While many heart conditions develop gradually over time, there are others that start before birth. Congenital heart disease refers to a variety of structural problems with the heart that happen while a fetus is still developing. (An individual type of congenital heart disease may also be referred to as a congenital heart defect.) It is the most common birth disorder in the U.S., affecting about 40,000 babies each year, with 800,000 adults living with the condition.

There is a spectrum of severity of congenital heart defects. While about 25% of all babies born with congenital heart disease have a critical heart defect (CHD) that requires surgery or other medical treatment, other types are mild. Take a look at some of the most common congenital heart defects.

What causes congenital heart disease?

In some types of congenital heart disease, the specific causes are unknown. Others have a genetic component and are passed through families. A mother’s health history and lifestyle habits can also affect how a baby’s heart develops in the womb. The following risk factors in a mother have been linked to a baby’s development of congenital heart disease.

• Having type 1 or type 2 diabetes, hypertension, obesity, thyroid disorders, or epilepsy

• Taking certain medications such as phenytoin and retinoic acid

• Alcohol use

• Smoking

If you are considering starting a family and have concerns about your baby’s risk of a genetic heart defect, ask your doctor about testing options that may detect a congenital heart disorder during pregnancy. In addition, consult with your doctor if you are unsure if a medication is safe to take during pregnancy.

Common types of congenital heart disease

Congenital heart disease may affect any of the following heart structures:

• The right atrium, one of the heart’s two upper chambers which receives blood without oxygen from other parts of the body

• The left atrium, the heart’s other upper chamber which receives oxygen-rich blood from the lungs

• The right ventricle, one of the heart’s two lower chambers which pumps blood without oxygen from the right atrium to the lungs

• The left ventricle, the heart’s other lower chamber which pumps oxygen-rich blood to the rest of the body

• Coronary arteries, which supply your heart with oxygen-rich blood

• The heart’s four valves, which keep blood flowing properly through the heart

• The septum, the wall of tissue separating the left and right sides of the heart

These are the most common types of congenital heart disease affecting U.S. adults. Symptoms, treatment, and diagnostic tests vary by heart defect.

Ventricular septal defect

Comprising about 20% of all congenital heart disease cases, ventricular septal defect is the most common congenital heart defect in babies. It is a small or large hole between the ventricles. Treatment depends on the size of the hole. If a hole is larger, surgery may be required within a baby’s first four to six months of life. There is often no additional treatment needed after surgery.

Most infants with ventricular septal defect also have a heart murmur, a swishing sound that is audible with a stethoscope. Other symptoms include fast breathing, high heart rates, frequent sweating, even while at rest, and poor weight gain.

Atrial septal defect

Another common type of congenital heart disease, atrial septal defect is a hole between the atria. Many infants with this defect do not have any symptoms.

In about 80% of cases, the hole closes naturally. If the hole does not close, a child may need surgery or a non-surgical procedure known as an interventional cardiac catheterization. As with ventricular septal defect, this condition typically does not require additional treatment after the first procedure.

Tetralogy of fallot

Tetralogy of fallot (TOF) is a congenital heart defect in which the wall that separates the ventricles — the ventricular septum — is abnormally positioned, with a hole. It can obstruct the flow of blood through the heart, in some cases causing heart muscle to thicken. All TOF cases require surgery, typically within a baby’s first year of life.

Patent ductus arteriosus

Patent ductus arteriosus involves the connection between the aorta and the heart’s pulmonary artery. While in the womb, a baby’s aorta and pulmonary artery are linked by a blood vessel called the ductus arteriosus, which allows blood to flow directly to the aorta. In healthy babies, the ductus arteriosus naturally closes not long after birth. In babies with this heart defect, the blood vessel remains open, potentially causing heavy blood flow to the lungs. 

There are a variety of treatment options for patent ductus arteriosus, including medications, non-invasive procedures, and surgery. Nonsteroidal anti-inflammatory drugs (NSAIDs) may help close a premature baby’s patent ductus arteriosus but typically aren’t effective for full-term babies, children, or adults. If a baby has minimal symptoms, surgery is often delayed until they are between 6 to 12 months old. However, if a baby is experiencing poor weight gain or rapid breathing, surgery may be recommended during their first six months.

Transposition of the great arteries (TGA)

About 10% of all babies with congenital heart disease have transposition of the great arteries (TGA), a problem with the positioning of the two main arteries that carry blood away from the heart to other organs. Babies born with this condition have low oxygen levels, which may cause a bluish tint to the skin. The condition requires a surgical procedure called an arterial switch operation shortly after birth. In most cases, heart function is restored to normal after surgery.

Aortic valve stenosis

Aortic valve stenosis is an issue with the aortic valve, from which oxygen-rich blood travels to other parts of the body. In healthy babies, the aortic valve has three flaps that open and shut to accommodate the flow of blood. Babies with this defect may have a small aortic valve or the flaps may not function properly. This structural problem can block the flow of blood from the heart, which can put additional pressure on the left ventricle. Treatment depends on the specific issue with the aortic valve and may include a non-invasive procedure or surgery.

Living with congenital heart disease as an adult

Living with congenital heart disease as an adult varies significantly by individual and by condition, given the wide spectrum of these defects. Most adults with a congenital heart defect are regularly monitored by a cardiologist who specializes in congenital heart disease throughout their lives. In some cases, you may have to take additional precautions to prevent complications related to certain types of congenital heart disease such as the following:

• Infective endocarditis, an infection caused by bacteria in the heart lining, or in a heart valve or blood vessel. If untreated, it can lead to a blood clot, heart valve damage, or heart failure

• Arrhythmia, an irregular heartbeat which can affect the heart’s ability to pump blood and increase your risk of developing a blood clot

• Pulmonary hypertension, high blood pressure in the arteries that run from the heart to the lungs

Care for your heart with support from Alto

At Alto, we make it as simple as possible to manage heart health issues and follow the treatment plan your doctor recommends. We will work with your doctor, your insurance (if applicable), and any third party savings programs that you may qualify for to ensure your medications are as affordable as possible. And our team of pharmacists is available to chat whenever questions come up about side effects or how to take your medication properly.

Reach out any time through in-app secure messaging or by phone at 1-800-874-5881.

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition.