According to DigoPaul, a heart defect or cardiac vitium is a general term for disorders of the composition and structure of the heart. A distinction is made between heart defects that are acquired (e.g. due to infections or heart diseases) and congenital heart defects. Congenital heart defects are usually cardiac malformations that can be detected and treated in the womb or in the newborn. Nevertheless, heart defects can usually be treated for a lifetime.
What is a heart defect?
The word heart defect is the generic term for both congenital malformations of the heart and for congenital or acquired heart valve defects. Furthermore, congenital heart defects are divided into acynotic and cyanotic heart defects. Cyanosis is the bluish-red discoloration of the skin and mucous membranes as a result of a decrease in the oxygen content in the blood (central cyanosis).
The most common acynotic heart defect is pulmonary stenosis, followed by aortic valve stenosis (narrowing) and coarctation of the aorta. Malformations of the aortic arch are rather rare. Primary acynotic heart defects include defects in the atrial and/or ventricular septa and the open ductus arteriosus.
The primary cyanotic heart defects include tetralogy of Fallot, hypoplasia of the right or left ventricle, anomalous pulmonary veins, etc. The frequency of congenital heart defects is 6-10 newborns in 1000 live births.
The embryonic heart and blood vessels develop between the 14th and 60th day of pregnancy. During this development phase, the cardiovascular system reacts sensitively to external and genetic factors. Certain exogenous, i.e. external, influences often produce certain cardiac defects. Excessive alcohol consumption during pregnancy often leads to septal defects and tetralogy of Fallot (pulmonary stenosis, atrial septal defect, right heart hypertrophy and displaced aorta).
Administering medication during pregnancy should always be weighed up, as numerous heart defects can also occur. Certain antiepileptic drugs can cause pulmonary and/or aortic stenosis. If the mother has certain diseases during pregnancy – such as diabetes mellitus – there is an increased risk of ventricular septal defects, especially if the metabolic status is poor.
Some infectious diseases during pregnancy are also dangerous and can cause a heart defect – for example, congenital rubella disease, which can lead to a patent ductus arteriosus.
Heart defects occur more frequently with certain genetic syndromes and chromosomal maldistributions (internal or endogenous factor). Typical in trisomy 21 or Down syndrome are ventricular and/or atrial septal defects of varying degrees of severity. In Marfan syndrome, mitral and tricuspid valve prolapse or aortic enlargement occur because there is a substance defect in the connective tissue.
Acquired heart defects occur throughout life. Infectious inflammations usually lead to valve defects, most of which have to be corrected surgically. Degenerative valve changes occur more frequently, which can initially be observed and operated on if they are of a certain degree of severity.
Symptoms, Ailments & Signs
A heart defect often causes the heart to fail. As a result, the affected person is less physically able and exhausted more quickly under stress. Breathing difficulties and cardiac arrhythmia are also typical and also increase with the progression of the disease.
The clinical picture also includes blood pressure fluctuations and circulatory disorders. Thrombosis can form as a result of increased blood clotting. In the worst case, a stroke or heart attack occurs . The general symptoms initially only occur during physical activity and persist in the advanced stage.
In general, the symptoms of a heart defect are similar to those of heart failure. Accordingly, water retention, exhaustion and tachycardia can also occur. Depending on its cause, a heart defect can cause numerous other symptoms and complaints. If, for example, a so-called mitral stenosis is the underlying cause, coughing up blood and increasing chest pain occur. Externally, bluish lips and bluish-red cheeks can often be noticed.
If the heart defect is an aortic stenosis, reduced blood flow to the heart muscle can occur. This manifests itself, among other things, in dizziness, brief fainting spells and the typical symptoms of angina pectoris. The signs of a congenital heart defect can already appear in the first years of life and develop gradually. Some people have no symptoms at all.
Heart defects can lead to various complications. In the case of congenital heart defects, there is always a risk of heart muscle weakness and an insufficient supply of oxygen to the organs. Depending on the type and severity of the heart defect, a variety of heart problems can occur in the course of life. This can lead to arrhythmias and pain, but also to serious organ damage or heart attacks.
The increased production of red blood cells can also lead to thickening of the blood. This increases the risk of stroke, vascular thrombosis and heart attack. If a congenital heart defect is not treated, it can also lead to severe inflammation, cardiac arrhythmias or diseases of the heart valves. Sometimes permanent lung damage and diseases of the internal organs occur.
Heart defects that develop as a result of inflammation, stress, or excessive drug use can cause a variety of other complications, depending on the cause. Complications can also occur during the surgical treatment of a heart valve defect.
The heart-lung machine can change blood clotting, temporarily cause kidney failure and sometimes even lead to life-threatening artery occlusions. Post-procedure bleeding and infection, but also temporary psychological complications may occur.
When should you go to the doctor?
People who suffer from frequent tiredness and exhaustion for no apparent reason should consult a doctor. This is especially true if the symptoms increase over time. A gradual decrease in performance, often associated with shortness of breath and weakness, indicates an acquired heart defect.
A doctor must clarify the symptoms and, if necessary, initiate therapy immediately in order to reduce the risk of serious complications. If signs of mitral stenosis become noticeable, a doctor must be consulted immediately.
Coughing up blood and external signs such as bluish lips and bluish-red cheeks in particular require investigation. You should also go to the doctor with water retention and other unusual symptoms that cannot be attributed to a specific cause. A congenital heart defect also requires immediate clarification as soon as the first symptoms are noticed.
Cardiac arrhythmias, pain and cramps must be examined immediately. In the event of a heart attack, the emergency services must be called. Accompanying first aid measures are to be provided. A diagnosed heart defect requires close monitoring by a cardiologist.
Treatment & Therapy
The treatment of congenital or acquired heart defects requires lifelong special cardiological care. Despite the necessary surgical corrections, there are usually residual and subsequent conditions.
These usually occur after heart defects have been corrected in early childhood. This heart surgery distinguishes between palliative and corrective operations to eliminate heart defects.
A corrective operation aims to restore the normal functional state. This can normalize life expectancy. Palliative surgeries for heart failure are performed when there are serious abnormalities.
This also includes heart or heart-lung transplants. Today, valve operations are the most common. Biological valves (from pigs, cattle or horses) or mechanical artificial prostheses are used.
Outlook & Forecast
The prognoses for an existing heart defect are very different, because the severity of the heart defect has to be taken into account. In addition, the time of diagnosis also plays a major role. The earlier the heart defect is detected, the better the chances of a complete and quick recovery.
The ever-advancing medical technology meanwhile offers very good chances that newborns with a heart defect will reach adulthood. In general, a congenital heart defect is considered a chronic disease. However, those who seek medical and drug treatment early on can have a positive impact on their prospects and prognosis. The quality of life can thus be maintained.
Anyone who decides against permanent treatment must expect serious complications. Severe chest pain and febrile seizures may occur. In the worst case, cardiac arrest is imminent. If no life-saving measures are taken, death will occur.
An important preventive measure for corrected or existing congenital or acquired heart defects is endocarditis prophylaxis during interventions with a possible risk of infection, e.g. B. in dental procedures. This can prevent inflammation and subsequent heart valve defects, especially in the case of pre-existing heart defects.
Every patient with heart defects should always carry a heart card with them and present it at every doctor’s visit. You should also refrain from drinking alcohol during pregnancy and make sure you have a sufficient vaccination status before the start of pregnancy in order to avoid heart defects in the newborn child.
Anyone who suffers from a heart defect should by no means take it lightly. Appropriate aftercare is essential. Otherwise there is a risk of serious complications and, in the worst case, even death. Affected people should have an existing heart defect monitored regularly by a specialist.
Such check-ups can identify potential dangers at an early stage. Various measures can then be taken to eliminate possible dangers or complications. Those who do without regular visits and check-ups are exposing themselves to great danger.
An unexpected heart attack or heart failure are just two of many consequences that can occur in such a case. A deterioration in the condition cannot be recognized without appropriate follow-up care. Anyone who suffers from a congenital or a sudden heart defect must not neglect appropriate follow-up care.
The heart is our most important and central organ, without which the human body cannot live. Follow-up care for an existing heart defect is all the more important.
You can do that yourself
People who suffer from a heart defect do not necessarily have to restrict themselves in everyday life. Depending on the type of complaint, however, a few things should be considered to avoid complications.
First of all, with regard to the type of heart defect, an individual therapy must be drawn up together with the doctor, which includes physical exercise, dietary measures and medical treatment. The diet should be composed in such a way that the heart is not additionally burdened.
A healthy diet with plenty of fiber-rich foods and polyunsaturated fatty acids is recommended. A lot of sugar, white flour and animal fat should be avoided. Those affected should also refrain from smoking and only enjoy other stimulants such as coffee or alcohol in moderation.
In addition, heart patients benefit from individually tailored exercise training and regular stress reduction. Yoga and breathing exercises, for example, are recommended. If necessary, a physiotherapist or an occupational therapist can be consulted.
Help from other people – for example in a self-help group – can also be useful in order to accept the disease and learn new strategies for better dealing with the heart defect. In addition, of course, close medical supervision is always indicated. The diseased heart needs to be checked regularly, especially if there are any unusual symptoms or signs.