Complications of congenital heart disease

Everyone knows that heart disease can be congenital or acquired, and congenital heart disease is common in children, while acquired heart disease is common in middle-aged and elderly people. If a child suffers from congenital heart disease, it is most likely closely related to genetics. And congenital heart disease also has many complications, so what are the common complications caused by congenital heart disease?

What are the possible complications of congenital heart disease?

pneumonia

Coughing and shortness of breath are common symptoms of pneumonia. Clinically, many children are often diagnosed with congenital heart disease by doctors due to pneumonia. In fact, heart disease is the root cause of pneumonia. In congenital heart diseases of pulmonary congestion in which a large amount of blood is shunted from left to right, such as the common ventricular septal defect, patent ductus arteriosus and atrial septal defect, the children's lungs become congested and the pulmonary artery pressure increases, causing water to seep into the alveolar interstitium, increasing the water and blood flow in the lungs, and the lungs tend to be full and lose compliance, resulting in labored breathing and choking. When the heart function is affected, pulmonary congestion and edema occur. On this basis, a mild upper respiratory tract infection can easily cause bronchitis or pneumonia, which often coexists with heart failure. Antibiotics alone are difficult to treat and heart failure must be controlled at the same time to be relieved. If congenital heart disease is not treated, pneumonia and heart failure may recur, causing the children to be critically ill multiple times or even die.

Heart failure

It means that the heart cannot provide enough blood to meet physiological needs, so it uses some compensatory mechanisms to make up for the lack of heart function. If the compensatory function is ineffective, it will cause heart failure, leading to the appearance of various symptoms, such as increased heart rate, rapid breathing, frequent coughing, laryngeal sounds or wheezing, enlarged liver, distended neck veins and edema, etc.

Pulmonary hypertension

Congenital congestive heart disease in which a large amount of blood is shunted from left to right leads to increased pulmonary circulation blood flow and elevated pulmonary artery pressure. In children, as their fetal blood vessels are not yet fully developed and based on their foundation, they have to endure the impact of high flow and high pressure for a long time. The body produces a protective response, causing the pulmonary blood vessels to contract and the pressure to increase in order to reduce the shunt from left to right. However, over time this will lead to pulmonary hypertension, which will eventually cause irreversible lesions. That is to say, even if the heart disease lesions are cured by surgery, the pulmonary artery pressure will still be high. Therefore, it is generally believed that if children with congenital heart disease undergo surgery within 2 years of age, pulmonary artery pressure can be restored after surgery. In addition, if the pulmonary artery pressure continues to rise and exceeds the systemic circulation pressure, blood will be shunted from right to left, the child will appear cyanotic, and the opportunity for surgery will be lost.

Infective endocarditis

It refers to inflammation of the heart's endothelium, valves or blood vessel endothelium, which often occurs in children with congenital or acquired heart disease. Based on congenital heart disease in children, the order of common diseases is: ventricular septal defect, patent ductus arteriosus, tetralogy of Fallot, and valvular disease. Among its inducing factors, bacteremia is the prerequisite for the onset of the disease, such as respiratory tract infection, urinary tract infection, tonsillitis, gingivitis, and its common pathogens are streptococci, staphylococci, pneumococci, Gram-negative bacilli, etc. Long-term impact of blood flow on the endocardium will cause it to become rough, causing platelets and fibrin to aggregate and form vegetation. Pathogenic bacteria in the blood will grow and multiply in the vegetation. Children may develop symptoms of sepsis, such as persistent high fever, chills, anemia, hepatosplenomegaly, heart failure, and sometimes embolism manifestations, such as skin hemorrhages and pulmonary embolism. If antibiotic treatment is ineffective, surgery is required to remove the vegetation, abscess, correct the intracardiac malformation or replace the diseased valve, which is very risky and has a high mortality rate.

Hypoxic Attack

Tetralogy of Fallot is a congenital complex cardiovascular malformation and the most common cyanotic congenital heart disease in children. Cyanosis is not obvious when the child is born, but gradually appears and worsens 3 to 6 months after birth. The child's shortness of breath worsens during feeding, crying, walking, and activities. About 20%-70% of the children have a history of hypoxia. The clinical manifestations are sudden onset, rapid and difficult breathing, significantly worsening cyanosis, fainting and convulsions in severe cases, and death from hypoxemia due to severe hypoxia. The duration of hypoxia attacks varies, and they usually resolve spontaneously, but they can occur frequently and pose a great threat to children.

Cerebral thrombosis and brain abscess

It is one of the most serious complications of tetralogy of Fallot. Due to long-term hypoxia and cyanosis in children with tetralogy of Fallot, their red blood cell count increases, hematocrit increases, blood viscosity increases, and blood flow slows down, creating conditions for the formation of blood clots in the cerebral blood vessels. Secondary infection may lead to infectious blood clots, or due to hypoxia of the brain tissue and softening of the brain tissue, bacterial infection may cause brain abscesses, which manifest as severe headaches, vomiting, impaired consciousness, hemiplegia, etc.