Congenital Heart Defect and its Physiology after Birth
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A congenital heart defect (CHD), also known as a congenital heart abnormality or congenital heart disease, is a birth problem in the anatomy of the heart or major arteries. Congenital heart disease is a kind of cardiovascular illness. Signs and symptoms vary depending on the kind of abnormality. Symptoms range from non-existent to life-threatening. Symptoms may include fast breathing, blue skin (cyanosis), low weight gain, and tiredness. Chest discomfort is not caused by CHD. The majority of congenital cardiac abnormalities are unrelated to other disorders. Heart failure is a CHD complication. A congenital cardiac defect's aetiology is frequently unknown. Risk factors include certain illnesses during pregnancy, such as rubella, the use of certain medicines or substances, such as alcohol or cigarettes, the parents' close relationship, and the mother's poor nutritional condition or obesity. Having a parent with a congenital cardiac condition increases the risk. Down syndrome, Turner syndrome, and Marfan syndrome are among the genetic diseases linked to cardiac abnormalities. Classification for congenital heart defects are Hypoplasia, Obstructive defects, Septal defects, Cyanotic defects. Hypoplasia can affect the heart, resulting in either the right or left ventricle underdevelopment. As a result, only one side of the heart can properly pump blood to the body and lungs. Heart hypoplasia is uncommon, although it is the most dangerous type of CHD. When it affects the left side of the heart, it is referred to as hypoplastic left heart syndrome, and when it affects the right side of the heart, it is referred to as hypoplastic right heart syndrome. When cardiac valves, arteries, or veins become abnormally narrowed or obstructed, this is referred to as an obstructive defect.
Pulmonic stenosis, aortic stenosis, and coarctation of the aorta are common abnormalities, with bicuspid aortic valve stenosis and subaortic stenosis being relatively rare. Heart enlargement or hypertension can result from any constriction or obstruction. The septum is a tissue wall that divides the left and right hearts. Defects in the interatrial septum or the interventricular septum enable blood to flow from the left to the right side of the heart, lowering the efficiency of the heart. Although ventricular septal defects are the most prevalent kind of CHD, roughly 30% of individuals have an atrial septal defect termed the patent foramen ovale. Cyanotic heart defects are so named because they induce cyanosis, which is a bluish-grey colouring of the skin caused by a shortage of oxygen in the body. Persistent truncus arteriosus, entire anomalous pulmonary venous connection, tetralogy of Fallot, transposition of the major vessels, and tricuspid atresia are examples of such disorders.
The placenta provides oxygen and nutrient transport during foetal life, receiving over 40% of total foetal cardiac output. The umbilical vein and ductus venosus return it to the foetal body through the right atrium. The lungs have little oxygenation function and receive only around 7% of the foetal cardiac output. The right ventricular output is still being transferred to the descending aorta via the ductus arteriosus. That is, in a 'right to left shunt' orientation. Furthermore, blood flows 'right to left' through the foramen ovale atrial level. These two primary connections allow both sides of the heart to communicate, allowing a wide range of cardiac abnormalities that become critically dangerous in postnatal life to be sustained. The placenta is no longer in control of circulation following delivery, and both lungs are responsible for oxygenation route with the first few breaths. The flap-like oval fossa virtually closes, the prostaglandin-dependent ductus arteriosum also closes into ligamentum arteriosum, and the right and left hearts remain functionally independent with the abrupt cessation of umbilical venous flow and the marked increase in return from the lungs to the left atrium. If the newborn has chronically significant cyanosis and acidosis, ductal closure may be delayed.