New Parent? How You Can Recognize a Congenital Heart Defect

Know these warning signs and seek evaluation when necessary

New Parent? How You Can Recognize a Congenital Heart Defect

Congenital heart defects are the most common type of birth defect in the United States, affecting nearly one in 100 births every year. Most heart defects are caught during pregnancy, but some are not.

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It’s important for parents to know the warning signs of heart defects that may appear in their baby’s first months of life, says pediatric cardiothoracic surgeon Hani Najm, MD.

Knowing these symptoms can help parents bring them to the attention of their child’s doctor for further evaluation, Dr. Najm says.

“Congenital heart defects come in many forms and shapes and they need to be diagnosed by an experienced physician,” he says. “While these symptoms may trigger the initiation of an evaluation, a routine exam by an experienced pediatrician will reveal the diagnosis.”

‘Blue baby’ syndrome

One serious warning sign is the so-called “blue baby syndrome.” This is when the baby’s skin has a bluish discoloration, especially when he or she cries. The discoloration is most apparent in the lips and hands.

The medical name for this condition is cyanosis, and it is due to mixing of oxygenated and un-oxygenated blood in the heart, which results in decreased oxygen saturation in the blood.

“This is not normal,” Dr. Najm says. “Babies should not turn blue when they cry. So if they do, that is an indicator of the oxygen de-saturation in the blood.”

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Babies born with cyanotic heart defects, which are structural defects of the heart, have this mix of blue and red blood. This may be because their blood bypasses the lungs or a mixture of oxygenated and unoxygenated blood is circulating through their bodies.

Generally, cyanotic heart defects are more life-threatening than acyanotic heart defects, which are more common and often involve defects in the wall that separates the heart’s chambers. With acyanotic heart defects, the blood often retains normal levels of oxygen saturation but the heart has to work harder to accommodate the over circulation.

Failure to thrive

Another important warning sign that parents need to know about is what doctors call failure to thrive, Dr. Najm says.

“When babies thrive, that means that they are putting on weight and are feeding well,” Dr. Najm says. “Failure to thrive is one of the most common symptoms of babies with acyanotic heart disease.”

Babies who fail to thrive usually have a hole between the heart’s lower chambers, which pumps the blood. As a result, the heart has to work three to four times as hard to pump blood, Dr. Najm says. Babies with this defect get short of breath when they feed, so they eat less and do not gain the proper amount of weight.

Advancements = better outcomes

Advances in surgical techniques and technology have made it possible for doctors to have very high success rates with surgeries for congenital heart defects, Dr. Najm says.

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What was once a devastating diagnosis now no longer needs to be, he says. The vast majority of children who have heart defects corrected will go on to live a normal and healthy life.

“Survival is no longer our measure of success,” Dr. Najm says. “Our measure of success is when I see a child on whom I’ve operated 10 or 15 years ago who is having a normal, active life, is not short of breath and did not need reoperations. That’s a true success of congenital heart surgery.” 

Dr. Najm said it’s important for every expectant mother to have a fetal echocardiogram during pregnancy to check for potential heart defects.

If a defect is found, it’s important that parents find a medical center that is equipped to give their baby the right surgery, executed well, in order to give their child the best chance possible of living a normal, healthy life, he says.

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