What you don't know about congenital heart disease

People who work in the clinic often hear "congenital heart disease", but they don't know what it is; relatives sometimes come to ask, the doctor says it is congenital heart disease, but the medical record says primary pulmonary hypertension, is this the same thing? But in fact, congenital heart disease includes this type of disease, which is a general term. Today, the editor will take you to understand what congenital heart disease is and what types of common congenital heart diseases are included.

To understand the abnormalities, we must first know the normal heart structure.

The heart can be roughly regarded as four small houses. The two houses on the top are the left and right atria, and the two houses on the bottom are the left and right ventricles. Of course, there are some "pipes" connected to the bottom of the house - the aorta and veins. The upper house, i.e. the atria, is connected to the veins, and the lower house, i.e. the ventricles, is connected to the arteries. The structure connecting the atria, i.e. the two houses on the top, is separated by the "atrial septum", and the structure connecting the ventricles, i.e. the two houses on the bottom, is separated by the "ventricular septum", so that the left and right sides are not connected to each other; the upper and lower houses are also separated by valves, the left one is called the mitral valve, and the right one is called the tricuspid valve. At the bottom of the heart, the left ventricle is separated from the aorta by the aortic valve, and the right ventricle is separated from the pulmonary artery by the pulmonary valve. The function of these valves is to prevent the internal blood from flowing back when the atria and ventricles contract or relax.

At the bottom of the heart, the aorta opens into the left ventricle. Through myocardial contraction, blood is transported to organs throughout the body through the aorta, becomes venous blood through the capillaries, and flows back into the superior and inferior vena cava and into the right atrium. This is how the heart pumps blood to complete the systemic circulation . The blood in the right atrium passes through the tricuspid valve into the right ventricle and into the pulmonary artery, and is converted into venous blood through the pulmonary capillaries. It flows into the left atrium through the pulmonary veins, and then into the left atrium through the pulmonary veins, and then into the left ventricle through the mitral valve. This completes the blood circulation in the lungs . Our heart is like this, beating autonomously and regularly to maintain the blood supply to the human body and ensure our basic life activities.

The formation of the heart does not happen overnight. Instead, it is a process that takes place during the embryonic period, from the formation of blood vessels to the formation of the atrioventricular septum, thus completing the development of a four-chamber heart. At 9-10 weeks of pregnancy, the valve structure begins to form, ensuring that blood can only flow in one direction. The fetal blood circulation is independent of the mother's blood circulation. Every step in this process is crucial. When a part of the house is defective, the order of blood flow changes, and it becomes what we commonly call congenital heart disease. Clinical manifestations include cyanosis of the lips and nails, pale complexion, difficulty breathing, chest tightness and breathlessness, and in severe cases, squatting, clubbing and developmental disorders.

Structural abnormalities can occur in various parts, for example: defects in the left and right septa , including atrial septal defects and ventricular septal defects, can cause left-to-right shunting of blood; valvular defects are common in mitral regurgitation, tricuspid regurgitation, pulmonary stenosis and aortic stenosis; patent ductus arteriosus, aortic stenosis, pulmonary artery stenosis and changes in the position and shape of the great arteries due to abnormal vascular formation . When the four conditions (ventricular septal defect, pulmonary artery stenosis, aortic co-saddle, right ventricular hypertrophy) occur at the same time, it is called tetralogy of Fallot , which is also a common type of congenital heart disease. In addition, there are some structural abnormalities such as simple pulmonary artery dilatation, primary pulmonary hypertension, single ventricle, etc., which all fall into the category of congenital heart disease.

After understanding the basic structure of the heart and the common types of congenital heart disease, I believe everyone has a better understanding of this type of disease. In clinical work, we should analyze symptoms and functional disorders based on specific circumstances and provide more individualized treatment intervention plans.

Author: Gao Yu, Li Yanyan

Editor: Jia Jing

Illustration: Li Chuan

This project is funded by the "National Society Science Popularization Capacity Improvement Project-Rehabilitation Science Popularization Service Capacity Improvement Action Plan"