Congenital heart disease in children

Congenital heart disease (CHD) also known as congenital heart defects as the conditions are often described, affects 1% of live births each year, equivalent to up to 9 in every 1000 babies born in the UK (Knowles and Hunter, 2014). CHD is frequently missed during prenatal screening which may impact on morbidity and mortality (Nisselrooj et al, 2020). Sometimes evidence of poor circulation is apparent during the newborn examination or later in the first few months of life. This includes mottling of the skin, blueish tinge around the lips, clubbing of the fingers and poor weight gain (Hinton and Ware, 2017).

Children who are diagnosed with a congenital heart defect may require several surgical procedures, numerous hospital admissions and many years of medication. However, some families may have little need for medical or nursing input. Many children with CHD will live with complications related to their condition, including learning difficulties

Transplant and ventricular assist devices

Surgery to repair the defect is not always successful or an option for some children, and a heart transplant may be the preferred treatment. While awaiting transplant, children can be in hospital or at home depending on how well they are. Sometimes children may need to be on a device to support their heart called a ventricular assist device (VAD) such as a Berlin Heart or Heart Wave (Children's Heart Federation, 2020). These devices are used when the patient's heart becomes too weak to pump itself. They can be inserted into one side of the heart (usually the left ventricle, an LVAD) or both (BIVAD). The device consists of one or more chambers that sit outside the heart and blood is pumped by a driving unit, which is attached to the child (Great Ormond Street Hospital, 2020).

Clinical considerations

• Early detection in the foetal or

References

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