Congenital Heart Disease

Congenital heart disease, the most common birth defect, is a heart defect that occurs during fetal development in the uterus. About one out of every 100 babies is born with a congenital heart defect, which can involve one or more heart structures or blood vessels around the heart.

In most cases, the cause of the defect is unknown, but research has suggested that congenital heart disease may be the result of a genetic abnormality or exposure of the developing fetus to certain medications, toxic substances, alcohol or drugs.

Congenital Heart Defects (ASD, VSD, PFO)

Some congenital cardiovascular defects let blood flow between the heart's right and left chambers. This happens when a baby is born with an opening between the wall (septum) that separates the right and left sides of the heart. This defect is sometimes called "a hole in the heart."

  • Atrial septal defect (ASD) — An opening exists between the heart's two upper chambers. This lets some blood from the left atrium (blood that's already been to the lungs) return via the hole to the right atrium instead of flowing through the left ventricle, out the aorta and to the body. Many children with ASD have few, if any, symptoms. Closing the atrial defect by open-heart surgery in childhood can prevent serious problems later in life.
  • Ventricular septal defect (VSD) — An opening exists between the heart's two lower chambers. Some blood that's returned from the lungs and been pumped into the left ventricle flows to the right ventricle through the hole instead of being pumped into the aorta. Because the heart has to pump extra blood and is overworked, it may enlarge.
  • Patent foramen ovale (PFO) — A hole in the wall that separates the two upper chambers of the heart known as the right atrium and left atrium. The hole can be located in various locations in the wall (the septum).

If the opening is small, it doesn't strain the heart. In that case, the only abnormal finding is a loud murmur. But if the opening is large, open-heart surgery is recommended to close the hole and prevent serious problems. Some babies with a large ventricular septal defect don't grow normally and may become undernourished. Babies with VSD may develop severe symptoms or high blood pressure in their lungs. Repairing a ventricular septal defect with surgery usually restores normal blood circulation. The long-term outlook is good, but long-term follow-up is required.

People with unrepaired ventricular septal defects are at risk for getting an infection of the heart's walls or valves (endocarditis). After a VSD has been successfully fixed with surgery, antibiotics should no longer be needed. If surgery or other procedures do not completely repair the VSD, the person is still at risk for developing endocarditis. Please read the section on “Endocarditis” to determine whether your child will need to take antibiotics before certain dental procedures.