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Acyanotic Heart Disease

Acyanotic heart disease is a circulatory problem that is congenital. It is atypical of most congenital heart defects in that it does not cause the patient to present with blue skin or fingernails, thus the term "acyanotic," "doesn't turn blue." What this means is that there is enough oxygen in the blood to sustain normal function; however, cyanosis (blue skin and nails due to lack of oxygen) can occur later in life. One of the concerns in acyanotic patients is that the condition can lead to right ventricle failure or other complications due to the increased strain that is placed upon the heart.

  1. Patent Ductus Arteriosus (PDA)

    • When the child is in the womb), there is a connection between the baby's aorta and the mother's pulmonary artery. It is this connection that allows the mother to supply oxygen to the fetus. At birth, there are usually changes in hormone levels that allow this connection to close. If those changes don't occur, the newborn can wind up with too much blood in the lungs, which can cause heart failure. Treatment methodologies include closing the PDA (patent ductus arteriosus) via surgery or cardiac cauterization.

    Ventricular Septal Defect (VSD)

    • VSD (ventricular septal defect) is the most common form of acyanotic heart disease and is often classified as a "hole in the heart," which indicates a small opening in the septum (wall) between the left and right chambers of the heart. It is characterized by oxygenated blood being forced into the right side of the heart, bypassing the lungs. According to the American Heart Association, surgically closing small VDSs is not necessary, as most often the hole will close up on its own. However, if the hole is large, it is best to close the perforation before the patient turns two, thus eliminating enlargement or further strain on the heart.

    Stenosis

    • Stenosis is characterized by a narrowing in the veins, arteries or valves of the heart. The three most common types are pulmonary, aortic and coarctation. Pulmonary stenosis is a narrowing of the valve that lets blood flow from the heart into the lungs, causing the right ventricle to work harder to distribute blood. Aortic stenosis is when the aortic valve in the heart is narrowed, creating high risk of infection in the valve (endocartidis). Coarctation stenosis is when the aorta is obstructed or "pinched" in some way, which prevents adequate blood flow to the lower half of the body and raises blood pressure. All of these stenoses can be handled either with surgery or the use of a balloon to open the obstruction.

    Hypoplastic Left Heart Syndrome (HLHS)

    • In HLHS (hypoplastic left heart syndrome), the left side of the heart has not adequately developed. Involvement includes the left ventricle and mitral valve and the aorta and valve. Due to an opening in the two upper chambers of the heart, blood must flow through an opening called an atrial septal defect. This means that the oxygenated blood leaks back into the right side of the heart, where it gets circulated again. (See PDA above.) This defect is usually fatal. There are surgical procedures that can relieve pressure on the heart, but to date there is no cure.

    Atrioventricular Septal Defect (AVSD)

    • With AVSD (atrioventricular septal defect), a large hole occurs in the septum that separates the lower chambers of the heart from the upper. Further affecting the heart is that the two valves that separate the upper and lower chambers have formed as one valve, causing oxygenated blood from the left side of the heart to flow into the right and circulating that blood into the lungs. This causes the heart to work overtime and possibly become enlarged. Surgery is usually done in infancy to separate the two valves and close the hole.

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