Congenital heart disease (CHD) refers to structural problems of the heart that are present at birth. While many of these issues are diagnosed and treated in infancy or childhood, some remain undetected until adulthood. In India, where cardiovascular diseases are rising, understanding CHD in adults has become crucial.

This blog will cover the causes, symptoms and implications of congenital heart disease in adults. You can connect with Neotia Getwel Multispecialty Hospital for the best medical assistance and 24/7 emergency care.

Understanding Congenital Heart Disease

Congenital heart disease refers to a range of heart defects caused by abnormal development of the heart or blood vessels in the womb. These defects can affect the heart's structure, its walls, valves, arteries, or veins, disrupting normal blood flow. CHD can be classified into several types, including:

1. Atrial Septal Defect (ASD): A hole in the wall (septum) separating the heart's upper chambers (atria).

2. Ventricular Septal Defect (VSD): A hole in the septum between the lower chambers (ventricles).

3. Tetralogy of Fallot: A combination of four heart defects that affect blood flow.

4. Patent Ductus Arteriosus (PDA): A persistent opening between two major blood vessels leading from the heart.

5. Transposition of the Great Arteries (TGA): A condition where the two main arteries leaving the heart are switched in position.

These conditions may cause symptoms that vary in severity, from mild to life-threatening, depending on the defect and whether it was treated during childhood.

Causes of Congenital Heart Disease in Adults

The exact cause of congenital heart disease often remains unknown. However, several factors increase the likelihood of CHD, including genetic, environmental and lifestyle influences. For the Indian context, these factors are particularly relevant:

1. Genetic Factors:

• Inherited gene mutations can play a significant role in CHD. If one or both parents have a congenital heart defect, the risk of passing it to their offspring increases.
• Chromosomal abnormalities, such as Down syndrome, are associated with a higher risk of CHD. In India, awareness of these genetic risks has been rising, leading to more prenatal screenings.

2. Maternal Health Conditions:

• Poor maternal health during pregnancy can contribute to congenital heart disease. Diabetes, untreated infections (like rubella) and exposure to certain medications or alcohol during pregnancy are known risk factors.
• In India, rural areas often lack proper prenatal care, increasing the chances of undiagnosed maternal health conditions affecting fetal development.

3. Environmental Factors:

• Exposure to environmental pollutants, especially in highly industrialized or polluted areas, may increase the risk of CHD. Urban centers in India like Delhi and Mumbai face heavy air pollution, which may be linked to higher incidences of congenital anomalies.
• Rural areas with limited access to clean water or healthcare may also see higher rates of CHD due to malnutrition or exposure to harmful substances.

4. Lack of Early Detection:

• In many cases, congenital heart disease may go undetected in infancy or childhood due to limited access to pediatric cardiology services, especially in rural India. Many adults discover their CHD only when symptoms appear or during routine health checks.

5. Rheumatic Heart Disease:

• Though distinct from CHD, rheumatic fever—still common in some parts of India—can cause heart valve damage, leading to complications similar to CHD in adults. Poor living conditions, lack of access to antibiotics and untreated strep throat infections increase this risk.

Symptoms of Congenital Heart Disease in Adults

The symptoms of congenital heart disease in adults depend on the type and severity of the defect, whether it was treated and any complications that may have developed over time. Some individuals may have mild symptoms or remain asymptomatic until adulthood, while others experience significant issues from childhood.

1. Shortness of Breath:

• Many adults with CHD experience breathlessness, particularly during physical activity. This occurs when the heart is unable to pump blood efficiently due to structural defects.
• In the Indian context, where physical exertion is often a daily necessity (e.g., walking or manual labour), individuals with undiagnosed CHD may notice this symptom more acutely.

2. Fatigue:

• Constant tiredness, especially after exertion, can be a sign of an underlying heart condition. Congenital heart defects that affect blood flow may result in reduced oxygen supply to muscles, causing fatigue.
• In India, where long working hours and a busy lifestyle are common, people may overlook this symptom, attributing it to routine exhaustion rather than CHD.

3. Swelling (Oedema):

• Swelling in the legs, ankles and abdomen is another common symptom of heart issues, including CHD. This happens when the heart’s pumping ability is compromised, leading to fluid buildup.
• In India’s hot and humid climate, mild oedema may be mistaken for heat-induced swelling, delaying diagnosis.

4. Heart Murmurs:

• A heart murmur, an unusual sound heard during a heartbeat, may be a sign of an abnormal heart structure. Many congenital heart defects cause murmurs, which may be detected during a physical exam.
• In India, especially in areas with limited access to healthcare, heart murmurs might be ignored or remain undiagnosed due to a lack of specialized cardiology services.

5. Palpitations or Arrhythmia:

• Irregular heartbeats or palpitations are common in adults with CHD. Defects in the heart's structure can disrupt its electrical system, causing abnormal heart rhythms.
• With an increase in stress and lifestyle-related disorders in India, palpitations are often mistaken for anxiety or stress, but they may signal an underlying heart condition.

6. Chest Pain:

• Though less common, some individuals with congenital heart disease may experience chest pain, particularly during exercise. This occurs when blood flow to the heart muscle is restricted.
• Given India’s high rates of ischemic heart disease and heart attacks, chest pain might be misinterpreted as coronary artery disease, overshadowing the possibility of CHD.

Complications in Adults with Congenital Heart Disease

As adults with congenital heart disease age, they are at increased risk of developing complications. These complications often arise from untreated defects or as side effects of earlier treatments. In India, where access to lifelong cardiology care can be inconsistent, these complications may pose a significant health burden.

1. Heart Failure:

• Over time, untreated or poorly managed CHD can weaken the heart muscle, leading to heart failure. This is a serious condition where the heart cannot pump enough blood to meet the body's needs.

2. Endocarditis:

• Individuals with congenital heart defects are at a higher risk of developing endocarditis, an infection of the heart lining. Poor dental hygiene and untreated infections in India may exacerbate this risk.

3. Stroke:

• Abnormal blood flow in the heart can lead to blood clots, which may travel to the brain and cause a stroke. Adults with CHD need to be aware of this risk, particularly in India, where stroke rates are climbing.

Conclusion

Congenital heart disease in adults is an important yet under-recognized issue in India. While advances in medical technology have improved the outlook for children born with CHD, many adults live with undiagnosed or untreated conditions. Awareness, timely diagnosis and proper management can make a significant difference in the quality of life for those affected.

Understanding the causes, symptoms and long-term impact of CHD in adults, especially in the Indian context, is vital for ensuring early intervention and better health outcomes. At Neotia Getwel Multispecialty Hospital, our team of experts is here to provide comprehensive care for heart diseases. We are committed to helping our patients lead healthier, fuller lives.

Disclaimer

Though all attempts are made to provide correct information on the subject, inadvertent & typographical errors arising out of manual intervention cannot be ruled out. Any such discrepancies should be brought to the blogger's notice for correction.