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Complications
By Mayo Clinic staffCongenital heart disease complications may not develop until years after initial treatment. Because the severity of congenital heart disease varies widely, the range of possible complications does, too. However, some common problems or complications that may develop in adulthood include:
- Abnormal heart rhythms (arrhythmias). Heart rhythm problems (arrhythmias) occur when the electrical impulses in your heart that coordinate your heartbeats don't function properly, causing your heart to beat too fast, too slow or irregularly. Heart rhythm problems are common in people who have congenital heart disease. This can be because your heart defect itself interferes with the normal electrical impulses, or because previous corrective surgery left scar tissue that can cause arrhythmias. In some people, these arrhythmias can become severe, even causing sudden cardiac death if not properly treated. The treatment of arrhythmias has improved in recent years, so it's important you seek appropriate follow-up care.
- Heart infections (endocarditis). The inside of your heart contains four chambers and four valves, which are lined by a thin membrane called the endocardium. Endocarditis is an infection of this inner lining. Some heart defects interrupt the smooth flow of blood in your heart, making it easier for bacteria to gather. Endocarditis typically occurs when bacteria or other germs from another part of your body, such as your mouth, enter your bloodstream and lodge in your heart. Left untreated, endocarditis can damage or destroy your heart valves or trigger a stroke. The consequences can be life-threatening. Your doctor may prescribe antibiotics to lower your risk of developing endocarditis.
- Stroke. Stroke occurs when the blood supply to a part of your brain is interrupted or severely reduced, depriving brain tissue of oxygen and nutrients. Within a few minutes, brain cells begin to die. Some congenital heart defects increase your risk of stroke due to an abnormal connection in the heart allowing a blood clot from a vein to pass through your heart and travel to your brain. Certain heart arrhythmias can also increase your chance of blood clot formation leading to a stroke.
- Heart failure. Heart failure, also known as congestive heart failure, means your heart can't pump enough blood to meet your body's needs. Some types of congenital heart disease can lead to heart failure. Over time, conditions, such as coronary artery disease or high blood pressure, gradually sap your heart of its strength, leaving it too weak or too stiff to fill and pump efficiently. Medications can improve the signs and symptoms of chronic heart failure and lead to improved survival. Lifestyle changes, such as exercising, reducing salt intake, managing stress, treating depression and especially losing excess weight, also can help prevent fluid buildup and improve your quality of life.
- Pulmonary hypertension. This is a type of high blood pressure that affects only the arteries in the lungs. Some congenital heart defects can cause more blood to flow to the lungs, increasing pressure. As the pressure builds, your heart's lower right chamber (right ventricle) must work harder to pump blood through your lungs, eventually causing the heart muscle to weaken and sometimes to fail completely. If this problem isn't caught early, permanent lung artery damage can occur.
- Heart valve problems. In some types of congenital heart disease, the heart valves are abnormal. Some heart defects may be minor early in life but cause problems in adulthood. In other cases a valve that has been repaired or replaced in childhood may require further surgery as an adult. Other types of surgical or catheter-based treatments performed in childhood also may require repeat procedures later in life.
References
- Williams RG, et al. Report of the National Heart, Lung, and Blood Institute Working Group on Research in Adult Congenital Heart Disease. Journal of the American College of Cardiology. 2006;47:701.
- Warnes CA. The adult with congenital heart disease: Born to be bad? Journal of the American College of Cardiology. 2005;46:1.
- Murphy DJ, et al. ACC/AHA/AAP recommendation: Task force 6: Training in transition of adolescent care and care of the adult with congenital heart disease. Journal of the American College of Cardiology. 2005;46:1399.
- Congenital Heart Defects. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/dci/Diseases/chd/chd_all.html. Accessed March 24, 2009.
- Walsh EP, et al. Arrhythmias in adult patients with congenital heart disease. Circulation. 2007;115:534.
- Thierren J, et al. Clinical update on adults with congenital heart disease. The Lancet. 2003;362:1305.
- Perloff JK, et al. Pregnancy in women with congenital heart disease: Specific lesions. http://www.uptodate.com/home/index.html. Accessed March 24, 2009.
- Grogan M. (expert opinion). Mayo Clinic, Rochester, Minn. April 10, 2009.
