parts of the body, resulting in symptoms such as fatigue, shortness of breath, swelling in legs and ankles.
• Arrhythmias: Abnormal heart rhythms occur when there is a problem with electrical signals controlling heartbeats, making them too fast, slow, or irregular. These may cause no symptoms or lead to severe complications depending on the severity and duration of arrhythmia.
• Valvular heart disease: Any damage or defect to one of the four heart valves disrupts regular blood flow through the heart. Leaking valves make the heart work harder than required while stenotic valves restrict proper filling of chambers. Symptoms might range from mild to life-threatening.
• Cardiomyopathy: Enlargement or thickening of the heart muscle affects its ability to pump efficiently, often progressing to heart failure. Various subtypes exist based on underlying causes, e.g., dilated cardiomyopathy, hypertrophic cardiomyopathy, etc.
• Pericarditis: Inflammation of the pericardium, a thin sac surrounding the heart, can lead to chest pain, fever, and difficulty breathing. Viral infection is among the most frequent triggers, although many cases remain idiopathic.
• Myocarditis: Infection or inflammation of the heart muscle itself typically results from viruses, bacteria, fungi, or parasites, manifesting primarily as flu-like symptoms alongside palpitations, shortness of breath, or even sudden death in rare instances.

These acquired heart diseases can significantly impact overall health, quality of life, and longevity, necessitating appropriate diagnosis, management strategies, and treatment approaches tailored to individual patient needs under medical supervision.

Causes of an Acquired heart disease

The primary factors contributing to the failure of valves are typically rheumatism, atherosclerosis, and infective endocarditis. However, there are significantly fewer instances where heart defects occur as a result of syphilitic damage, trauma, diffuse connective tissue diseases (such as Bechterew’s disease, systemic scleroderma, and dermatomyositis), or degenerative changes in the valves accompanied by the presence of lime salts.

As the inflammatory process progresses within the valve flaps, it ultimately leads to impairment, destruction, and the formation of scar tissue. When the valve function is compromised, it puts added strain on the heart, leading to the development of hypertrophy, which is the thickening of the heart muscle. Additionally, the heart chambers expand, causing a decrease in the ability of the cardiac muscle to contract effectively, and this ultimately manifests as signs of heart failure.

Symptoms of an acquired heart disease

The symptoms of the disease vary depending on which valve or combination of valves is affected. In terms of the overall functioning of the blood flow, there are three distinct states of defects: compensated, subcompensated, and decompensated. The patient might experience various distressing symptoms such as a fast heartbeat, difficulty breathing, swelling, and other indications of heart failure that can disrupt their well-being. These symptoms can significantly impact the patient’s overall health and daily functioning.

Diagnostics of an acquired heart disease

Diagnosis and treatment of heart defects is performed by a cardiologist on the basis of clinical symptoms, auscultation of the heart and additional methods of investigation:

• electrocardiography (ECG);
• echocardiography (ECHO-KG);
• Chest X-ray.

Probing of the heart cavities and angiography is carried out only with indications for surgical treatment of vices.

Treatment of acquired heart defects

Conservative treatment is aimed at preventing relapses and complications of the underlying disease, correction of heart rhythm disturbance, prevention and treatment of heart failure.

The primary form of treatment for acquired heart disease is typically surgical in nature. It is crucial for patients suffering from this condition to promptly seek consultation with a cardiac surgeon. Doing so ensures that the possibility of undergoing a highly effective surgical treatment is not overlooked or delayed.

Treatment with Aspirin

Aspirin is a widely used medication that can help prevent and treat AHD by reducing inflammation, preventing blood clots, and lowering blood pressure. Aspirin therapy is recommended for most patients with AHD, especially those who have had a heart attack, stroke, or angina.

However, aspirin is not suitable for everyone, as it can cause side effects such as bleeding, ulcers, or allergic reactions. Therefore, it is recommended that individuals with AHD seek professional medical advice prior to commencing or discontinuing the use of aspirin as a therapeutic approach.

Side effects:

Most patients with unstable angina will be told to take aspirin every day. Your doctor will tell you how much to take. When coated or buffered aspirin is used there are few major side effects. Aspirin should not be used if you are allergic to it or if you have had an ulcer or any other bleeding problem.

Nitrates

How they work:

Nitrates (usually nitroglycerin and isosorbide) are used to open blood vessels.

Have the capability to enhance the circulation of blood towards both the heart muscle and the blood vessels, which makes it easier for the heart to work. Nitrates can relieve most anginal discomfort very quickly.

Come in tablets that you put under your tongue or a different type of tablet that you swallow, as a patch that you wear on your skin, or as a cream that you apply on your skin.

Nitrate in form of tablets, cream, and patches possess a finite duration of effectiveness beyond which they will cease to be efficacious.

Ask your pharmacist how long they will last and when you should replace them.

Nitrate cream and patches are for maintenance therapy only. If you are using a nitrate patch or cream, you should still use nitrate tablets if you have anginal discomfort.

Take one nitroglycerin tablet as soon as you feel discomfort. If the discomfort does not go away in 5 minutes, take a second tablet. If the discomfort does not go away after 5 more minutes, take a third tablet.

Attention! If the discomfort has not gone away after taking three tablets in 15 minutes, go to the hospital immediately. Do not wait!

Persistent discomfort that does not go away could be a sign that you are having a heart attack. You should see a doctor immediately.

• Side effects:

You may feel dizzy or lightheaded right after taking nitrates. Patients are usually told to take nitrate tablets while sitting down. Some people may also get a headache when they take nitrates.

Beta Blockers

This drug decreases the amount of work your heart has to do and the amount of oxygen your heart needs.

• Side effects:

Beta blockers are very powerful drugs that can have many side effects. About 10 percent of patients taking beta blockers will feel tired or dizzy. Depression, diarrhea, or skin rash may also happen in about 5 percent of patients. Mental confusion, headaches, heartburn, and shortness of breath are much less common.