Congenital Heart Disease

Medically reviewed by Carina Fung, PharmD, BCPPS

What is heart disease?

Heart disease1 describes a range of conditions that affect your heart.

Diseases under the heart disease umbrella include blood vessel diseases, such as coronary artery disease, heart rhythm problems (arrhythmias), and heart defects you're born with (congenital heart defects), among others.

The term "heart disease" is often used interchangeably with the term "cardiovascular disease." Heart disease generally refers to conditions that involve narrowed or blocked blood vessels that can lead to a heart attack, chest pain (angina), or stroke.

Other heart conditions, such as those that affect your heart's muscle, valves, or rhythm, are also considered forms of heart disease.

Heart disease is a leading cause of death around the world. In the United States, 48%2 of adults aged 20 and over have some form of heart disease based on 2013 to 2016 data, although only 9% have congenital heart disease, heart failure, or stroke (the other 39% have hypertension).

Many forms of heart disease can be prevented or treated with healthy lifestyle choices.

Source: Getty Images

Congenital Heart Disease Symptoms

What is congenital heart disease?

Congenital heart diseases3 are problems with the heart’s structure that are present at birth. Congenital heart disease, also known as congenital heart defect, may change the normal flow of blood through the heart.

Congenital heart diseases are the most common type4 of birth defect, affecting nearly 1% of births per year in the United States. About 25% of babies have a critical congenital heart disease, which generally requires surgery or other procedures in the baby’s first year of life.

Researchers estimate that about 1 million U.S. children and about 1.4 million U.S. adults are living with congenital heart diseases.

There are many types of congenital heart defects. The most common defects involve the inside walls of the heart, the valves of the heart, or the large blood vessels that carry blood to and from the heart.

Some defects require no treatment, but some require treatment soon after birth. Because diagnosis and treatment of congenital heart defects has improved, more babies are surviving, and many adults are now living with congenital heart defects.

If you have congenital heart disease, you might need care throughout your life. Check with your provider to determine how often your heart should be checked as an adult.

Heart disease causes

The causes of heart disease depends on the type of heart problem5 you have.

Heart diseases due to atherosclerosis

The term heart disease is often used to mean damage to your heart or blood vessels by a buildup of fatty plaques in your arteries. This plaque buildup, also known as atherosclerosis, is the most common cause of heart disease.

Plaque buildup thickens and stiffens artery walls, which can inhibit blood flow through your arteries to your organs and tissues.

Atherosclerosis is responsible for stroke, coronary artery disease, and peripheral artery disease. Many of its causes are correctable problems.

Factors that cause heart diseases due to atherosclerosis include:

  • Tobacco use
  • Physical inactivity
  • Unhealthy diet (rich in salt, fat and calories)
  • Harmful use of alcohol
  • Raised blood pressure (hypertension)
  • Raised blood sugar (diabetes)
  • Raised blood lipids (e.g. cholesterol)
  • Overweight and obesity
  • Inherited (genetic) disposition
  • Psychological factors (e.g. stress, depression)

It should be noted that many of the issues listed here that contribute to the development of atherosclerosis can be corrected with lifestyle modifications.

Heart disease due to heart arrhythmia

Irregular heart rhythms, or abnormal electrical activity in the heart, is known as heart arrhythmia.

In a healthy person, it's unlikely for a fatal arrhythmia to develop without some outside trigger, such as an electrical shock or the use of illegal drugs.

However, in a heart that is diseased or deformed, electrical impulses may not properly start or travel through the heart, making arrhythmias more likely to develop.

Common causes of arrhythmias include:

  • Congenital heart defects (or heart defects you're born with
  • Coronary artery disease
  • High blood pressure
  • Diabetes
  • Smoking
  • Excessive use of alcohol or caffeine
  • Drug abuse
  • Stress

Heart disease due to congenital heart defects

Congenital heart defects usually develop while a baby is in the womb. Heart defects can sometimes develop about a month after conception and can change the flow of blood in the heart. Some medical conditions, medications, and genes may play a role in causing heart defects.

Congenital heart defects can happen because the heart does not develop normally while the baby is growing in the womb. Providers often do not know why congenital heart defects occur. Researchers do know that genetics can sometimes play a role.

Sometimes, congenital heart disease can resurface in adulthood. Even if the treatment you received in childhood was successful, a problem can occur or worsen as you age. It's also possible that problems in your heart, which weren't serious when you were a child, have worsened and now require treatment.

Life-saving childhood surgeries to correct congenital heart disease may cause later complications, such as scar tissue in your heart that can contribute to abnormal heart rhythm.

Certain environmental and genetic risk factors might play a role in the development of your heart defect, including:

  • Rubella: A mother infected with rubella while pregnant could affect fetal heart development.
  • Diabetes: A mother with insulin resistance (Type 1, 2, or gestational diabetes) can increase the baby’s risk of developing cardiovascular defects.
  • Medications: Taking certain medications while pregnant may cause congenital heart malformations. Examples of such medications include isotretinoin (generic Absorica, Amnesteem, Claravis) used to treat acne; and lithium, which can be used to treat bipolar disorder. Drinking alcohol while pregnant also contributes to the risk of heart defects in the baby.
  • Heredity: Congenital heart disease appears to run in families and is associated with many genetic syndromes. For instance, children with Down syndrome may often have heart defects. Genetic testing can detect Down syndrome and other disorders during a baby's development.
  • Smoking: A mother who smokes while pregnant increases her risk of having a child with a congenital heart defect.

Heart disease due to cardiomyopathy

The cause of cardiomyopathy, a thickening or enlarging of the heart muscle, may depend on the type of cardiomyopathy:

  • Dilated cardiomyopathy: As the most common type of cardiomyopathy, this condition means the enlargement and weakening of the heart’s main pumping chamber, decreasing the heart’s ability to pump blood.

The cause of dilated cardiomyopathy is often unknown. It may be caused by reduced blood flow to the heart (ischemic heart disease) resulting from damage after a heart attack, infections, toxins and certain drugs. It may also be inherited from a parent.

  • Hypertrophic cardiomyopathy: This type of cardiomyopathy, in which the heart muscle becomes abnormally thick, is usually inherited. It can also develop over time because of high blood pressure or aging.
  • Restrictive cardiomyopathy: This least common type of cardiomyopathy, which causes the heart muscle to become rigid and less elastic, can occur for no known reason. It may also be caused by diseases such as connective tissue disorders, excessive iron buildup in your body (hemochromatosis), the buildup of abnormal proteins (amyloidosis), or some cancer treatments.

Heart disease due to infection

A heart infection, such as endocarditis, is caused when an irritant, such as a bacterium, virus, or chemical, reaches your heart muscle. The most common causes of heart infection include:

  • Bacteria
  • Viruses
  • Parasites

Overall risk factors for developing heart disease

The overall factors6 for developing heart disease include:

  • Age: Aging increases your risk of damaged and narrowed arteries and weakened or thickened heart muscle.
  • Sex: Men are generally at greater risk of heart disease. However, women's risk increases after menopause.
  • Family history: A family history of heart disease increases your risk of coronary artery disease, especially if a parent developed it at an early age (before age 55 for a male relative, and before 65 for a female relative).
  • Smoking: Nicotine in tobacco smoke constricts your blood vessels, and carbon monoxide can damage the inner lining of blood vessels, making them more susceptible to atherosclerosis. Smokers are two to four times7 more likely to have heart disease than nonsmokers.
  • Poor diet: A diet high in fat, salt, sugar and cholesterol can contribute to the development of heart disease.
  • High blood pressure: Uncontrolled high blood pressure can result in hardening and thickening of your arteries, narrowing the vessels where blood flows.
  • High blood cholesterol levels: High levels of cholesterol in your blood can increase the risk of formation of plaques and atherosclerosis.
  • Diabetes: Diabetes increases your risk of heart disease.
  • Obesity: Excess weight typically worsens other risk factors.
  • Physical inactivity: Lack of exercise also is associated with many forms of heart disease and some of its other risk factors, as well.
  • Stress: Unrelieved stress may damage your arteries and worsen other risk factors for heart disease.
  • Poor hygiene: Not regularly washing your hands and not establishing other habits that can help prevent viral or bacterial infections can put you at risk of heart infections, especially if you already have an underlying heart condition. Poor dental health also may contribute to heart disease.
  • Certain chemotherapy drugs and radiation therapy for cancer: Some chemotherapy drugs and radiation therapies may increase the risk of cardiovascular disease.

Heart disease symptoms

Heart disease symptoms depend on what type of heart disease you have.

Heart disease symptoms caused by atherosclerosis

Symptoms for heart disease due to plaque buildup in your blood vessels (atherosclerosis) may include:

  • Chest pain, chest tightness, chest pressure and chest discomfort (angina)
  • Shortness of breath
  • Pain, numbness, weakness or coldness in your legs or arms if the blood vessels in those parts of your body are narrowed
  • Pain in the neck, jaw, throat, upper abdomen or back

Heart disease symptoms may be different for men and women. For instance, men are more likely to have chest pain; women are more likely to have other symptoms along with chest discomfort, such as shortness of breath, nausea and extreme fatigue.

You might not be diagnosed with cardiovascular disease until you have a heart attack, angina, stroke or heart failure. It's important to watch for cardiovascular symptoms and discuss concerns with your provider. Cardiovascular disease can sometimes be found early with regular evaluations.

Heart disease symptoms caused by arrhythmia

An abnormal heartbeat, or heart arrhythmia, is when your heart beats too quickly, too slowly, or irregularly. Heart arrhythmia symptoms can include:

  • Fluttering in your chest
  • Tachycardia (racing heartbeat)
  • Bradycardia (slow heartbeat0
  • Chest pain or discomfort
  • Shortness of breath
  • Lightheadedness
  • Dizziness
  • Fainting (syncope) or near fainting
  • Heart disease symptoms caused by heart defects

Heart disease symptoms caused by cardiomyopathy

In early stages of cardiomyopathy (weak heart muscle), you may have no symptoms. As the condition worsens, symptoms may include:

  • Breathlessness with exertion or at rest
  • Swelling of the legs, ankles and feet
  • Fatigue
  • Irregular heartbeats that feel rapid, pounding or fluttering
  • Dizziness, lightheadedness and fainting
  • Heart disease symptoms caused by heart infections

Heart disease symptoms caused by infection

Endocarditis is an infection that affects the inner membrane that separates the chambers and valves of the heart (endocardium). Heart infection symptoms can include:

  • Fever
  • Shortness of breath
  • Weakness or fatigue
  • Swelling in your legs or abdomen
  • Irregular heartbeat
  • Dry or persistent cough
  • Skin rashes or unusual spots
  • Heart disease symptoms caused by valvular heart disease

Congenital heart disease symptoms

Some congenital heart defects cause no signs or symptoms8. For some people, signs or symptoms occur later in life. They can recur years after you've had treatment for a heart defect.

Serious congenital heart defects—defects you're born with—usually become evident soon after birth. Heart defect symptoms in children could include:

  • Pale gray or blue skin color (cyanosis)
  • Swelling in the legs, abdomen or areas around the eyes
  • In an infant, shortness of breath during feedings, leading to poor weight gain

Less serious congenital heart defects are often not diagnosed until later in childhood or during adulthood. Signs and symptoms of congenital heart defects that usually aren't immediately life-threatening include:

  • Easily getting short of breath during exercise or activity
  • Easily tiring during exercise or activity
  • Swelling in the hands, ankles or feet

Common congenital heart disease symptoms you might have as an adult include:

  • Abnormal heart rhythms (arrhythmias)
  • A bluish tint to the skin, lips and fingernails (cyanosis)
  • Shortness of breath
  • Tiring quickly upon exertion
  • Swelling of body tissue or organs (edema)

When to see your provider

Seek emergency medical care if you have these heart disease symptoms:

  • Chest pain
  • Shortness of breath
  • Fainting

Heart disease is easier to treat when detected early, so talk to your provider about your concerns regarding your heart health. If you are concerned about heart disease, talk to your provider about steps you can take to reduce your heart disease risk. This is especially important if you have a family history of heart disease.

If you think you may have heart disease, based on new signs or symptoms you're having, make an appointment to see your provider.

Disclaimer: The information on this site is generalized and is not medical advice. It is intended to supplement, not substitute for, the expertise and judgment of your healthcare professional. Always seek the advice of your healthcare professional with any questions you may have regarding a medical condition. Never disregard seeking advice or delay in seeking treatment because of something you have read on our site. RxSaver makes no warranty as to the accuracy, reliability or completeness of this information.

If you are in crisis or you think you may have a medical emergency, call your doctor or 911 immediately.