Overview

Acyanotic heart disease is a cardiac defect that disrupts normal blood flow. A hole in the heart wall is one example. The issue is present at birth but does not always generate symptoms or consequences. Occasionally, the condition resolves itself during childhood. However, some patients require treatment, which may include surgery.

Some kids born with congenital heart disease will need surgery right away, while many others will most likely need surgery or treatment at some time throughout their childhood.

 

Anatomy of the Pediatric Heart

The anatomy of the pediatric heart is similar to that of the adult heart, but there are some important differences. The main structures of the heart include the atria, which are the upper chambers of the heart, and the ventricles, which are the lower chambers. The right atrium receives deoxygenated blood from the body and pumps it into the right ventricle, which then pumps it to the lungs to be oxygenated. The left atrium receives oxygenated blood from the lungs and pumps it into the left ventricle, which then pumps it to the rest of the body.

In the pediatric heart, the atrial septum and ventricular septum are not yet fully formed, so blood can flow between the atria and ventricles through the foramen ovale and ductus arteriosus. These structures normally close after birth, but if they do not, it can lead to a congenital heart defect such as an atrial septal defect (ASD) or patent ductus arteriosus (PDA).

Additionally, the pediatric heart is smaller in size, and the pulmonary and aortic valves are also smaller than the adult ones. In addition to this, the walls of the pediatric heart are thinner and less muscular than in adults.

It's also important to note that the pediatric heart anatomy can be affected by congenital heart disease, which is a heart condition present at birth. These conditions can cause structural abnormalities or defects in the heart, which can affect how blood flows through the heart and to the rest of the body.

 

What is Heart Function?

The heart is a muscular organ that pumps blood throughout the body. It has four chambers: the right atrium, the left atrium, the right ventricle, and the left ventricle. The right atrium receives deoxygenated blood from the body and pumps it into the right ventricle. The right ventricle then pumps the blood into the lungs, where it is oxygenated. The oxygenated blood then returns to the left atrium, which pumps it into the left ventricle. The left ventricle then pumps the oxygenated blood to the rest of the body through the aorta, the body's main artery.

The heart is also responsible for maintaining blood pressure and flow, by contracting and relaxing its chambers, it generates the pressure needed to circulate the blood through the body. This process is known as the cardiovascular system and is vital for the body's metabolism and the delivery of oxygen and nutrients to the body's cells.

Additionally, the heart plays a key role in the body's immune system by providing an immune barrier that prevents pathogens and foreign particles from entering the circulatory system.

Overall, the heart's main function is to pump blood throughout the body, providing oxygen and nutrients to the body's cells and removing waste products, allowing the body to function properly.

 

Types of Congenital Heart Diseases

Cyanotic heart disease and acyanotic heart disease are two types of congenital heart defects that are characterized by the presence or absence of cyanosis.

Cyanotic heart disease is a type of congenital heart defect that causes a lack of oxygen in the body, resulting in a bluish tint to the skin, lips, and nails, known as cyanosis. Examples of cyanotic heart defects include tetralogy of Fallot, transposition of the great vessels, and total anomalous pulmonary venous return.

Acyanotic heart disease, on the other hand, is a type of congenital heart defect that does not cause cyanosis. These defects typically involve a structural problem with the heart or blood vessels that disrupts blood flow but does not reduce oxygen levels in the body. Examples of acyanotic heart defects include atrial septal defect, ventricular septal defect, and patent ductus arteriosus.

It is important to note that some defects can be classified as both cyanotic and acyanotic depending on their severity and the stage of the disease. Also, some defects may present with cyanosis at an early stage but may not present with cyanosis later on.

 

What is Acyanotic Heart Disease?

Acyanotic heart disease refers to a group of congenital heart defects that do not cause cyanosis, or a bluish discoloration of the skin and mucous membranes due to low oxygen levels in the blood. Examples of acyanotic heart defects include atrial septal defect (ASD), ventricular septal defect (VSD), and patent ductus arteriosus (PDA). 

These defects can cause blood to flow in abnormal patterns, leading to increased blood flow to the lungs or decreased blood flow to the body. Some acyanotic heart defects may not cause any symptoms, while others can lead to heart failure or other complications.

 

How Common is Acyanotic Heart Disease?

Acyanotic heart disease is relatively common, accounting for about 40-50% of all congenital heart defects. Some of the most common acyanotic heart defects include atrial septal defect (ASD), ventricular septal defect (VSD), and patent ductus arteriosus (PDA).

Atrial septal defect (ASD) is one of the most common congenital heart defects, affecting about 1 in every 1,500 to 2,000 live births.

Ventricular septal defect (VSD) is also a common congenital heart defect, occurring in about 1 in every 125 to 250 live births.

Patent ductus arteriosus (PDA) is also one of the more common congenital heart defects, occurring in about 1% to 2% of all live births.

It is important to note that the exact prevalence of acyanotic heart disease can vary depending on the population and the methods used to detect these defects.

 

What are the Types of Acyanotic Heart Disease?

There are several kinds of acyanotic congenital heart defects:

1. Aortic stenosis: The aorta is the primary artery that connects your heart to the rest of your body. The aortic valve connects the heart to the aorta. It opens and shuts with each cardiac cycle to let blood to exit the heart while preventing blood from seeping back in. Aortic stenosis occurs when the aortic valve narrows and fails to open properly.
2. Atrial septal defect (ASD): An atrial septal defect (ASD) is a hole in the wall that divides the heart's two upper chambers, known as the atria. The majority of ASDs do not close on their own. Small ASDs are frequently left alone, while bigger ASDs may need a treatment or heart surgery to close.
3. Atrioventricular septal defect: An atrioventricular septal defect is a hole in the wall that divides the upper and lower chambers of the heart. The majority of patients who have an atrioventricular septal defect also have abnormalities in some of their heart valves (the mitral and tricuspid valves). Previously, the defect was known as an atrioventricular canal defect or an endocardial cushion defect.
4. Bicuspid aortic valve: An aortic valve is a one-way valve that connects the heart to the aorta. The valve generally has three flaps that open and shut to control blood flow. A bicuspid aortic valve has just two flaps, which can cause the valve to malfunction.
5. Aortic coarctation: It occurs when the aorta is constricted or restricted, reducing blood flow.
6. Arteriosus ductus patent: For oxygen, a baby's blood does not need to pass through its lungs. Instead, your kid gets oxygen from you. The ductus arteriosus is a tiny blood artery that permits blood to bypass the lungs in a fetus. The hole does not seal properly in patients with patent ductus arteriosus (PDA). Extra blood is pushed from the aorta to the pulmonary arteries in the lungs. PDA occurs more frequently in premature newborns.
7. Pulmonary stenosis: The pulmonary artery transports oxygen-depleted blood from the right side of the heart to the lungs, where it is oxygenated. The pulmonary valve is located between the heart's right side and the pulmonary artery. Pulmonary stenosis occurs when the pulmonary valve narrows and does not open fully.
8. A ventricular septal defect (VSD): It is similar to an atrial septal defect in that it is a hole in the wall that divides the heart's two lower chambers (the ventricles). The most common congenital cardiac abnormality is VSD. Many of these holes can seal on their own, while others may necessitate a treatment or surgery to do so.

 

Symptoms of Acyanotic Heart Disease

The symptoms of acyanotic heart disease can vary depending on the specific type of defect and its severity. Some common symptoms of acyanotic heart disease include:

1. Fatigue - due to the heart's inability to pump enough blood to meet the body's needs.
2. Shortness of breath - particularly during physical activity.
3. Rapid breathing - due to increased effort to breathe.
4. Chest pain - due to increased pressure in the heart or blood vessels.
5. Swelling in the legs, ankles, and feet - due to fluid accumulation caused by heart failure.
6. Rapid heartbeat - due to increased pressure in the heart or blood vessels.
7. Pale or blue skin, lips, or nails - due to decreased oxygen levels in the body.
8. Heart murmur - a whooshing or swishing sound heard through a stethoscope, caused by turbulent blood flow through a narrowed or leaky valve.

Some defects, such as coarctation of the aorta, may not show symptoms until later in life and the symptoms can vary widely depending on the stage of the disease and the severity of the defects. It is important to note that some acyanotic heart defects can be asymptomatic, and may only be discovered during a routine physical examination.

 

What causes Acyanotic Heart Disease?

Acyanotic heart disease is caused by congenital heart defects, which means that the heart develops abnormally during pregnancy. The exact cause of these defects is not always known, but there are several factors that may increase the risk of acyanotic heart disease, including:

• Genetic factors: Certain genetic conditions or mutations in certain genes can increase the risk of congenital heart defects, such as Down syndrome, Turner syndrome, and Marfan syndrome.
• Environmental factors: Certain environmental factors, such as exposure to certain chemicals or drugs during pregnancy, may also increase the risk of congenital heart defects.
• Infections: Certain infections during pregnancy, such as rubella (German measles), cytomegalovirus (CMV), and toxoplasmosis, may increase the risk of congenital heart defects.
• Lifestyle factors: Some lifestyle factors such as smoking, alcohol use, and poor nutrition during pregnancy may also increase the risk of congenital heart defects.

It's important to note that in many cases, acyanotic heart disease is not caused by a single factor, and it is likely that a combination of genetic and environmental factors play a role in their development.

 

Acyanotic Heart Diseases Diagnosis

Some congenital heart disease infants seek medical intervention straight away. This is especially true for newborns with cyanotic illness, who may have more evident symptoms.

In this situation, clinicians begin assembling signals from the medical history, physical exam, laboratory testing, and imaging studies to form a diagnosis. Medical practitioners utilize this procedure to rule out other probable reasons, such as lung illness, infection, or some uncommon genetic abnormalities.

Some newborns with congenital cardiac disease, however, may not exhibit any symptoms immediately away. When a baby is admitted to the hospital in the United States, most states check for congenital heart disease. A pulse oximeter, which detects the quantity of oxygen in the blood, is widely used for this. This test aids in the identification of newborns who may have curable congenital cardiac disease. 

If a practitioner detects a problem based on symptoms or a screening test, more medical workup is required. An electrocardiogram (ECG) can aid in the detection of some cardiac abnormalities, such as heart rhythm issues caused by congenital heart disease.

Imaging tests are critical if problems are suspected. Early imaging tests might include chest X-ray and echocardiogram. Additional, more detailed imaging tests may be needed if a problem is found. Some possibilities are:

• Cardiac catheterization and angiography
• Magnetic resonance imaging (MRI)
• Computerized tomography (CT)

It’s especially important that infants with critical heart defects be diagnosed quickly, because early diagnosis may decrease the risk of death and complications.

 

How is Congenital Heart Disease Treated?

The kind and severity of a congenital cardiac abnormality determine the therapy. Some newborns are born with minor cardiac abnormalities that mend on their own over time. Others may have serious flaws that need considerable therapy. Treatment in these instances may involve the following:

 

Medications

Several drugs can help the heart perform more efficiently. Some can also be used to prevent blood clots or to regulate an irregular pulse.

 

Implantable Cardiovascular Devices

Certain devices, such as pacemakers and implanted cardioverter defibrillators, can help prevent some of the consequences associated with congenital cardiac abnormalities (ICDs). A pacemaker can assist regulate an erratic heart rhythm, while an ICD can rectify potentially fatal irregular heartbeats.

 

Catheter insertion Procedures

Catheterization procedures enable surgeons to correct some congenital heart abnormalities without having to open the chest and heart surgery. The doctor will place a tiny tube into a vein in the leg and guide it up to the heart during these operations. Once the catheter is in the proper location, the doctor will fix the problem with tiny instruments threaded through the catheter.

 

Open-Heart Surgery

If catheter techniques are insufficient to correct a congenital heart abnormality, this form of surgery may be required. An open-heart surgery may be performed by a surgeon to fix holes in the heart, repair heart valves, or enlarge blood arteries.

 

Heart Transplant

In the rare cases in which a congenital heart defect is too complex to fix, a heart transplant may be needed. During this procedure, the child’s heart is replaced with a healthy heart from a donor.

 

How Do You take care of your child with an Acyanotic Heart Defect?

A person with an acyanotic heart defect should have regular checkups with an adult congenital cardiologist. That’s a physician who specializes in adults who were born with heart conditions. An adult congenital cardiologist can help you:

• Determine what level of physical activity is safe.
• Eat a heart-healthy diet.
• Monitor your heart’s condition over time as you age.
• Take medications that will lessen the strain on the heart, such as drugs to lower blood pressure.
• Weigh the decision to become pregnant, which can put stress on the heart.
• Help decide when a procedure or surgery might be necessary to treat your heart condition.

 

Conclusion

Acyanotic heart illness occurs when the blood has enough oxygen yet is circulated around the body improperly.

Babies born with acyanotic heart disease may not show any signs at birth, but the illness can create health concerns over time.

Blood pressure can rise significantly in this set of disorders, placing the heart under extra strain as it works harder. This can weaken the heart and raise the chance of developing heart failure, a condition in which the muscle is unable to adequately pump blood throughout the body.

Furthermore, the blood pressure in the lungs is frequently excessively high. This is known as pulmonary hypertension, and it can harm the lungs and produce symptoms such as shortness of breath, exhaustion, dizziness, and fainting.

The prognosis for congenital heart disease varies based on the degree and kind of heart abnormality.

Because of research into the causes and improved therapies, 80% of children with congenital heart disease will live into adulthood.