Annex A > Chapter 3 - Developments in the UK, in the Diagnosis and Treatment of Congenital Heart Abnormalities in Children, 1984-1995 > An outline of some of the types of congenital heart disease > The heart with a congenital abnormality
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The heart with a congenital abnormality
35 There are two principal consequences ((a) and (b)) of being born with a heart abnormality. These are set out below. It is essential to understand them as background to the descriptions of the specific abnormalities which follow.
(a) The abnormality may cause one of the pumping chambers (ventricles) to fail to work properly. In general terms this is known as `heart failure'. A patient may be in heart failure for days, months or years depending on how severely the ventricle's function is compromised. Congenital heart abnormalities may cause heart failure for a number of possible reasons:
- There may be too much blood flowing through the ventricle, causing it to be `volume loaded'.
- There may be too little blood flowing through the ventricle, causing it to be too small to function normally.
- The ventricle may be required to pump blood against a higher resistance than normal (such as through a narrow valve) causing it to be stretched and put under strain.
(b) The blood which returns in the main veins from the body to the heart and which should flow to the lungs in order to be re-oxygenated, may be diverted and be pumped to the body again without additional oxygen. This causes the skin of the baby or child to have a blue appearance, known as `cyanosis'. More important, all of the organs then receive less oxygen than normal. If the lack of oxygenation is mild, the baby or child will not be seriously affected, apart from tiring more easily than normal children, and being at risk of other complications, especially in the presence of a serious infection. If the lack of oxygenation is more profound, the function of the other organs may also be affected and this can be most serious for the brain, liver or kidneys.
Generally a child will have one or other of these types of abnormality, but there are some rare conditions where a child may have both types.
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