Congenital heart disease: What are the symptoms?
The symptoms of congenital heart disease differ depending on the age and severity of the disease at presentation.
A. Neonatal age. Very serious cardiac diseases occur in the first few days of life with cyanosis or severe difficulty in breathing (“blue” lips, tongue and nails caused by lack of oxygen in the blood). Oxygen saturation, which is measured by nursing or medical staff in these cases is commonly below 90-93%. Also, newborns with severe dyspnoea (difficulty in breathing), tiredness/lethargy, tachycardia and inability to eat should be checked promptly by a pediatrician. The pediatrician, beyond the full checkup and recording of oxygen saturation, must also confirm that the femoral arteries are palpable to exclude coarctation or severe aortic valve stenosis. Finally, in the case of an intubated and ventilated newborn that is unable to come off the ventilator without any obvious reason, cardiac anatomy and function should also be checked.
B. Infancy. Less urgent – but equally important and complex congenital heart diseases can present between 4-6 weeks of life and later into the first year or two of life. Commonly a cardiac murmur may be heard by the pediatrician during examination, tachypnea or fast heart rhythm (tachycardia). In the above instances the child must be referred promptly for a cardiac examination.
C. School age / Adult life. A small percentage of congenital heart diseases are incidentally discovered during sports check up or even in adult life. Occasionally congenital heart disease that has gone undiagnosed in childhood, may present with symptoms such as shortage of breath on exercise or progressive reduction in one’s strength during the third and fourth decade of life (eg, bicuspid aortic valve with stenosis / regurgitation, large ASD, congenitally corrected transposition etc.).