by Neff DM

Hypoplastic Left Heart Syndrome

(HLHS)

Definition

Hypoplastic left heart syndrome is a rare heart defect. In a normal heart, the blood flows in from the body to the right atrium. It then goes into the right ventricle. Next, the blood travels to the lungs through the pulmonary valve. Here, it picks up fresh oxygen. The blood returns to the left atrium and goes into the left ventricle. The blood then moves out to the rest of the body.
With this syndrome, structures on the left side of the heart, which includes the aorta, aortic valve, left ventricle, and mitral valve, may be:
  • Too small
  • Absent
  • Abnormally developed
Since the heart cannot function properly, oxygen-rich blood flow to the body is limited. This condition requires immediate care from a doctor.
Heart Chambers and Valves
heart anatomy
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Blood Flow Through the Heart
IMAGE
Copyright © Nucleus Medical Media, Inc.

Causes

This is a congenital heart defect. This means that the heart forms incorrectly when the baby develops in the womb. The baby is born with the condition. It is not known why the heart forms this way.

Risk Factors

These factors increase your chance of having a child with hypoplastic left heart syndrome:
  • Previous pregnancy with fetal heart abnormalities or fetal loss
  • Family history of congenital heart defect

Symptoms

Symptoms usually appear within days after birth. Tell the doctor if you notice the following in your infant or child:
  • Blue/gray skin color
  • Cool skin
  • Rapid or difficult breathing
  • High heart rate
  • Sweaty, clammy skin
  • Poor feeding

Diagnosis

You will be asked about your child's symptoms and medical history. A physical exam will be done.
Images may be taken of your child's chest. This can be done with:
Other tests may be done to evaluate your child's heart. This can be done with:

Treatment

Talk with your doctor about the best treatment plan for your child. Some defects may be so severe that they are difficult to treat. Treatment options include:

Medications

Medications are necessary to keep blood flowing through the ductus arteriosus. The ductus arteriosus is a connection between the pulmonary artery and the aorta, which is the largest artery in the body. It usually closes within a few days after birth. Keeping this passage open is a temporary treatment. Other medications may be used as well.

Surgery

Surgery may be done to improve blood flow. This can be done through a variety of reconstructive and shunting procedures. Surgeries are usually done in stages:
  • After birth
  • 4-6 months of age
  • 2-4 years of age

Lifelong Monitoring

Your child will need to see a heart specialist regularly. Heart medication will be needed throughout your child's life.

Prevention

There is no way to prevent this condition. Getting proper prenatal care is always important.

RESOURCES

FamilyDoctor.org—American Academy of Family Physicians http://familydoctor.org

American Heart Association http://www.heart.org

CANADIAN RESOURCES

Canadian Cardiovascular Society http://www.ccs.ca

Heart and Stroke Foundation of Canada http://ww2.heartandstroke.ca

References

Hypoplastic left heart syndrome. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/CongenitalHeartDefects/AboutCongenitalHeartDefects/Single-Ventricle-Defects%5FUCM%5F307037%5FArticle.jsp. Updated March 26, 2014. Accessed June 3, 2014.

Hypoplastic left heart syndrome. Children’s Hospital Boston website. Available at: http://www.childrenshospital.org/az/Site502/mainpageS502P0.html. Accessed June 3, 2014.

Hypoplastic left heart syndrome. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated January 20, 2014. Accessed June 3, 2014.

Hypoplastic left heart syndrome. Johns Hopkins University, Cove Point Foundation website. Available at: http://www.pted.org/?id=hypoplasticleft4. Updated May 16, 2011. Accessed June 3, 2014.

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