Congenital Heart Defects in Infants: Recognizing the Common Symptoms
Congenital heart disease refers to structural abnormalities in the heart or major blood vessels that develop during the embryonic stage, particularly within the first two to three months of pregnancy. These defects may result from developmental issues during formation or the failure of certain passages to close naturally after birth—something that is normal during fetal development.Types and Classification of Congenital Heart Defects
Congenital heart defects can be classified based on hemodynamic and pathophysiological changes into cyanotic or acyanotic types. Another classification divides them into three groups depending on blood flow patterns: no shunt (e.g., pulmonary stenosis, coarctation of the aorta), left-to-right shunt (e.g., atrial septal defect, ventricular septal defect, patent ductus arteriosus), and right-to-left shunt (e.g., tetralogy of Fallot, transposition of the great arteries). The severity and complexity of the defect largely determine the symptoms a child may experience.
Common Symptoms of Specific Heart Defects
Atrial Septal Defect (ASD): Many infants with ASD show no symptoms early on. However, during childhood, symptoms may include shortness of breath during physical activity, reduced stamina, delayed growth, and frequent respiratory infections. In cases with large shunts, heart failure may occur.
Ventricular Septal Defect (VSD): Small VSDs often cause no noticeable symptoms and do not affect growth. Larger defects, however, can lead to feeding difficulties, rapid breathing, excessive sweating, poor weight gain, and recurring lung infections. Severe cases may result in congestive heart failure within the first six months of life. If pulmonary hypertension develops, symptoms such as cyanosis, limited physical activity, and eventual right heart failure may follow.
Patent Ductus Arteriosus (PDA): When the ductus arteriosus remains open, symptoms vary depending on the size of the opening. Small openings may cause no symptoms, while larger ones can lead to shortness of breath, coughing, hoarseness, fatigue, excessive sweating, and heart palpitations. Frequent lung infections and heart failure may also occur.
Pulmonary Stenosis: Mild cases may not present symptoms early on. As the condition worsens, symptoms may include cyanosis, shortness of breath during exertion, fatigue, and heart palpitations. In severe cases, swelling and fainting may occur due to the heart's inability to pump effectively.
Tetralogy of Fallot: A Complex Heart Defect
Tetralogy of Fallot: Before the ductus closes, symptoms may be minimal. However, within the first three to six months after birth, cyanosis typically appears. Some cases may not show symptoms until later childhood or even adulthood. Cyanosis worsens during physical activity or crying and improves at rest. Due to low oxygen levels in the blood, children may become short of breath during exertion, suffer from hypoxic episodes, lose consciousness, or experience seizures. Many children instinctively squat during physical activity to increase resistance in the systemic circulation, which helps reduce the right-to-left shunt and improve oxygenation.