Congenital Heart Defects

When your baby's born with a heart malformation
Eight out of 1,000 babies are born with structural flaws in their hearts — congenital heart defects. Surgery can correct all but the most severe. Knowing what to expect can help you cope.

If your infant or child has been diagnosed with a congenital heart defect, it means he or she was born with a problem in the heart's formation. You're likely to be anxious and worried about your child's immediate and long-term future. Knowing how the heart develops can help you understand your child's condition and what to expect in the coming months.

Some defects are as simple as a small hole between heart chambers that closes on its own. Others are a complex misconfiguration of blood vessels that require phased surgery over time.

How the heart works

The heart is divided into four hollow 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 of the heart moves blood to the lungs through vessels called pulmonary arteries. In the lungs, blood picks up oxygen then returns to the heart's left side through the pulmonary veins. The left side of the heart then pumps the blood through the aorta and out to the body.

How heart defects develop

A baby's heart starts beating just 22 days after conception. At that point, the heart has a simple tube shape. Between days 22 and 24, the heart begins to bend to the right and fold in on itself to form a loop. By 28 days after conception, the tube has a vaguely heart-like shape with structures corresponding to the heart's two sides and the large blood vessels that carry blood in and out of them.
You may not even realize you are pregnant when these important changes are occurring. But if there are errors in the genetic messages that direct the growth and movement of early heart cells, part of the heart muscle may fail to develop. If the process of bending and looping doesn't go exactly the way it's supposed to, the heart may form abnormal connections to the large vessels leading to and from the lungs.

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