Congenital Heart Defects - Treatment Overview

Treatment Overview

Your child's treatment for a congenital heart defect will be based on the type of problem he or she has. Your child's age, size, and general health also are important.

Treatment helps most children to live fairly normal lives. Your child may need:

• Medicines to help with symptoms. Some medicines can control a heartbeat that is not regular. Others make the heart stronger until a defect can be fixed. Your child may need some medicines after surgery.
• Heart catheterization to find out details about the heart defect or sometimes to repair the defect. With heart catheterization, a doctor threads a thin, flexible tube called a catheter through a blood vessel—typically in the groin—and into the heart. This lets the doctor see how blood is flowing through the heart and heart arteries.
• Surgery to repair the structural defect. If a young baby (for example, newborn to 3 months old) has a life-threatening defect, surgery may be needed right away. For some defects, the best time for surgery is before the child is 2 years old. For other defects, the best time may be between the ages of 2 and 4. In some cases, surgery may be done when a child is older. Surgery may be delayed if the defect is likely to heal on its own.

Initial treatment

If your child has a mild heart defect, a doctor may want to see if the defect gets better on its own. Your child may need some medicines during this time to help his or her heart work better. For example, a medicine called a prostaglandin inhibitor can be given to a premature baby to help close a patent ductus arteriosus.

Heart catheterization may be done to partially or completely repair a defect. More severe defects require surgery.

If a newborn needs surgery, the surgery may be delayed until the baby is stronger. If the defect threatens the baby's life, surgery will be done right away.

Medicines may be given in a vein for severe defects such as coarctation of the aorta, transposition of the great vessels, or tetralogy of Fallot.

Medicine, heart catheterization, or surgery may also be used as initial treatment for a mild congenital heart defect that is not noticed until later in childhood, adolescence, or early adulthood.

Ongoing treatment

If your child needs surgery, your doctor may want to wait until your child is about 2 to 4 years old. Meanwhile, caring for your child who has a heart problem can be hard. You may need to keep track of many medicines and make frequent trips to the doctor. Costs can be overwhelming. And you may feel guilty, as if something you did caused the child to have a heart defect. The defect is not your fault. Try to find support groups and other parents who can help you with the many emotions involved.

Until your child can have surgery, you may need to focus on:

• Making sure your child has enough nutrients.
• Giving medicines.
• Taking special precautions if your child has problems getting enough oxygen.

Some congenital heart defects can be completely repaired with one surgery. More complex defects often require several surgeries over the years. Knowing what to expect in the hospital can help you plan ahead. For example, you can consider what kinds of items to bring and how you will want to record instructions from the health professionals in the hospital.

If your child is older, talking to him or her about what to expect may be helpful.

With most congenital heart defects, your child's heart will not be completely normal even after surgery. Medicines and trips to the cardiologist may be needed throughout life.

It can be difficult to accept that your child has a heart defect, and it is normal to worry about his or her future. Make sure you take time to adjust to these challenges.

Adults who have congenital heart defects also need regular checkups. You also may need to be careful when you exercise or avoid exercise altogether.

Treatment if the condition gets worse

If your child has a severe congenital heart defect or develops complications, more treatment is needed.

Medicines often are used for young children with large defects who have heart failure. Complex cyanotic heart defects usually require medicines more often than acyanotic heart defects.

At this stage, medicines are used to help the heart work better:

• In a child with heart failure, medicines called diuretics can reduce the amount of extra fluid in the body. Cardiac glycosides may be used to increase the strength of the heartbeats. Vasodilators can enlarge blood vessels. All of these medicines make it easier for the heart to pump blood.
• Antiarrhythmics may be used to control irregular heartbeats.
• Prostaglandins and prostaglandin inhibitors may be used to improve blood flow to the lungs or the body.

Additional heart catheterization procedures or surgeries are sometimes needed to further correct—either fully or partially—the defect.

What to think about

Some people die from severe congenital heart defects or related complications, such as heart failure.

If your baby is born with a severe heart defect, be assured that there is a good chance that he or she will survive with treatment. But you must also prepare for the possibility that your child may die. Talk with your doctor about local resources and organizations that can help you manage the many emotional and practical struggles when faced with this possibility. It may help to talk with other parents who have had children with congenital heart disease. For more information on these resources, see the Other Places to Get Help section of this topic.