heart conditions

Has Your Heart Ever “Skipped a Beat”? It Was Probably a Premature Contraction

Heart AtriumThe heart is made up of two upper chambers (atria) and two lower chambers (ventricles). In a normal heartbeat, an electrical impulse originates from an area in the right atrium called the sinus node. This impulse travels first to the atria, causing them to contract and pump blood into the ventricles. The electrical impulse then continues along its circuit to the ventricles, signaling them to contract and pump blood out to the lungs and the body.

Sometimes, abnormal electrical signals originate from areas of the heart other than the sinus node. These extra impulses may target the atria or the ventricles, causing them to contract out of rhythm with the regular heartbeat. This type of arrhythmia is called a premature contraction.

Premature contractions are common and may even go unnoticed. However, some people report a feeling of the heart skipping a beat, often followed by a stronger-than-usual beat. The pause is actually the heart waiting for the regular rhythm to resume. Following the pause, the normal contraction is often stronger than usual due to the presence of a greater volume of blood in the chambers.

Premature contractions may occur for a number of reasons, including an imbalance of electrolytes in the body, certain medications, alcohol or drug use, or increased adrenaline, for instance from exercise or anxiety or the consumption of caffeine or tobacco. Rarely, premature contractions are an indication of an underlying heart condition, such as congenital heart disease, heart failure or scarring of the heart muscle.

In most cases, premature contractions do not require treatment. However, if the symptoms are bothersome or the contractions may exacerbate underlying heart conditions, premature contractions may be treated with medications such as beta-blockers, calcium channel blockers or antiarrhythmics. Your doctor may also instruct you to avoid things that can trigger the contractions, such as caffeine, alcohol or stressful situations.

If lifestyle changes and medications are not effective in reducing or eliminating the premature contractions, your doctor may use cardiac ablation to treat them instead. During an ablation procedure, one or more thin, flexible tubes are guided with X-rays into blood vessels and directed to the heart muscle. Then radiofrequency energy is delivered to destroy very tiny areas of tissue that give rise to abnormal electrical signals.

Emory Healthcare recently launched new screening centers across the Atlanta area to help diagnosis abnormal heart rhythms. If you experience symptoms of premature contractions or any other abnormal heart rhythm, you can visit one of our new screening locations to determine if your condition is serious. In addition to screenings, the new clinics offer state-of-the-art care by some of the country’s leading arrhythmia experts. Clinics in Villa Rica, Conyers and Johns Creek are already operating, and a fourth location in Decatur will open later this summer.

About Dr. Merchant

Faisal Merchant, MDFaisal Merchant, MD , is an assistant professor of medicine who practices primarily at Emory University Hospital Midtown. He received his medical degree from Duke University, completed internal medicine and general cardiology training at Massachusetts General Hospital in Boston and a cardiac electrophysiology fellowship at Emory. He specializes in cardiac electrophysiology and treats all forms of arrhythmias, including pacemaker and defibrillator implantation and catheter ablation.

About Emory’s Arrhythmia Center

Emory’s Arrhythmia Center is one of the most comprehensive and innovative clinics for heart rhythm disorders in the country. Our electrophysiologists have been pioneers in shaping treatment options for patients with arrhythmias such as atrial fibrillation, as well as for those with congestive heart disease. Our specialized electrophysiology (EP) labs host state-of-the-art equipment, including computerized three-dimensional mapping systems to assist with the ablation of complex arrhythmias, and an excimer laser system to perform pacemaker and defibrillator lead extractions.

Patients with devices, whether implanted at Emory or elsewhere, have access to Emory’s comprehensive follow-up care. Patients benefit from remote monitoring, quarterly atrial fibrillation support groups and 24-hour implantable cardiac device (ICD) and pacemaker monitoring services. Inpatient telemetry and coronary care units, as well as outpatient care and educational support of patients with pacemakers and ICDs, complete Emory’s comprehensive range of arrhythmia treatments and services.

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What Is Atrial Flutter?

Atrial FlutterAtrial flutter, also called “heart flutter,” is a type of arrhythmia that occurs when the upper two chambers of the heart (the atria) contract too rapidly. The first contraction in a normal heartbeat occurs in the atria. This contraction pumps the blood into the lower chambers of the heart, called the ventricles. The second contraction occurs in the ventricles and serves to pump blood out of the heart.

In atrial flutter, the atria contract at an abnormally fast rate, but only about half of these contractions are followed by the second ventricular contraction. This causes the heart to work inefficiently and may result in poor blood supply to the body, including the brain and the heart muscle itself. If the heart and brain do not receive enough blood, organ failure can occur in the form of congestive heart disease, heart attack or stroke.

Atrial flutter can occur on its own, but often occurs in people with other conditions, including atrial fibrillation , heart failure, congenital heart defects, high blood pressure, diabetes, thyroid conditions, heart valve conditions and chronic lung disease. The risk of atrial flutter also increases following serious illness, an episode of heavy drinking, surgery or a heart attack. Symptoms may include heart palpitations (rapid, noticeable heartbeats), dizziness, shortness of breath, lightheadedness and chest pain (angina).

A simple, non-invasive test called an electrocardiogram (ECG) that measures the electrical impulses in the heart can be used to diagnose atrial flutter and other arrhythmias. Upon diagnosis, the doctor will determine the best way to control the rapid heartbeat. If there are serious symptoms, this might be accomplished with IV medications or cardioversion (electrical shock to interrupt the arrhythmia and restore a normal heartbeat). Oral medication is more common if there are not serious symptoms. Because atrial flutter can increase the risk of stroke, many people are also prescribed a blood thinner.

If you believe you are experiencing atrial flutter, it is important to seek emergency care. In addition, follow-up care with a physician that specializes in arrhythmias is also important. Emory’s arrhythmia treatment program is one of the most comprehensive and innovative clinics for heart rhythm disorders in the country. Our physicians have been pioneers in shaping treatment options for patients with arrhythmias. Our Arrhythmia Center offers screening, treatment and heart rhythm management services at locations across Atlanta .

About Dr. Merchant

Faisal Merchant, MDFaisal Merchant, MD , is an assistant professor of medicine who practices primarily at Emory University Hospital Midtown. He received his medical degree from Duke University, completed internal medicine and general cardiology training at Massachusetts General Hospital in Boston and a cardiac electrophysiology fellowship at Emory. He specializes in cardiac electrophysiology and treats all forms of arrhythmias, including pacemaker and defibrillator implantation and catheter ablation.

About Emory’s Arrhythmia Center

Emory’s Arrhythmia Center is one of the most comprehensive and innovative clinics for heart rhythm disorders in the country. Our electrophysiologists have been pioneers in shaping treatment options for patients with arrhythmias such as atrial fibrillation, as well as for those with congestive heart disease. Our specialized electrophysiology (EP) labs host state-of-the-art equipment, including computerized three-dimensional mapping systems to assist with the ablation of complex arrhythmias, and an excimer laser system to perform pacemaker and defibrillator lead extractions.

Patients with devices, whether implanted at Emory or elsewhere, have access to Emory’s comprehensive follow-up care. Patients benefit from remote monitoring, quarterly atrial fibrillation support groups and 24-hour implantable cardiac device (ICD) and pacemaker monitoring services. Inpatient telemetry and coronary care units, as well as outpatient care and educational support of patients with pacemakers and ICDs, complete Emory’s comprehensive range of arrhythmia treatments and services.

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What Causes Congenital Heart Disease?

Congenital heartCongenital heart defects (CHDs) are the most common type of birth defect, affecting about 1% of infants born in the United States. While doctors can sometimes pinpoint the likely cause of a particular defect, most of the time the cause is uncertain.

Most CHDs are the isolated type, meaning that they occur alone without other birth defects. In most isolated CHDs, the cause cannot be determined and is generally assumed to be a combination of genetic (inherited) and environmental factors.

There are a number of genetic birth defects that often occur together with CHDs, including Down syndrome, Turner syndrome, Marfan syndrome and Williams syndrome. In these cases, a defect in the infant’s DNA causes the heart to develop improperly. For instance, about half of babies born with Down syndrome also have a CHD, most often a defect in the wall between the left and right sides of the heart (atrioventricular septal defect).

A mother’s exposure to certain substances during pregnancy can increase the risk for CHDs. Some medications increase risk, including certain acne and seizure medications. Environmental exposures can be more difficult to pinpoint but may contribute as well. A mother ingesting too much alcohol during pregnancy can also increase the risk of her infant being born with a heart defect.

In addition to environmental exposures, some health issues in pregnant women can play a role in increasing the risk for CHDs. These include infections such as rubella, as well as chronic conditions that are not under control, such as diabetes and lupus.

The Congenital Heart Center of Georgia was created to bridge the gap between pediatric and adult care for people with CHDs. If you were born with a CHD and haven’t been evaluated regularly by a cardiologist, you were recently diagnosed with a CHD or you have a child who will be transitioning into adult care in the near future, learn more about the Congenital Heart Center of Georgia and make an appointment today.

About Dr. Rodriguez

Fred Rodriguez, MDFred Rodriguez, MD, is a pediatric cardiologist who practices pediatric cardiology at the Children’s Healthcare of Atlanta Sibley Heart Center and adult congenital heart disease at the Emory Clinic and Emory University Hospital. Dr. Rodriguez earned his medical degree from the Louisiana State University at New Orleans School of Medicine, where he also completed his combined residency in both internal medicine and pediatrics. Following his residency, he completed a cardiology fellowship at Texas Children’s Hospital in Houston, with additional training in adult congenital heart disease. He is board certified in pediatrics, pediatric cardiology and internal medicine.

About the Congenital Heart Center of Georgia

The Congenital Heart Center of Georgia is a collaboration between Children’s Healthcare of Atlanta and Emory Healthcare. The Congenital Heart Center of Georgia is a comprehensive program for children and adults with congenital heart disease (CHD) that provides a continuum of lifesaving care from before birth through adulthood. It is the first comprehensive CHD program in the South and one of the largest in the country. The program is led by Emory Healthcare cardiologist Wendy Book, MD, along with Robert Campbell, MD, chief of cardiac services and director of cardiology at Children’s Sibley Heart Center. To schedule an appointment, please call 404-778-7777.

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What Is Arrhythmia?

arrhythmiaAn arrhythmia refers to an abnormal pattern or rate of the heartbeat. Arrhythmias can include heartbeats that are too fast, too slow or irregular, as is the case with atrial fibrillation , the most common arrhythmia in the United States that requires medical attention.

The normal rhythm of the heart is a tightly regulated but dynamic electrical phenomenon that changes according to the needs of the body. The heart has built-in pacemakers and “wiring” that coordinate contractions in the organ’s upper chambers (the atria) and lower chambers (the ventricles). Glitches in this complicated electrical system can cause the heart to “misfire.”

Everyone has felt their heart “skip” a beat or two or speed up in times of fear or excitement or during exercise. Too much caffeine and certain medications can also cause heart palpitations (rapid thumping in the chest) in some people. These types of arrhythmias are generally harmless.

If irregular heartbeats are frequent or chronic, they can be serious. The consequences of having an arrhythmia usually depend not only on symptoms they can cause (such as faintness), but also on the presence of heart disease or structural abnormalities. In serious cases, the heart may not be able to pump enough blood to the body. Lack of blood flow can damage the brain, heart and other organs.

Common symptoms of arrhythmia include:

  • Shortness of breath
  • Chest pain
  • Palpitations
  • Feeling tired or light-headed
  • Passing out

Call your doctor if you have any of these symptoms of arrhythmia, especially if you have heart disease or have had a heart attack.

If you have experienced an irregular heartbeat, palpitations, a racing heartbeat or other heart irregularities, we recommend that you schedule an appointment with a specialty-trained Emory Healthcare Nurse Practitioner who will begin a comprehensive screening evaluation to determine whether you need follow-up care with an Emory Electrophysiologist. Call 404-778-7777 to schedule your screening appointment. You can also learn more about the Emory Arrhythmia Center online .

About Dr. Lloyd

Michael Lloyd, MDMichael Lloyd, MD , began practicing medicine at Emory in 2007. He specializes in cardiology and cardiac electrophysiology. His areas of clinical interest and research include arrhythmias in athletes, arrhythmias in young adults with congenital heart disease, atrial fibrillation and implantable devices for the treatment of heart failure. Dr. Lloyd is the program director for the Cardiac Electrophysiology Fellowship Program at Emory and holds organizational leadership positions with the American College of Cardiology, the American Heart Association and the Heart Rhythm Society.

About Emory’s Arrhythmia Center

Emory’s Arrhythmia Center is one of the most comprehensive and innovative clinics for heart rhythm disorders in the country. Our electrophysiologists have been pioneers in shaping treatment options for patients with arrhythmias such as atrial fibrillation, as well as for those with congestive heart disease. Our specialized electrophysiology (EP) labs host state-of-the-art equipment, including computerized three-dimensional mapping systems to assist with the ablation of complex arrhythmias, and an excimer laser system to perform pacemaker and defibrillator lead extractions.

Patients with devices, whether implanted at Emory or elsewhere, have access to Emory’s comprehensive follow-up care. Patients benefit from remote monitoring, quarterly atrial fibrillation support groups and 24-hour implantable cardiac device (ICD) and pacemaker monitoring services. Inpatient telemetry and coronary care units, as well as outpatient care and educational support of patients with pacemakers and ICDs, complete Emory’s comprehensive range of arrhythmia treatments and services.

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How Does Heart Disease Present Differently in Women?

Women's Heart DiseaseHeart disease is the leading cause of death in both men and women in the United States, but it can manifest differently in women. In addition, certain types of heart disease affect women more often than men.

The most common type of heart disease is coronary artery disease (CAD). This occurs as a result of plaque buildup in the arteries (atherosclerosis) causing a decrease in blood flow to the heart muscle. It is well known that women may experience different symptoms of CAD than men. One of the most common symptoms is chest pain, also known as angina, which occurs when the heart does not receive enough oxygen-rich blood. In men, angina tends to manifest as a pressure or squeezing sensation in the chest. Although women also have chest pain, they are more likely to have atypical symptoms such as indigestion, shortness of breath or pain in the neck, jaw, stomach or back.

Coronary microvascular disease (MVD) is similar to CAD in that it affects the blood supply to the heart muscle. Instead of the major coronary arteries being blocked by significant plaque, in MVD there is spasm of the smaller arteries of the heart. This disorder affects women in greater numbers than men. Risk factors for coronary MVD are similar to those for CAD, such as high blood pressure, diabetes, smoking and high cholesterol. As with CAD, angina is the most common symptom. However, in MVD, the angina tends to occur during normal daily activities and at times of mental stress.

Broken heart syndrome is another type of heart disease that is more common in women. Broken heart syndrome is also known as stress-induced cardiomyopathy or takotsubo cardiomyopathy and is characterized by chest pain and shortness of breath. Although, the symptoms are similar to a heart attack, stress-induced cardiomyopathy is not associated with significantly blocked coronary arteries. As the name implies, this syndrome develops as a result of extreme emotional or physical stress. Most individuals completely recover within a short amount of time with appropriate treatment.

Because heart disease often affects women differently than men, Emory created the Women’s Heart Center, a unique program dedicated to diagnosis, screening, treatment and prevention of heart disease in women. The Emory Women’s Heart Center physicians understand these differences and have specialized education and expertise in this area.

About Dr. Isiadinso

Ijeoma Isiadinso, MDIjeoma Isiadinso, MD, MPH, is an assistant professor of medicine at Emory University School of Medicine. Dr. Isiadinso completed her undergraduate studies at Binghamton University in New York, majoring in biology and sociology. She then pursued a joint degree in medicine and public health at MCP Hahnemann (Drexel University) School of Medicine. Dr. Isiadinso completed a residency in internal medicine and a fellowship in cardiology at Temple University Hospital in Philadelphia. She served as chief fellow during the final year of her cardiology fellowship.

Her commitment to public health has led to her involvement in several projects focused on heart disease and diabetes. She has participated in research projects with the Philadelphia Department of Public Health and the Centers for Disease Control and Prevention (CDC). She has been the recipient of numerous awards and presented her work at national conferences. Her research interests include inequalities in health care, community and preventive health, lipid disorders, women and heart disease, and program development and evaluation.

Dr. Isiadinso has served as the health advisor to nonprofit organizations. She has participated in panel discussions at high schools and universities and with the Black Entertainment Television Foundation.

Dr. Isiadinso is board certified in internal medicine, cardiovascular diseases, nuclear cardiology, echocardiography and cardiovascular computed tomography. She is a member of several professional organizations, including the Association of Black Cardiologists, the American College of Cardiology, the American Society of Preventive Cardiology and the American Public Health Association.

About the Emory Women’s Heart Center

Emory Women’s Heart Center is a unique program dedicated to screening for, preventing and treating heart disease in women. The Center, led by nationally renowned cardiologist Gina Lundberg, MD, provides comprehensive cardiac risk assessments and screenings for patients at risk for heart disease, as well as a full range of treatment options for women already diagnosed with heart disease. Call 404-778-7777 to schedule a comprehensive cardiac screening and find out if you are at risk for heart disease.

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Emory Opens Heart Rhythm Clinics to Treat Growing Problem

arrhythmia screening centerEmory Healthcare is launching new screening centers across the Atlanta area to help diagnosis abnormal heart rhythms, or arrhythmias. An arrhythmia is a disorder of the heart that occurs when the body’s electrical impulses, which direct and regulate heartbeats, do not function properly and cause the heart to beat slowly (bradyarrhythmias), rapidly (tachyarrhythmias) or in an uncoordinated manner.

The new clinics will offer screening and, if needed, state-of-the-art care by some of the country’s leading arrhythmia experts. Clinics in Villa Rica, Conyers and Johns Creek are already operating, and a fourth location in Decatur will open later this summer.

Emory has been a pioneer in shaping arrhythmia treatment options, serving as primary and principal investigators for many national clinical trials. We rank among the world’s leaders in cardiac resynchronization therapy and have performed more cardiac ablation procedures than anyone in the Southeast.

According to the American Heart Association, atrial fibrillation (A-fib) is the most common chronic cardiac dysrhythmia and affects nearly 2.3 million people in the United States. The prevalence of arrhythmias is age-related and is expected to rise substantially as the baby boomer population continues to age.

Emory has one of the most wide-ranging and innovative treatment programs for heart rhythm disorders in the United States. Anyone who is experiencing palpitations, heart racing or other rhythm symptoms can visit one of our new screening locations to determine if their condition is serious and requires treatment by a specialist.

To learn more about arrhythmia screening, treatment and heart rhythm management services at Emory, please visit emoryhealthcare.org/arrhythmia.

About Dr. Hoskins

Michael Hoskins, MDMichael Hoskins, MD , is an assistant professor of medicine and electrophysiologist who practices primarily at Emory University Hospital. Dr. Hoskins received his medical degree from the Medical College of Wisconsin in Milwaukee, after which he completed his residency in internal medicine at Emory. He was chief resident in Internal Medicine from 2005 to 2006. He then completed fellowships in cardiology and electrophysiology, also at Emory, and has been practicing here since 2010.

About Emory’s Arrhythmia Center

Emory’s Arrhythmia Center is one of the most comprehensive and innovative clinics for heart rhythm disorders in the country. Our electrophysiologists have been pioneers in shaping treatment options for patients with arrhythmias such as atrial fibrillation, as well as for those with congestive heart disease. Our specialized electrophysiology (EP) labs host state-of-the-art equipment, including computerized three-dimensional mapping systems to assist with the ablation of complex arrhythmias, and an excimer laser system to perform pacemaker and defibrillator lead extractions.

Patients with devices, whether implanted at Emory or elsewhere, have access to Emory’s comprehensive follow-up care. Patients benefit from remote monitoring, quarterly atrial fibrillation support groups and 24-hour implantable cardiac device (ICD) and pacemaker monitoring services. Inpatient telemetry and coronary care units, as well as outpatient care and educational support of patients with pacemakers and ICDs, complete Emory’s comprehensive range of arrhythmia treatments and services.

Related Links

What Is Atrial Fibrillation (A-Fib)?

Atrial FibrillationAtrial fibrillation is the most common irregular heart rhythm in the United States. According to the American Heart Association, about two million Americans suffer from atrial fibrillation. This irregular heart rhythm occurs when multiple circuits of disorganized electrical activity in the top chambers of the heart (the atria) replace the organized electrical activity that is normally generated by the heart. The result is “quivering” (or “fibrillation”) of the atria instead of regular heartbeats.

Although not directly life threatening, atrial fibrillation often produces a fast, irregular and ineffective heart rhythm that can cause a variety of symptoms, including chest pain, decreased blood pressure, weakness, lightheadedness and shortness of breath.

There are many conditions that can cause atrial fibrillation. The most common include:

  • Hypertension (high blood pressure)
  • Coronary artery disease (CAD)
  • Heart valve disease
  • Heart surgery
  • Chronic lung disease
  • Heart failure
  • Cardiomyopathy
  • Congenital heart disease
  • Pulmonary embolism
  • Alcohol use

Recently, it has been discovered that high-level athletes competing in endurance sports are at higher risk of developing this condition. Of note, the risk of atrial fibrillation increases with age, particularly after age 60. However, in at least 10% of cases, atrial fibrillation occurs without any identifiable cause or risk factor. This is called “lone atrial fibrillation” and can be successfully treated in many cases.

Atrial fibrillation was once thought to be a harmless condition, but we now know that it can contribute to additional heart problems over time, including stroke and heart failure. Only a few years ago, people suffering from this common heart arrhythmia were told they would probably have to live with the problem. Today, however, an increasing number of people with atrial fibrillation can be treated and cured, thanks to innovative therapies and procedures such as cardiac ablation, available through the Emory Heart & Vascular Center’s Atrial Fibrillation Program.

With sites at Emory University Hospital, Emory University Hospital Midtown and Emory Saint Joseph’s Hospital, Emory’s Heart & Vascular Center has one of the few truly comprehensive atrial fibrillation treatment programs of its kind in the Southeast.

For more information about the Emory Atrial Fibrillation Program or to schedule an appointment, please call Emory HealthConnection℠ at 404-778-7777 or 1-800-75-EMORY.

About Dr. Lloyd

Michael Lloyd, MDMichael Lloyd, MD , began practicing medicine at Emory in 2007. He specializes in cardiology and cardiac electrophysiology. His areas of clinical interest and research include arrhythmias in athletes, arrhythmias in young adults with congenital heart disease, atrial fibrillation and implantable devices for the treatment of heart failure. Dr. Lloyd is the program director for the Cardiac Electrophysiology Fellowship Program at Emory and holds organizational leadership positions with the American College of Cardiology, the American Heart Association and the Heart Rhythm Society.

About Emory’s Arrhythmia Center

Emory’s Arrhythmia Center is one of the most comprehensive and innovative clinics for heart rhythm disorders in the country. Our electrophysiologists have been pioneers in shaping treatment options for patients with arrhythmias such as atrial fibrillation, as well as for those with congestive heart disease. Our specialized electrophysiology (EP) labs host state-of-the-art equipment, including computerized three-dimensional mapping systems to assist with the ablation of complex arrhythmias, and an excimer laser system to perform pacemaker and defibrillator lead extractions.

Patients with devices, whether implanted at Emory or elsewhere, have access to Emory’s comprehensive follow-up care. Patients benefit from remote monitoring, quarterly atrial fibrillation support groups and 24-hour implantable cardiac device (ICD) and pacemaker monitoring services. Inpatient telemetry and coronary care units, as well as outpatient care and educational support of patients with pacemakers and ICDs, complete Emory’s comprehensive range of arrhythmia treatments and services.

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Congenital Heart Defect Repair in Childhood: Will I Need Another Surgery?

congenital heart repairNot too long ago, most babies born with serious heart defects died in childhood. Thanks to advances in cardiac care, some estimates indicate that today as many as 90% of children with congenital heart disease (CHD) are able to live well into adulthood. In fact, there are now more adults than children living with CHD, and it has become increasingly clear that this growing population requires ongoing, specialized care. For instance, even if their defects are treated surgically in childhood, many patients will require additional surgery as adults to keep their hearts functioning correctly.

When many surgical procedures were first performed to correct congenital heart defects in children, the medical community generally assumed they were curative. But as the first generation of post-operative patients survived into adulthood, some began to develop late complications associated with the procedures they underwent as children.

Unfortunately, many of these late complications develop gradually and are associated with non-specific symptoms. In addition, CHD is so closely associated with infancy and childhood, that many patients assume they no longer need to worry about their condition once they have reached adulthood. Consequently, they may not make the connection between the symptoms they develop as adults and their CHD—especially if it was successfully corrected in childhood.

This relatively recent phenomenon bolsters the argument that patients with CHD—even if their defect was surgically corrected in childhood—need to continue regular follow-up with a congenital heart specialist into adulthood so that he or she can monitor for subtle changes that may indicate a serious problem.

Another issue with managing CHD in adulthood is that adult cardiologists may have difficulty treating conditions in hearts repaired—often effectively re-configured—by pediatric surgeons years earlier. Conversely, pediatric surgeons may be unfamiliar with the unique complications that can arise years later as “corrected” anatomy ages, and in general may not have the specific training and experience required to address congenital disease in adults.

In response to this growing crisis, Emory and Children’s Healthcare of Atlanta have teamed up to help ensure that patients with CHD don’t get lost to follow-up as they transition into adulthood. The Congenital Heart Center of Georgia combines the expertise of Children’s Sibley Heart Center with that of Emory’s Adult Congenital Heart Center to address this crucial need. It is the first program of its kind in the South and one of the largest in the country.

About Dr. Kogon

Brian E. Kogon, MD , is chief of Pediatric Cardiothoracic Surgery at Children’s Sibley Heart Center and Emory University Hospital , surgical director of the Adult Congenital Heart Disease Program at Emory University Hospital and director of the Congenital Cardiac Surgery Fellowship at the Emory University School of Medicine.

Dr. Kogon received his medical degree from the University of Cincinnati and completed his residency in general surgery and a fellowship in cardiothoracic surgery at Indiana University. He then went on to complete his fellowship in pediatric cardiac surgery at Emory University, joining the staff in 2004.

Dr. Kogon is now a nationally recognized leader in pediatric and adult congenital heart disease. He has numerous publications in peer-reviewed journals and presents nationally at the major cardiothoracic surgery society meetings. He has earned various awards over the years, most recently the Teacher of the Year award for Pediatric Cardiac Surgery from the Sibley Cardiology Fellowship Program and Emory University.

Dr. Kogon’s major areas of interest include pediatric cardiac surgery, cardiac transplantation and adult congenital heart surgery.

About the Congenital Heart Center of Georgia

The Congenital Heart Center of Georgia is a collaboration between Children’s Healthcare of Atlanta and Emory Healthcare. The Congenital Heart Center of Georgia is a comprehensive program for children and adults with congenital heart disease (CHD) that provides a continuum of lifesaving care from before birth through adulthood. The program is led by Emory Healthcare cardiologist Wendy Book, MD, Robert Campbell, MD, chief of cardiac services and director of cardiology at Children’s Sibley Heart Center, and Brian Kogon, MD, chief of Pediatric Cardiothoracic Surgery at Children’s Sibley Heart Center and Emory University Hospital and surgical director of the Adult Congenital Heart Disease Program at Emory University Hospital. To schedule an appointment please call 404-778-7777.

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Signs and Symptoms of Congenital Heart Defects

CDH BabyBecause congenital defects can decrease the heart’s ability to pump blood and deliver oxygen throughout the body, they often produce telltale signs. Below are some of the more common symptoms that indicate a baby may have congenital heart disease (CHD).

  • Heart Murmur

A heart murmur is often the first sign of CHD. In basic terms, a murmur is just an extra heart sound, in addition to the regular sounds of a beating heart. Heart murmurs usually don’t indicate the presence of any heart problem. Sometimes a doctor can use a stethoscope alone to determine whether a particular murmur is a sign of heart disease. In other cases additional tests are necessary to determine the exact nature of a murmur.

  • Breathing Difficulties

Breathing difficulty caused by blood building up in the lungs (lung congestion) is a sign of a serious defect that will likely need medical or surgical intervention in the first year of life. Lung congestion may be the result of excessive blood flow from the left side of the heart to the right side through an abnormal connection, such as a hole in the heart or a connection between major blood vessels that allows blood to bypass the heart. Congestion can also be the result of an obstruction in blood flow on the left side of the heart that causes blood to back up in the vessels returning blood from the lungs.

  • Blue Skin

Some CHDs result in an inadequate amount of oxygen in the blood, which can cause the baby’s skin to have a bluish tint, especially in the lips, tongue, fingernails and toenails—called cyanosis. Cyanosis can result from an obstruction of blood flow to the lungs or a hole within the heart that allows oxygen-poor blood to flow from the right side to the left side and out to the body. It can also be related to other heart issues, including an abnormal positioning (transposition) of the arteries leaving the heart.

  • Failure to Thrive

Another result of inadequate oxygen in the blood is that an infant may lose weight or not gain enough, or may take longer to reach developmental milestones. These symptoms can result directly from the body not receiving enough oxygen to thrive, or they may be an indirect consequence of the infant tiring during feeding because of a lack of oxygen and, as a result, not receiving enough nutrients.

  • Excessive Sweating

Many CHDs can cause excess blood flow through the lungs, which makes breathing more difficult. The increase in exertion required to breathe can, in turn, result in excess sweating. Because feeding is a common form of activity in babies, this excess sweating is often closely associated with feeding, though any activity that causes an increase in the infant’s breathing rate can also cause increased sweat production. Excess blood flow to the lungs can also accelerate the infant’s metabolism, a side effect of which is increased sweating.

If you notice any of these signs in your baby or child, call your doctor right away. If your doctor notices these signs, you may be referred to a pediatric cardiologist.

About Dr. Rodriguez

Fred Rodriguez, MDFred Rodriguez, MD, is a pediatric cardiologist who practices pediatric cardiology at the Children’s Healthcare of Atlanta Sibley Heart Center and adult congenital heart disease at the Emory Clinic and Emory University Hospital. Dr. Rodriguez earned his medical degree from the Louisiana State University at New Orleans School of Medicine, where he also completed his combined residency in both internal medicine and pediatrics. Following his residency, he completed a cardiology fellowship at Texas Children’s Hospital in Houston, with additional training in adult congenital heart disease. He is board certified in pediatrics, pediatric cardiology and internal medicine.

About the Congenital Heart Center of Georgia

The Congenital Heart Center of Georgia is a collaboration between Children’s Healthcare of Atlanta and Emory Healthcare. The Congenital Heart Center of Georgia is a comprehensive program for children and adults with congenital heart disease that provides a continuum of lifesaving care from before birth through adulthood. It is the first comprehensive congenital heart disease program in the South and one of the largest in the country. The program is led by Emory Healthcare cardiologist Wendy Book, MD, Robert Campbell, MD, chief of cardiac services and director of cardiology at Children’s Sibley Heart Center, and Brian Kogon, MD, chief of pediatric cardiothoracic surgery. To schedule an appointment, please call 404-778-7777.

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Congenital Heart Defects in Newborns

newbornCongenital heart defects (CHDs) are abnormalities present at birth that can affect the structure and function of the heart. Approximately 1% of infants born in the United States have CHDs. A baby’s heart begins to develop at conception, but is completely formed by eight weeks into the pregnancy. CHDs occur during this crucial first eight weeks of the baby’s development. Specific steps must take place in order for the heart to form correctly. Often, CHDs are a result of one of these crucial steps not happening at the right time, leaving a hole where a dividing wall should have formed or a single blood vessel where two ought to be, for example.

Some CHDs are known to be associated with genetic disorders, such as Down syndrome, but the cause of most CHDs is unknown. In these cases, doctors generally assume the cause is some mixture of environmental and inherited (genetic) factors.

Common types of congenital heart defects, which can affect any part of the heart or its surrounding structures, include:

While CHDs sometimes go undiagnosed for years — even into adulthood — others cause serious symptoms at birth, requiring the infant to be placed in the hospital’s neonatal intensive care unit (NICU) for immediate evaluation by a cardiologist.

Today there are more treatment options for CHDs than ever before, and most defects are treated successfully. If you suspect that your child has a heart defect, the sooner you get medical attention, the better chance your child will have of making the fullest recovery possible.

About Dr. Campbell

Robert Campbell, MD, is chief of cardiac services and director of cardiology at Children’s Sibley Heart Center. Dr. Campbell earned his medical degree from Emory University, where he also completed a residency in pediatrics. He completed a pediatric cardiology fellowship at the University of Michigan C.S. Mott Children’s Hospital.

About the Congenital Heart Center of Georgia

The Congenital Heart Center of Georgia is a collaboration between Children’s Healthcare of Atlanta and Emory Healthcare. The Congenital Heart Center of Georgia is a comprehensive program for children and adults with congenital heart disease that provides a continuum of lifesaving care from before birth through adulthood. It is the first comprehensive congenital heart disease program in the South and one of the largest in the country. The program is led by Emory Healthcare cardiologist Wendy Book, MD, Robert Campbell, MD, chief of cardiac services and director of cardiology at Children’s Sibley Heart Center, and Brian Kogon, MD, chief of pediatric cardiothoracic surgery. To schedule an appointment, please call 404-778-7777.

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