Congenital heart disease are defects affecting the structure and function of the heart, present at birth. The defects may be mild, such as a small hole in the heart, or they may be severe and life-threatening ones whereby an entire structure in the heart is missing. What are the common congenital heart disease symptoms and how can a baby or child be screened for such defects?
When Heart Defects May Start Developing
According to SingHealth, it is possible for the baby’s heart to start developing defects as early as during the first six weeks of pregnancy – this is when the heart develops, starts beating, and major blood vessels also start to develop. However, most congenital heart defects happen as a result of complications during childhood.
Learn More: Congenital Heart Disease In Singapore >>
Congenital Heart Disease Symptoms
Many congenital heart defects do not present any obvious symptoms. However, where the defect is severe, or if there are multiple defects present, symptoms may show. These include:
- A bluish tint to the skin, lips, and fingernails due to low oxygen levels in the blood.
- Infants with CHD may breathe quickly, even when at rest.
- Difficulty in feeding and inadequate weight gain for infants.
- Older children may experience fatigue and shortness of breath, especially during physical activities.
- Swelling in the legs, abdomen, or areas around the eyes can occur due to poor blood circulation.
- Heart Murmurs, arrhythmias or irregular heartbeats.
- Infants and children with CHD may appear unusually sleepy or lethargic.
Congenital Heart Defects Screening & Diagnosis
Congenital Heart Disease Detection During Pregnancy
Foetal Echocardiography
The signs of congenital heart disease may detected during a routine ultrasound scan of the baby in the womb. In such situations, the doctor may perform a foetal echocardiography (a specialised form of ultrasound scan to study the foetus’ heart), around the 18th to 22nd week of the pregnancy to try to confirm the diagnosis.
A foetal echocardiography may also be ordered when there are risk factors such as a family history of congenital heart disease.
However, foetal echocardiography may sometimes fail to detect a heart defect, especially if it is mild.
Diagnosis Of CHD After Birth
Babies’ hearts are checked as part the newborn physical examinations. During these examinations, the doctor may detect heart murmurs. Congenital heart disease symptom may also be noticed by the doctor.
Should CHD be suspected, the doctor may order further tests to diagnose congenital heart disease.
Echocardiography
Heart defects that were missed during foetal echocardiography may be more readily detectable as the child develops.
Electrocardiogram
An electrocardiogram (ECG) measures the heart’s electrical activity and shows how well the heart is beating.
Chest X-ray
A chest X-ray of the heart and lungs can show whether there is excessive blood in the lungs, or if the size of the heart is abnormal.
Pulse Oximetry
Pulse oximetry measures the amount of oxygen present in the blood using a special sensor placed on the fingertip.
Cardiac Catheterisation
A cardiac catheterisation is a procedure whereby a small, flexible tube is inserted into a blood vessel. This tube (i.e. catheter) is moved into the heart, guided sometimes by an MRI scanner, and takes pressure measurements in different parts of the heart (or lungs).
An angiogram may also be carried out by injecting a coloured dye through the catheter. The flow of the dye through the heart allows the shape and function of each heart chamber, vessels and the lung to be examined.
Learn More: Medical Imaging >>
Estimated Costs Of Congenital heart Disease Screening And Diagnosis In Singapore
The estimated costs of the various diagnostic imaging for congenital heart disease detection are:
| Name Of Congenital Heart Disease Test | Estimated Cost In Singapore* (Costs are estimates compiled from various sources as of Sep 2024, and may vary over time) |
| Foetal Echocardiogram | S$200 – S$300 |
| Echocardiogram | S$400 – S$600 |
| Electrocardiogram (ECG) | S$35 – S$60 |
| Chest X-ray | S$40 – S$50 |
| Cardiac Catheterisation | $2,200 – $4,300 (Subsidised, public hospital) ; S$11,000 – S$17,000 (Private hospital) |
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This article is informative only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment, and should never be relied upon for specific medical advice.
