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‘Cyanosis’ one of the ‘general signs of congenital heart disease’ – other symptoms

It’s November now and the festive season is nearly upon us. The signs and decorations are up and the adverts are on the television reminding us that the big day is coming. With said celebrations comes an array of foods rich in fat, cholesterol, and all those juices which give the heart a hard time. And yet, not all forms of heart disease occur during life. Some, such as congenital heart disease, occur before the first breath.

Congenital heart disease (CHD), says the NHS, “is a general term for a range of birth defects that affect the normal way the heart works…congenital heart disease is one of the most common types of birth defect, affecting almost one in 100 babies born in the UK.”

In common with all forms of heart disease, CHD causes a range of symptoms, including cyanosis, also known as a blue tinge to the skin or lips. The word cyan is in fact a reference to the colour cyan, defined as between green and blue.

Other symptoms of CHD include:
• Rapid breathing
• Rapid heartbeat
• Swelling in the legs, tummy, and around the eyes
• Shortness of breath in babies during feeding
• Extreme tiredness and fatigue
• Fainting during exercise
• Swelling in the hands, ankles, and feet.

The NHS added: “In more severe cases, these problems may develop shortly after birth. However, symptoms sometimes don’t develop until the teenage years or early adulthood.”

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Why CHD happens

In the majority of cases, there are no obvious reasons why CHD happens. However, some factors can increase the likelihood of it developing.

This includes Down’s Syndrome, the mother having infections such as rubella during pregnancy or taking certain medicines.

Furthermore, smoking or drinking during pregnancy can increase the risk of CHD, as can the presence of type 1 or type 2 diabetes as well as inherited chromosome defects.

As well as inherited defects or chronic conditions, having flu during the first three months can increase the risk; the NHS say: “The reasons for this are unclear.”

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How is it treated?

Treatment for CHD depends on the severity. The NHS said: “The majority of congenital heart disease problems are mild heart defects and don’t usually need to be treated, although it’s likely that you’ll have regular check-ups to monitor your health in an outpatient setting throughout life.

“More severe heart defects usually require surgery or catheter intervention (where a thin hollow tube is inserted into the heart via an artery) and long-term monitoring of the heart throughout adult life by a congenital heart disease specialist.

“In some cases, medications may be used to relieve symptoms or stabilise the condition before and/or after surgery or intervention. These may include diuretics (water tablets) to remove fluid from the body and make breathing easier, and other medication, such as digoxin to slow down the heartbeat and increase the strength of the heart’s pumping function.”

As well as direct surgical interventions, there is another simple way to help treat the condition, one which involves merely heading outside.

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Exercise is recommended as a way to build strength in the cardiovascular system. The NHS said that the guidance has changed for children as scientific understanding has evolved: “In the past, children with congenital heart disease were discouraged from exercising.

“However, exercise is now believed to improve health, boost self-esteem and help prevent problems developing in later life. Even if your child can’t do strenuous exercise, they can still benefit from a more limited programme of physical activity, such as walking or, in some cases, swimming.

“Your child’s heart specialist can give you more detailed advice about the right level of physical activity that’s suitable for your child.”

Although the condition can be treated effectively, this doesn’t mean there aren’t potential complications from the condition.

Examples of complications are developmental problems, respiratory tract infections, endocarditis, pulmonary hypertension, heart rhythm problems, sudden cardiac death, heart failure, and blood clots.

Having CHD can also affect pregnancy. The NHS say: “Many women with congenital heart disease can have a healthy pregnancy, but pregnancy puts an extra strain on the heart and can cause problems.

“If you have congenital heart disease and you’re considering having a baby, you should discuss it with your heart specialist (cardiologist) before getting pregnant. If you have congenital heart disease and you become pregnant, you must get help from healthcare professionals with experience in treating pregnant women with a history of the condition.

“If you have congenital heart disease and become pregnant, your congenital heart specialist will usually arrange an echocardiogram (heart scan) for your baby approximately 20 weeks into your pregnancy. This is to check whether your baby has any evidence of congenital heart disease. This scan will be in addition to your usual antenatal ultrasound scans.”

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