Congenital heart disease is the most common type of birth defect and causes more infant deaths than any other congenital disorder. Generally detected during pregnancy or in early childhood, congenital heart disease can also be discovered in adults.

Mount Sinai Heart has one of the country's premier pediatric cardiology programs. We have extensive experience in innovative diagnostic technologies, such as fetal echocardiogram and magnetic resonance imaging (MRI). Our doctors offer every possible treatment for pediatric and congenital heart disease, ranging from interventional procedures to mechanical support and transplant surgery.

"We have a congenital heart institute that goes from prenatal diagnosis all the way to treating the elderly," says Ira Parness, MD, Professor of Pediatrics and Chief of the Division of Pediatric Cardiology.

Risk Factors

Some pregnant women have risk factors that increase their likelihood of having a baby born with congenital heart disease. These women are advised to have a fetal echocardiogram. Our Fetal Heart Program is the first of its kind in the New York metropolitan area.

The following factors put a fetus at higher risk of congenital heart disease:

• Family history of congenital heart disease

• Diabetes on the mother's side

• Exposure to certain medications

• First-trimester exposure to German measles (rubella)

• A history of certain genetic diseases, such as Down, Noonan, or Marfan syndrome)

• Viral or bacterial infections during pregnancy

• Maternal recreational drug or alcohol use

Congenital Heart Defects

During the complicated process of embryonic and fetal development, the heart is subject to more potential defects than any other organ. These defects include:

• Atrial Septal Defect (ASD). The wall between the heart's upper chambers has a hole in it.

• Ventricular Septal Defect (VSD). The wall between the heart's lower chambers has a hole in it.

• Patent ductus arteriosus (PDA). The blood vessel connecting the aorta and the pulmonary artery does not close up properly after birth.

• Tetraology of Fallot. The heart has a hole between the pumping chambers and obstructions within the artery leading to the lungs.

• Coarctation of the aorta. A segment of the aorta is narrowed.

• Transposition of the Great Arteries (TGA). The position of the aorta and the pulmonary artery are reversed inside the ventricles.

• Hypoplastic left heart disease. The left ventricle is so poorly formed that it cannot pump efficiently.

Acquired Pediatric Heart Diseases

Some heart diseases are not present at birth but develop later:

• Rheumatic fever
• Kawasaki disease
• Cardiomyopathy
• Myocarditis
• Endocarditis
• Arrhythmia

Genetic Heart Disorders

Some genetic disorders carry an increased risk of heart disease:

• Marfan syndrome. Connective tissue disorder that weakens artery walls

• Down syndrome. Chromosomal abnormality associated with several congenital heart conditions

• Hypertrophic cardiomyopathy. Condition that thickens heart walls, often running in families

• Long QT Syndrome. Abnormal electrical condition that can cause sudden death

• Noonan syndrome. Disorder that can cause obstructed blood flow from the heart to the lungs

Our Cardiovascular Genetics Program

Mount Sinai Heart's Cardiovascular Genetics Program is dedicated to preventing, diagnosing, and treating genetic-based cardiovascular diseases. We provide preconception counseling, comprehensive cardiovascular genetic evaluation, state-of-the-art DNA testing, detailed information about the prognosis and treatment of cardiovascular genetic disorders, and genetic counseling about the risks to future offspring.

Bruce Gelb, MD, Professor of Cardiology and Genetics and Genomic Sciences, and Director of the Mount Sinai Center for Molecular Cardiology, is a world leader in cardiovascular genetics.

Symptoms of Pediatric and Congenital Heart Disease

Some babies born with heart defects experience no symptoms at first. Certain congenital heart defects can be so severe, though, that the newborn becomes very ill shortly after birth. With milder defects, signs or symptoms can surface years later.

Symptoms of congenital heart disease in newborns include:

• Rapid breathing or deep rib retraction during breathing
• Bluish skin, lips, and nails
• Fatigue or difficulty feeding
• Poor weight gain
• Sweating, especially while feeding

Symptoms of congenital heart disease in older children and adults include:

• Low exercise tolerance
• Fatigue
• Difficult or rapid breathing either at rest or with exercise
• Swollen feet, ankles, and legs
• Loss of consciousness
• Loss of appetite or unexplained chronic bellyache