No podemos cambiar la incidencia de las cardiopatías congénitas, pero sí podemos llegar a más niñas y niños que necesitan cuidados que les salven la vida.

How does the heart work?

The heart is a muscle whose function is to pump blood.

The right side of the heart is responsible for pumping blood without oxygen into the lungs, so that once it is there, we can breathe.

The oxygenated blood returns to the left side of the heart, so that it pumps it towards the aorta artery, which will finally take charge of taking and delivering the oxygenated blood to each of the organs of the body so that they can perform their various functions.

What is Congenital Heart Disease?

A heart disease is a medical term used to refer to any heart condition or disease. There are two types:

Congenital heart diseases are those that originate since the baby is in the womb, while acquired heart diseases are those that are acquired after birth. cardiopatías congénitas son aquellas que se originan desde que el bebé está en el vientre, mientras que las cardiopatías adquiridas son las que se adquieren después del nacimiento.

Signos de alerta

What are the signs that should indicate that my child has heart disease?

  • Le cuesta trabajo respirar o lo hace de manera rápida y agitada.
  • Struggles to eat, gets tired or pauses a lot during his feeding.
  • The skin, lips, tongue or nails have a bluish or purple tone.
  • Has a problem gaining weight.
  • Sweats a lot while eating or sleeping.
  • Gets tired very fast when exercising.

In case of any suspicion, go to a doctor so that he or she can make a proper assessment and give a diagnosis.

 

Detección de cardiopatías

Can they be detected before birth?

The vast majority of congenital heart diseases can be diagnosed prenatally, through a review and analysis of the record (Clinical History) and the realization of a fetal echocardiogram, performed by a pediatric cardiologist specialized in echocardiography. cardiopatías congénitas sí pueden diagnosticarse de manera prenatal, mediante una revisión y análisis de los antecedentes (Historia Clínica), además de con la ayuda de un ecocardiograma fetal, realizado por un cardiólogo pediatra con especialidad en ecocardiografía.

How can it be detected?

Una cardiopatía congénita se puede detectar con una revisión y análisis de los antecedentes (historia clínica), una exploración física detallada, así como a través de estudios de gabinete entre los que se encuentran:

  • Chest x-ray (Rx thorax)
  • Electrocardiogram (ECG)
  • Echocardiogram (Echo)
  • Computed tomography (CT)
  • Magnetic resonance (MR)
  • Angiography (Cardiac catheterization)
  • Tilt table test

 

What are the causes of congenital heart disease?

Aún no se sabe con exactitud cuáles son las razones por las que se presenta una cardiopatía congénita, sin embargo, existen algunos factores de riesgo entre los que destacan algunas enfermedades maternas previas al embarazo, ciertas infecciones durante el periodo de gestación, familiares con cardiopatías congénitas, exposición de los padres a contaminantes, etc.

Treatment

What is the treatment that should be given to a patient with congenital heart disease?

El tratamiento para el defecto cardíaco de tu hija o hijo dependerá de la causa del problema. La mayoría de los defectos cardíacos se resuelven solos con el tiempo, y algunos pueden solucionarse con medicamentos. A veces, se puede necesitar cirugía u otros procedimientos, como el cateterismo cardiaco. En algunos casos, la o el paciente puede necesitar una combinación de tratamientos.

Medicamentos:

Para algunos problemas cardíacos, las niñas y los niños pueden tomar medicamentos que se pueden suspender una vez que el problema ha mejorado. A veces, los medicamentos deben tomarse durante muchos años, o incluso durante toda la vida del paciente.

Cirugía:

Cardiac surgery can provide a lifelong cure for some heart conditions. A heart surgeon will discuss the risks and benefits with you in detail. Sometimes surgery may be delayed until your child is older and stronger, which means they can tolerate surgery better. Depending on the condition of your child, multiple operations may be necessary.

In very rare cases where surgery, procedures or medications do not help, a child may need a heart transplant.

Cateterismo:

Algunos procedimientos implican colocar un tubo delgado, llamado catéter, a través de las venas hasta el corazón para tratar el defecto cardíaco. A tu hija o hijo se le administra anestesia general para este procedimiento.

¿Cómo debe ser el seguimiento de un niño o niña con cardiopatía congénita?

Las niñas y niños con cardiopatías congénitas deben de ser evaluados por especialistas en cardiología pediátrica. Ellos diagnostican los problemas cardíacos y pueden ayudar en el manejo antes y después de reparar el problema cardiaco. Las y los especialistas que corrigen el problema en la sala de operaciones son los cirujanos cardiovasculares o cardiotorácicos.

 

What are the types of heart diseases?

Heart diseases can be classified in different ways, but mainly in:

Defects that cause a lot of flow to the lung:
Patent Ductus Arteriosus (PDA)

Crédito de imagen: Stanford Children’s Health.

Prior to birth there is a vessel, called ductus arteriosus, which connects the aorta with the pulmonary artery. This structure closes almost immediately at birth. The opening between the aorta and the pulmonary artery allows oxygen-rich blood to recirculate into the lungs. Although exact reasons why this happens in some patients and not in others are not known, the most common association for a PDA is prematurity, but it can happen to any child.

Atrial Septal Defect (ASD) 

Crédito de imagen: Stanford Children’s Health.

An atrial septal defect is an opening in the the dividing wall between the two upper chambers of the heart . This extra blood passes through the pulmonary artery into the lungs, causing higher amounts of blood flow than normal in the vessels in the lungs and congest them.

Ventricular Septal Defect (VSD)

Crédito de imagen: Stanford Children’s Health.

A ventricular septal defect is an opening in the dividing wall (septum) between the two lower chambers of the heart known as the right and left ventricles. It allows oxygen-rich blood to pass from the left ventricle, through the opening in the septum, and then mix with oxygen-poor blood in the right ventricle and causes the lungs to receive more blood than normal.

Atrioventricular Canal (AV Canal or AVC)

Crédito de imagen: Stanford Children’s Health.

It is a complex malformation that involves various structures of the heart, including the septum that separates the upper chambers, the septum that separates the lower chambers, and the valves that separate the upper chamber from the lower chamber. These alterations in the structure of the heart cause problems in blood flow from the left side to the right side, congestion of the lungs and malfunction of the heart valves involved.

Defects that cause very little flow to the lung:

They are a group of malformations characterized by anatomical alterations that reduce, in some way, the blood flow that reaches the lungs. These alterations are usually due to a failure in the development of the structure of the right chambers of the heart or of the pulmonary artery, and generally cause a lack of blood oxygenation in the patients' body that manifests as blue coloration of the tissues, including the skin, called cyanosis.

Tricuspid Atresia (TA)

Crédito de imagen: Stanford Children’s Health.

The tricuspid valve does not form at all, and instead a plate of tissue is present in its place. This plate of tissue prevents oxygen-poor blood from passing from the right atrium to the right ventricle and on to the lungs as it should.

Transposition of the Great Arteries (TGA)

Crédito de imagen: Stanford Children’s Health.

In transposition of the great arteries, the aorta is connected to the right ventricle, and the pulmonary artery is connected to the left ventricle — the opposite of a normal heart's anatomy. Oxygen-poor blood returns to the right atrium from the body, passes through the right atrium and ventricle, then goes into the misconnected aorta back to the body. Oxygen-rich blood returns to the left atrium from the lungs, passes through the left atrium and ventricle, then goes into the pulmonary artery and back to the lungs.

Tetralogy of Fallot

Crédito de imagen: Stanford Children’s Health.

"Tetralogy" refers to 4 heart problems:

  • Ventricular septal defect (VSD). An opening in the ventricular septum, or dividing wall between the two lower chambers of the heart known as the right and left ventricles.
  • Pulmonary (or right ventricular outflow tract) obstruction. A muscular obstruction in the right ventricle, just below the pulmonary valve, that decreases the normal flow of blood. The pulmonary valve may also be small.
  • Overriding aorta . The aorta is shifted towards the right side of the heart so that it sits over the ventricular septal defect.
  • The fourth problem is that the right ventricle becomes thickened as it tries to pump blood past the obstruction into the pulmonary artery.

Truncus Arteriosus

Crédito de imagen: Stanford Children’s Health.

The aorta and pulmonary artery start as a single blood vessel, which eventually divides and becomes two separate arteries. Truncus arteriosus occurs when the single great vessel fails to separate completely, leaving a connection between the aorta and pulmonary artery.

Pulmonary Stenosis

Crédito de imagen: Stanford Children’s Health.

The pulmonary valve is found between the right ventricle and the pulmonary artery. With pulmonary stenosis, problems with the pulmonary valve make it harder for the leaflets to open and permit normal blood flow from the right ventricle to the lungs in a normal fashion.

Pulmonary Atresia (PA)

Crédito de imagen: Stanford Children’s Health.

Pulmonary atresia means that there is an abnormal development of the pulmonary valve. With pulmonary atresia, problems with the valve prevent the leaflets from opening; therefore, blood cannot flow forward from the right ventricle to the lungs.

Defects that cause little flow through the body

Coarctation of the Aorta 

Crédito de imagen: Stanford Children’s Health.

The aorta is the large artery that carries oxygen-rich blood from the left ventricle to the body. It is shaped like a candy cane. The first section moves up towards the head and arms, then curves in a C-shape as smaller arteries that are attached to it carry blood to the head and arms. After the curve, the aorta becomes straight again, and moves downward towards the abdomen, carrying blood to the lower part of the body.

The narrowed segment called coarctation can occur anywhere in the aorta, but is most likely to happen in the segment just after the aortic arch. This narrowing restricts the amount of oxygen-rich (red) blood that can travel to the lower part of the body. Varying degrees of narrowing can occur.

Aortic Stenosis

Crédito de imagen: Stanford Children’s Health.

The aortic valve is found between the left ventricle and the aorta. With aortic stenosis, problems with the aortic valve make it harder for the leaflets to open and permit blood to flow forward from the left ventricle to the aorta.

Hypoplastic Left Heart Syndrome

Crédito de imagen: Stanford Children’s Health.

Hypoplastic left heart syndrome (HLHS) is a combination of several abnormalities of the heart and great blood vessels. In hypoplastic left heart syndrome, most of the structures on the left side of the heart are small and underdeveloped. The degree of underdevelopment differs from child to child. Perhaps the most critical defect in HLHS is the small, underdeveloped left ventricle. This chamber is normally very strong and muscular so it can pump blood to the body. When the chamber is small and poorly developed, it will not function effectively and can't provide enough blood flow to meet the body's needs.

Can they be cured?

Many heart diseases are cured with surgical procedures or by catheterization. Others, although they are not cured, can, with these same types of procedures, be improved and allow patients to carry out their activities with greater or lesser degree of physical limitations. Cardiological follow-up is always fundamental to allow patients to obtain the greatest benefit from their treatments.

"The doctors were always willing to address our concerns, despite the tough times, we never felt alone"

- Kardias parent
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