Associated conditions

Many people with congenital heart disease are at risk for pulmonary hypertension and heart arrhythmias.

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Pulmonary hypertension is a debilitating and often fatal condition in which the blood pressure is elevated in the arteries that supply the lungs. Individuals with congenital heart disease that causes excessive blood flow through the pulmonary blood vessels are susceptible to developing pulmonary hypertension. For example, people with Eisenmenger's syndrome and mitral valve stenosis are at increased risk for developing pulmonary hypertension.

The early symptoms are fatigue and shortness of breath that become progressively worse over time. As the condition progresses, chest pain, blueness of the skin, fainting, swelling of the legs, bulging of the neck veins, loss of appetite, and abdominal pain may develop. It is important to diagnose and treat this condition early on, before irreversible damage to the lungs occurs.

Some people diagnosed with pulmonary hypertension take vasodilators, medications that dilate the blood vessels, to control symptoms. The most effective of these, epoprostenol, is also the most complicated to administer, requiring continuous injection into a vein. In these cases, a permanent venous catheter is inserted and the patient wears a small pump 24 hours a day. Other vasodilators can be taken orally in pill form or via a specialized inhaler. The blood thinner warfarin also can increase the lifespan in some people with pulmonary hypertension.

Arrhythmias, abnormal changes in the rhythm of the heartbeat, are not unusual in individuals with congenital heart disease. Arrhythmias may involve the heart beating too fast, too slow, skipping a beat, or adding an extra beat periodically. The symptoms of arrhythmias vary with severity from negligible to sudden death. Most frequently, arrhythmias involve sudden shortness of breath, lightheadedness, or fainting.

Arrhythmias can be lethal; any individual with congenital heart disease who becomes acutely short of breath needs to get an EKG immediately to identify any arrhythmias.