Description

Truncus arteriosus (TRUNG-kus ahr-teer-e-O-sus) is a rare disease of the heart present at birth. That means that it is a congenital defect of the heart. In this condition, a large blood vessel leaving the heart, in place of two.

Only have a large blood vessel, means that the oxygen-poor and oxygen-rich blood from mixing. This mixture reduces the amount of oxygen supplied to the body. Normally increases the amount of blood flow in the lungs. The heart has to work harder to adjust to the changes in the blood flow.

A baby, also called a fetus, with truncus arteriosus also usually has a hole between the two lower chambers of the heart (the ventricles). The hole is called a ventricular septal defect.

Another name for the truncus arteriosus the common arterial trunk.

Symptoms

Symptoms of truncus arteriosus is most often occur in the first days of life. They include:

  • The blue or the grey of the skin due to low oxygen levels.
  • Extreme drowsiness.
  • A bad diet.
  • Poor growth.
  • A strong heartbeat.
  • The rapid breathing.
  • Shortness of breath.

When to see a doctor

If you are concerned about your baby, feeding, sleep patterns, or growth, contact a health professional for an appointment.

Always seek emergency medical attention if a baby has any of the following:

  • Blue or gray skin.
  • The rapid breathing.
  • Shallow breathing.
  • Any difficulty breathing.

Causes

The truncus arteriosus occurs as the heart of a baby during pregnancy. There are often no clear cause. The genetic and environmental factors may play a role.

How the heart works

To understand more about the truncus arteriosus, may be useful to know how the heart works normally.

The typical heart has four chambers. They are:

  • The right upper chamber, also called the right atrium. This chamber of the heart receives oxygen-poor blood from the body.
  • The right lower chamber, also called the right ventricle. This chamber of the heart pumps blood into the lungs through a large vessel called the pulmonary artery. The blood flows through the pulmonary artery in small blood vessels in the lungs, where the blood picks up oxygen.
  • The top left of the camera, also called the left atrium. This chamber of the heart receives oxygen-rich blood from the lungs through blood vessels called pulmonary veins.
  • The left lower chamber, also called the left ventricle. This chamber pumps blood rich in oxygen to the body through the body's largest blood vessel called the aorta.

A baby's heart before birth

The way in which the unborn baby's heart forms during pregnancy is complex. At some point, there is not a single large blood vessel that exits the heart. The ship is called the truncus arteriosus. It is usually divided into two as the baby grows in the womb. One part becomes the lower end of the body's main artery, called the aorta. The other part becomes the lower part of the pulmonary artery.

But in some babies, the truncus arteriosus is never divided. The wall separating the two lower chambers of the heart has not been closed. This results in a large hole between the chambers, called a ventricular septal defect.

Babies with truncus arteriosus also often have a problem with the heart valve that controls the flow of blood from the lower chambers of the heart to the only ship. This valve does not close all the way when the heart relaxes. The blood can move the wrong way, back into the heart. This is called a truncal valve regurgitation.

Risk factors

The exact cause of the truncus arteriosus is unknown. But there are some things that may increase the risk of a heart problem at birth. The risk factors include:

  • Viral disease during pregnancy. Some infections can harm a developing baby. For example, after the rubella during pregnancy can cause changes in a baby's heart development. German measles, also called rubeola.
  • Poorly controlled diabetes during pregnancy. A careful control of your blood sugar before and during pregnancy can reduce the risk of heart problems for your baby. If you have diabetes, talk with your health care professional to make sure that the blood sugar is well controlled before you become pregnant.
  • Some medicines taken during pregnancy. Some medications can cause heart problems and other health conditions in a baby. Tell your healthcare provider about all the medicines you are taking, including those bought without a prescription.
  • Some chromosomal disorders. An extra or irregular chromosome increases the risk of truncus arteriosus. Examples are the DiGeorge syndrome, also called 22q11.2 deletion syndrome, and velocardiofacial syndrome.
  • Smoking during pregnancy. If you smoke, stop smoking. Smoking during pregnancy increases the risk of heart disease in your baby.
  • The consumption of Alcohol. Drinking alcohol during pregnancy increases the risk of heart disease and other health problems in a baby.
  • Obesity. Obesity increases the risk of giving birth to a baby with a heart condition.

Complications

The truncus arteriosus, it causes serious issues with the way blood flows through the lungs, the heart and the rest of the body.

Complications of truncus arteriosus in babies include:

  • Breathing problems. The excess fluid and blood in the lungs can make it hard to breathe.
  • High blood pressure in the lungs, also called pulmonary hypertension. This condition causes the blood vessels in the lungs to narrow. It makes it difficult for the heart to pump blood to the lungs.
  • Enlargement of the heart. Pulmonary hypertension and increased blood flow to the strain of the heart. The heart must work harder to pump blood. This causes the heart muscle to make it larger. Enlargement of the heart gradually weakens.
  • Heart failure. In this condition, the heart cannot supply enough blood to the body. Very little oxygen and the excess strain on the heart can lead to heart failure.

The babies who had their hearts set successfully fixed with surgery can have complications later in life. The possible complications are:

  • Pulmonary hypertension worsens.
  • Retrograde flow of the blood through a valve of the heart, called regurgitation.
  • Irregular heartbeats, called arrhythmias.

The common symptoms of these complications include:

  • The dizziness.
  • It feels very fast, fluttering heartbeat.
  • Feeling very tired.
  • Shortness of breath with exercise.
  • Swelling of the abdomen, legs or feet.

The truncus arteriosus in adults

In rare cases, some people are born with truncus arteriosus can survive without a heart surgery. They can live up to adulthood. But with the condition that is almost guaranteed to have heart failure and to develop a complication called Eisenmenger syndrome. This syndrome is caused by a permanent lung damage to the vessels. This results in a significant lack of blood flow to the lungs.

Prevention

Because the cause is not clear, it may not be possible to prevent the truncus arteriosus. Get good prenatal care is important. If you or someone in your family has had a heart condition present from birth, talk with your health care professional before you get pregnant. You might need to consult a geneticist and medical center, called a cardiologist.

If you decide to get pregnant, taking these steps can help keep your baby healthy:

  • Vaccination is recommended. Some infections can be detrimental to the development of your baby. For example, you have German measles — also called the rubella during pregnancy can cause changes in a baby's heart development. A blood test before pregnancy can show you if you are immune to rubella. A vaccine is available for those who are not immune.
  • Talk with your health care professional about your medications. Consult with your healthcare professional before taking any medicine if you are pregnant or thinking about becoming pregnant. Many medications are not recommended for use during pregnancy because it can harm a developing baby.
  • Take a folic acid supplement. Take a multivitamin with folic acid. Take 400 micrograms of folic acid daily has been shown to reduce the brain and spinal cord conditions in babies. You can help reduce the risk of heart disease present at birth.
  • The Control of diabetes. If you have diabetes, ask your healthcare professional how best to manage the disease during pregnancy.

Diagnosis

Truncus arteriosus is generally diagnosed shortly after a child is born. The baby can look blue or gray and has difficulty breathing.

When a baby is born, a health professional always listening to the baby's lungs to check for breathing. If a baby has truncus arteriosus, the health care provider may hear of fluid in the lungs during this test. The health professional also hear the baby's heart to check for irregular heart beats, or a "whooping" sound is called a murmur.

Tests

The tests to diagnose the truncus arteriosus include:

  • Pulse oximetry. A sensor that is placed at the tip of the fingers of the records of the amount of oxygen in the blood. Very little oxygen can be a sign of a heart or lung problem.
  • X-ray of the chest. This test shows the condition of the heart and the lungs. It can show the size of the heart. A chest x-ray may also determine whether the lungs of extra fluid.
  • The echocardiogram. An echocardiogram uses sound waves to create images of the beating heart. This is the main test to diagnose the truncus arteriosus. Shows the flow of blood through the heart and the heart valves. In a baby with truncus arteriosus, the test shows that a single large vessel that exits the heart. There is typically a hole in the wall between the lower chambers of the heart.

Treatment

Babies with truncus arteriosus need of surgery to improve the blood flow and oxygen levels. Many of the procedures or surgeries may be needed, especially as the child grows. Medicines may be given before surgery to help improve the health of the heart.

Children and adults with surgically repaired truncus arteriosus need of regular health examinations for life.

Drugs

Some of the drugs that could be given in advance of the truncus arteriosus surgery include:

  • Water pills. Also called water pills, these medications help the kidneys remove excess fluid from the body. The fluid accumulation is a common symptom of heart failure.
  • Positive inotropes. These medications help the heart to pump harder, which improves the flow of blood. They also help to control the blood pressure. Positive inotropes may be administered INTRAVENOUSLY to treat severe heart failure symptoms.

Surgery or other procedures

The majority of babies with truncus arteriosus to have surgery within the first few weeks after birth. The type of surgery depends on the condition of the baby. Normally, the baby surgeon:

  • Reconstructs the only large vessel and the aorta to create a new one, full of the aorta.
  • Separates the upper part of the pulmonary artery of the great vessels.
  • Use a patch to close the hole between the two lower chambers of the heart.
  • A tube and a valve to connect the right lower chamber of the heart with the top of the pulmonary artery. This creates a new, full of the pulmonary artery.

The tube that is used to create the new pulmonary artery does not grow with the child. Follow-up surgeries are required to replace the tube as the child grows.

Future surgeries can be done with a flexible tube called a catheter. This avoids the need for open-heart surgery. The health care provider inserts the catheter into a blood vessel in the groin and the guide for the heart. A new valve can be delivered through the catheter to the appropriate area.

Sometimes a small balloon at the tip of the catheter is inflated at the site of the obstruction, making it a blocked artery wider. This procedure is called balloon angioplasty.

After surgery to the truncus arteriosus, a person will need lifelong follow-up care with a medical center specialized in congenital diseases. This type of health care provider that is called a congenital cardiologist.

Lifestyle and home remedies

If you or your child had truncus arteriosus, your health care professional may recommend that you take a couple of steps to protect the heart.

  • Exercise limits. Some people with heart disease need to limit the exercise and sporting activities, especially in competitive sports. Ask your health care professional sports and types of exercise are safe for you or your child. People with Eisenmenger syndrome should avoid strenuous physical activity.
  • Antibiotics. Sometimes, heart disease can increase the risk of infection in the lining of the heart or of the heart valves. This infection is called infective endocarditis. Antibiotics may be recommended to prevent infections before dental procedures and other surgeries. It is also important to have good oral hygiene and regular dental check-ups
  • Pregnancy.If you have had truncus arteriosus repair surgery and you want to become pregnant, talk with your health care professional in the first place. Ask about the possible risks and complications. It is better to be checked by a health professional with training in adult congenital heart disease and high-risk pregnancies. Together, you and your care team can discuss and plan any special care needed during pregnancy. Depending on the level of lung damage that occurred before the truncus arteriosus surgery, pregnancy may or may not be recommended. Pregnancy is considered very high risk for those with Eisenmenger syndrome, and is not recommended.

Pregnancy. If you have had truncus arteriosus repair surgery and you want to become pregnant, talk with your health care professional in the first place. Ask about the possible risks and complications. It is better to be checked by a health professional with training in adult congenital heart disease and high-risk pregnancies. Together, you and your care team can discuss and plan any special care needed during pregnancy.

Depending on the level of lung damage that occurred before the truncus arteriosus surgery, pregnancy may or may not be recommended. Pregnancy is considered very high risk for those with Eisenmenger syndrome, and is not recommended.

Coping and support

Caring for a baby with a heart condition such as truncus arteriosus, it can be a challenge. Here are some strategies that may be useful.

  • Seek support. Request the assistance of family members and friends. Connect with others in support groups can help you manage stress. Contact with non-profit organizations, such as the American Heart Association.
  • Keep track of your baby's health history.Details are included on the diagnosis, medications, surgeries, and other procedures. Note: the dates for the surgeries and procedures. Include the dose of the drug. List any professional of the health professionals ' names and phone numbers. If possible, get a copy of the medical reports. This information helps to remember that they provided care. It is also useful for health professionals who are not familiar with your child's health history.
  • Talk about your concerns. You might worry about the risks of strenuous activity, especially after the heart of the repair surgery. Ask your child's medical center, called a pediatric cardiologist, what activities are safe for your child.

Keep track of your baby's health history. Details are included on the diagnosis, medications, surgeries, and other procedures. Note: the dates for the surgeries and procedures. Include the dose of the drug. List any professional of the health professionals ' names and phone numbers.

If possible, get a copy of the medical reports. This information helps to remember that they provided care. It is also useful for health professionals who are not familiar with your child's health history.

Preparing for your appointment

What you can do

If possible, ask the members of your family about your medical history. Heart problems at birth can be passed down through the families. So it is very useful to know if someone in your family has a history of the first problems of the heart.

Also make a list of questions to ask your baby's healthcare professional. The preparation of this checklist can help you and your healthcare team make the most of your time together. Here are some questions you might ask:

  • What tests are needed?
  • What are the treatment options?
  • What are the possible side effects or complications of treatment?
  • How can we verify that there are no complications?
  • What is the long-term prognosis for my child?
  • My baby has other health conditions. How do we best manage them together?
  • If I have another baby in the future, what are the chances of this happening again?
  • Are there brochures or other printed material I can have? What sites do you recommend?

Do not hesitate to ask other questions.

What to expect from your doctor

Your child's health care professional usually makes the following questions:

  • Does your baby every time they look blue or gray?
  • How long are the hours of food?
  • How much does your baby drink?
  • How often and how much time does your baby sleep?
  • How is your baby responds to touches?
  • Does your child ever to breathe fast?
Symptoms and treatment of Truncus arteriosus