Cyanotic and Acyanotic Heart Diesases; What are they?

Congenital Heart Disease (CHD) is the presence of anatomical defects affecting the heart and the great blood vessels arising from it and present at the time of birth. According to the best pediatric cardiologists in Hyderabad, the exact cause of congenital heart disease remains unknown, but risk factors such as infections like rubella during pregnancy, use of some medications during pregnancy, use of recreational drugs, alcohol, and smoking during pregnancy, parents being closely related, presence of congenital heart disease in either or both the parents, poor nutritional status of the mother, obesity of the mother, etc., can lead to the development of congenital heart defects. Apart from this, there are certain genetic conditions, such as Down syndrome, Turner syndrome, Marfan syndrome, etc., that are also associated with the presence of congenital heart defects in addition to other medical problems.

Congenital heart defects are the most common birth defects seen. They can include defects in the interior walls of the heart that separate the 4 chambers of the heart, the heart valves that regulate the flow of blood between the chambers of the heart, and the between the blood getting blood into and out of the heart, and also the large blood vessels arising from the heart. According to children’s heart specialists, congenital heart defects are divided into two types, namely Acyanotic Heart Disease and Cyanotic Heart Disease, depending on how the heart defect affects the supply of oxygenated blood and oxygen to the rest of the body.

What are Acyanotic heart defects?

In acyanotic heart disease and defects, the blood that is supplied to the rest of the body is oxygenated, and although it does not immediately cause a reduced supply of oxygen, the path of the blood flow through the heart is abnormal and can eventually lead to problems, especially depending on the severity of the defect.

What are the different types of Acyanotic Heart Defects?

Acyanotic heart defects can include aortic stenosis in which the aortic valve which regulates the flow of blood out of the heart is narrowed, atrial septal defect in which there is an abnormal opening in the wall separating the two upper chambers (atria), atrioventricular septal defect in which there is an abnormal opening in the wall separating the upper and lower chambers of the heart, bicuspid aortic valve in which the aortic valve only has two leaflets instead of the normal 3 leaflets resulting in abnormal flow of blood in the hearts chambers, PDA or Patent Ductus Arteriosis that results from a closure of the ductus arteriosis resulting in excess blood being pumped into the lungs, ventricular septal defect in which there is an abnormal opening in the wall that separates the two lower chambers of the heart resulting in a mixing of the oxygenated and deoxygenated blood, pulmonary stenosis in which there is a narrowing of the pulmonary valve which regulates the flow of deoxygenated blood into the lungs for oxygenation, etc.

What are the signs, symptoms, and complications of Acyanotic Heart Defects?

Acyanotic heart disease may not present with any symptoms in the early stages of the disease, but over time, due to various factors such as an increase in blood pressure in the system as well as in the lungs, symptoms such as breathlessness, dizziness, fatigue, fainting, tiredness, cough, respiratory infections, respiratory distress, and eventually leads to right heart failure and congestive heart failure. 

How is Acyanotic Heart Disease treated?

Management of acyanotic heart disease is mainly with medical treatment and using agents such as digoxin and diuretics such as furosemide. Surgical procedures are done to correct the defects and restore normal blood flow when the condition is severe or progressively worsening despite treatment.

What are Cyanotic Heart Defects?

In Cyanotic heart defects, the deoxygenated blood from the right side of the heart does not go into the lungs. Still, it directly enters the systemic circulation, supplying deoxygenated blood to the rest of the body. Cyanotic heart defects result when there is a mixing of pure and impure blood within the heart due to right to left flow of blood within the heart, an abnormal positioning of the large blood vessels into and out of the heart, and an increase in the pulmonary resistance that prevents blood from going into the lungs.

What are the different types of Cyanotic Heart Defects?

Cyanotic heart defects can include Tetralogy of Fallot, which is a combination of 4 structural defects including pulmonary stenosis, ventricular septal defects, etc., Total Anomalous Pulmonary Venous Connection involving the pulmonary veins which carry oxygenated blood from the lungs, Hypoplastic Left Heart Syndrome in which the left side of the heart is very poorly developed, Transposition of the Great Arteries in which the large blood vessels arising from the heart are wrongly placed, Pulmonary Atresia and Pulmonary Stenosis in which there is a defect in the pulmonary valve resulting in improper blood flow to and out of the lungs, etc.

What are the signs, symptoms, and complications of Cyanotic Heart Disease?

Cyanotic heart defects' signs and symptoms depend on the condition's type and severity. Some defects may not be present until later in life, but in most cases, the symptoms are seen at birth or very early in life. Symptoms and signs include shortness of breath, clubbing, cyanosis or bluish discoloration of the skin and lips, rapid heart rate, rapid breathing, large nails and toes, delayed and poor growth and development, difficulty with feeding, etc. Complications from cyanotic heart disease include congestive heart failure, arrhythmias, and death.

What is the treatment for cyanotic heart disease?

Cyanotic heart diseases require prompt management in the form of surgical correction and repair of birth defects. The surgery's type and timing depend on the defect's type and severity. In some cases, surgical procedures may have to be done immediately after birth or in infancy. In contrast, in other cases, surgical procedures can be done when the child is slightly older, and the symptoms experienced are not so severe.

With advances in technology, birth defects are now increasingly being detected at an early stage, and therefore, surgical procedures and treatments are being planned. It is advisable always to get regular medical check-ups during pregnancy, especially if there is a history of congenital heart disease in the family. Suppose the symptoms of congenital heart disease are detected after birth. In that case, it is advisable to seek a consultation with a pediatric cardiologist or book an appointment with a pediatric heart specialist to get a proper evaluation and plan to manage the condition.