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CHD - TGA

Congenital heart disease is a general term for a range of birth defects that affect
the normal workings of the heart.

Types of congenital heart disease


There are many types of congenital heart disease and they sometimes occur in
combination. Some of the more common defects include:
septal defects where there's a hole between two of the heart's chambers
(commonly referred to as a "hole in the heart")
coarctation of the aorta where the main large artery of the body, called the aorta,
is narrower than normal
pulmonary valve stenosis where the pulmonary valve, which controls the flow of
blood out of the lower right chamber of the heart to the lungs, is narrower than
normal
transposition of the great arteries where the pulmonary and aortic valves and the
arteries they're connected to have swapped positions

TGA
Transposition of the great arteries is a serious but rare heart defect present at birth
(congenital), in which the two main arteries leaving the heart are reversed
(transposed).

Transposition of the great arteries changes the way blood circulates through the
body, leaving a shortage of oxygen in blood flowing from the heart to the rest of the
body. Without an adequate supply of oxygen-rich blood, the body can't function
properly and your child faces serious complications or death without treatment.
Transposition of the great arteries is a congenital (present at birth) heart defect.
Due to abnormal development of the fetal heart during the first 8 weeks of
pregnancy, the large vessels that carry blood from the heart to the lungs, and to the
body are improperly connected. Essentially, the connections in the heart are
"swapped."

Normally, oxygen-poor (blue) blood returns to the right atrium from the body,
travels to the right ventricle, then is pumped through the pulmonary artery into the
lungs where it receives oxygen. Oxygen-rich (red) blood returns to the left atrium
from the lungs, passes into the left ventricle, and then is pumped through the aorta
out to the body.

In transposition of the great arteries, the aorta is connected to the right ventricle,
and the pulmonary artery is connected to the left ventricle the opposite of a
normal heart's anatomy.
Transposition of the great arteries is usually detected either prenatally or within the
first hours to weeks of life.
It isnt clear what causes congenital heart malformations, including TGA, although in
most cases it appears that some combination of genetics and environment is
involved.
Corrective surgery soon after birth is the usual treatment for transposition of the
great arteries. Having a baby with transposition of the great arteries can be
alarming, but with proper treatment, the outlook is promising.
Symptoms

Transposition of the great arteries symptoms include:

Blue color of the skin (cyanosis)


Shortness of breath
Lack of appetite
Poor weight gain
Rapid breathing
Labored breathing
Rapid heart rate
Cool, clammy skin

Echocardiogram (cardiac ultrasound)


An echocardiogram evaluates the structure and function of a childs heart, using
electronically recorded sound waves that produce a moving picture of the heart and
heart valves. No discomfort is involved. It takes 30-60 minutes.

If, during pregnancy, a routine prenatal ultrasound or other signs raise suspicion of
a congenital heart defect in the fetus, a cardiac ultrasound (described in the
paragraph above) of the baby in utero will usually be the next step. The cardiac
ultrasound focusing exclusively on the babys heart can usually detect a
congenital heart defect.

Chest x-ray
A conventional chest x-ray will evaluate the size and spatial relationships of the
heart within the childs chest. It takes a few moments. There's no pain or
discomfort.

Electrocardiogram (EKG)
An EKG is used to evaluate the electrical activity of the heart. An EKG is usually the
initial test for evaluating the causes of symptoms and detecting heart
abnormalities, including TGA. Its performed by placing electrodes on the arms, legs
and chest to record the electrical activity. The test takes five minutes or less and
involves no pain or discomfort.

Cardiac catheterization
Cardiac catheterization provides detailed visual information and measurements
about the structures and pressures inside the heart. Blood pressure and oxygen
measurements are taken in the four chambers of the heart, as well as the
pulmonary artery and aorta.

Cardiac magnetic resonance imaging (MRI)


MRI provides a picture of the heart and blood vessels, but without using x-rays. MRI
is rarely used in babies with TGA but may be helpful in follow-up to TGA surgery to
detect complications.

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