The incidence may be up to 1% of live births and the mortality is low,becouse is readily preventable trough maternal care.
Causes:
Exposure of the embryo to adverse genetic and intrauterinefactors that interfere with development of the heart.They cause congenital malformation that involve different sites of heart and blood vessels.
Exposure during the first trimester of pregnancy is particularily important,due to rapid embryogenesis during this period:the heart develops between the 3td and 7th week.
1.Genetic factor:chromosomal abnormalities are associated with Down's Syndrome with high incidence of heart disease,specially coartation of aorta.
2.Exposure to adverse intrauterine invironment:
-Viral infection of the pregnant during first trimester(rubella for exemple).Congenital anomalies of viral infection may involve the heart causing persistent ductus arteriosus,aortic stenosis,pulmonarystenosis and others.
-Teratogenic drugs
-Inhalationof chemical pollutanta in air:
-isecticides and cigarette smoke(pasive smoking0-they are teratogenic.
-carbone monoxide,occasionally.
-Cigarette smoking and alcohol consumption during pregnancy.
Manifestations:some cases only are suspected at birth,while the other nonfatal cases are detected later,on heart appraisal(at school entry for exemple).
Prevention:
-family hystory
-genetic examination and counseling
-family planning service
-avoiding exposure to infection
-immunization
-avoid cigarette smoking and passive smoking,alcohol consumption,any drug without medical prescription and supervision,insecticide application at home.
-no exposure to radiation
prevention and control of air pollution.
Management of screened cases:
-surgical repair
-medical care:treatment to manage manifestations and prevent complications.prophylaxis to prevent infective endocarditis if is necessary.
-general measures for case:health promotion,specially adequate nutrition,guidelines for healtful lifestyle.
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