What is congenital heart disease?
Congenital heart disease is a general term for any defect of the heart, heart valves or central blood vessels that is present at birth.
It can take many forms, such as holes between the pumping chambers of the heart, valves that do not open or close properly and narrowing of major blood vessels such as the aorta and pulmonary artery. Congenital heart disease can range from simple to complex, and more than 1 anomaly can occur in the same heart.
Diagnosis usually occurs within the first month of life. Common symptoms include bluish lips, fingers and toes, breathlessness or trouble breathing, low birth weight, difficulty feeding and gaining weight, and chest pain.
Most congenital heart disease is multifactorial and arises through combinations of genetic and environmental factors. Some of the known risk factors include a family history of congenital heart disease, maternal illnesses such as rubella (German measles), misuse of alcohol, illicit drugs and medications, and maternal health factors such as preeclampsia and poorly controlled diabetes.
The National Strategic Action Plan for Childhood Heart Disease aims to reduce the impact of congenital heart disease and other childhood heart diseases in Australia. It outlines priority areas and actions to help people with Childhood Heart Disease live longer, healthier and more productive lives.
How many Australians have congenital heart disease?
Main types of congenital heart disease
Ventricular septal defect—a hole in the muscle wall between the right and left ventricles.
Atrial septal defect—a hole in the muscle wall between the right and left atria.
Patent ductus arteriosus—where the ductus arteriosus, the connection between the aorta and pulmonary artery, fails to close after birth.
Tetralogy of Fallot—a condition that consists of 4 heart anomalies: ventricular septal defect, a narrowing of the outflow tract into the pulmonary artery, an enlarged aorta and thickening of the muscle wall of the right ventricle.
Transposition of great vessels—a condition that is usually characterised by the aorta arising from the right ventricle and the pulmonary artery from the left ventricle.
Coarctation of the aorta—narrowing of the aorta.
Aortic stenosis—obstruction of the aorta. This can be due to a narrowing of the aorta or a problem with the aortic valve.
Hypoplastic left heart syndrome—where the left ventricle is small and functionally inadequate.
Pulmonary atresia—a condition in which there is no pulmonary valve and no blood flow to the pulmonary artery.
In 2020–21, there were around 5,900 hospitalisations in Australia where congenital heart disease was the principal diagnosis—a rate of 23 hospitalisations per 100,000 population.
Age and sex
In 2020–21, where congenital heart disease was recorded as the principal diagnosis, hospitalisation rates:
- were similar for males and females (age-standardised rates of 25 and 23 hospitalisations per 100,000 population)
- were highest for infant boys and girls (605 and 513 per 100,000 population), followed by boys and girls aged 1–4 (45 and 39 per 100,000 population)
Unlike many other cardiovascular conditions, the number and rate of hospitalisation for congenital heart disease declines with age (Figure 1).
Figure 1: Congenital heart disease hospitalisation rates, principal diagnosis, by age and sex, 2020–21