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Causes
By Mayo Clinic staff
Hypoplastic left heart syndrome occurs during fetal growth when the baby's heart is developing. The cause is unknown. However, if your family has one child with hypoplastic left heart syndrome, the risk of having another with the same condition is increased.
A normal heart has four chambers, two on the right and two on the left. In performing its basic job — pumping blood throughout the body — the heart uses its left and right sides for different tasks. The right side moves blood to the lungs. In the lungs, oxygen enriches the blood, which then circulates to the heart's left side. The left side of the heart pumps blood into a large vessel called the aorta, which circulates the oxygen-rich blood to the rest of the body.
What happens in hypoplastic left heart syndrome
In hypoplastic left heart syndrome, the left side of the heart can't properly supply blood to the body because the lower left chamber (left ventricle) is too small or in some cases it may not even exist. In addition, the valves on the left side of the heart (aortic valve and mitral valve) don't work properly, and the main artery leaving the heart (aorta) is smaller than normal.
For the first several days of life, the right side of the heart can pump blood both to the lungs and to the rest of the body through a natural opening (foramen ovale) between the upper chambers of the heart (atria) or through a blood vessel that connects the pulmonary artery directly to the aorta (ductus arteriosus). When the foramen ovale and the ductus arteriosus are open, they are referred to as being "patent."
If the ductus arteriosus and the foramen ovale close — which they normally do after the first day or two of life — the right side of the heart has no way to pump blood out to the body. However, many infants with hypoplastic left heart syndrome also have another heart defect, a hole in the wall between the upper chambers of the heart (atrial septal defect), that allows the right side of the heart to continue pumping blood to the body even if the ductus arteriosus or foramen ovale closes.
- Marshall A. Hypoplastic left heart syndrome. http://www.uptodate.com/index. Accessed June 27, 2012.
- Facts about hypoplastic left heart syndrome. Centers for Disease Control and Prevention. http://www.cdc.gov/ncbddd/heartdefects/HLHS.html. Accessed July 24, 2012.
- Brenner JI, et al. Hypoplastic left heart syndrome and other left heart disease: Evolution of understanding from population-based analysis to molecular biology and back again — A brief overview. Cardiology in the Young. 2011;21:23.
- Grossfield P, et al. Hypoplastic left heart syndrome: New genetic insights. Journal of the American College of Cardiology. 2009;53:1072.
- Murtuza B, et al. Changing attitudes to the management of hypoplastic left heart syndrome: A European perspective. Cardiology in the Young. 2011;21:148.
- Said SM, et al. Longer-term issues for young adults with hypoplastic left heart syndrome: Contraception, pregnancy, transition, transfer, counselling, and re-operation. Cardiology in the Young. 2011;21: 93.
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- Waltzman M. Initial evaluation of shock in children. http://www.uptodate.com/index. Accessed June 27, 2012.
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