【Heart valve leak】What are the symptoms? Can it improve? Is congenital heart disease covered by insurance?

All parents hope their children will grow up healthy. However, some congenital conditions may be unavoidable, leaving parents caught off guard. For example, among every 1,000 newborn babies, 8 have congenital heart disease, with heart septal defects being the most common. So, what are the symptoms of heart septal defects? What causes them? What signs should parents look out for so they can detect early if their baby may have a heart septal defect? Can heart septal defects be cured? Will they affect a baby’s lifespan? 10Life has compiled information on congenital heart disease to help parents guard against this “hidden killer”. 

According to information from the Children’s Heart Foundation and the mutual support organisation for heart disease patients, “Care for Your Heart”, congenital heart defect is a general term referring to abnormal heart development during foetal growth in the womb, resulting in a congenital defect in the heart at birth. The most common congenital heart defects are atrial septal defect and ventricular septal defect, also known as “heart leakage”.

Taking atrial septal defect (atrial heart leakage) as an example, during foetal development, a gap remains in the atrial septum, preventing the left and right atria from being fully separated, causing blood from the left atrium to flow through the gap into the right atrium. Small defects may not produce any symptoms and may gradually close naturally as the child grows. However, more severe defects, if left untreated, may lead to heart failure.

Many parents mistakenly believe that babies and children with congenital heart disease must have purple or black lips, but this is not necessarily the case.

Congenital heart disease can broadly be divided into two types: “cyanotic” and “acyanotic”. Cyanotic congenital heart disease is generally more serious, with the lips, fingers and toes appearing purplish-black. Conditions in this category include Tetralogy of Fallot and pulmonary atresia. As for babies with acyanotic congenital heart disease, their appearance is usually normal, but they may develop symptoms such as rapid breathing and a faster heartbeat. Ventricular septal defect belongs to this category.

Babies and children may not know how to express discomfort, so in general parents can watch for the following symptoms:

• Bluish-purple skin
• Feeling sleepy for no apparent reason
• Difficulty breathing, shortness of breath
• Slower growth, etc.

If you suspect that your child has congenital heart disease, you should seek medical attention as soon as possible. A doctor will check the baby’s pulse, blood vessels, heartbeat, and whether there is any heart murmur, and may also make a diagnosis through X-rays, electrocardiograms, ultrasound scans and other methods. 

In addition, a cardiologist has pointed out that although a ventricular septal defect is a congenital condition, some patients may have no symptoms at all, and even their heartbeat may be normal, meaning the condition remains undetected for a long time. According to his clinical experience, many patients only discover they have congenital heart disease when they are older, even in their 40s or 50s.

The vast majority of congenital heart diseases have no identifiable cause, but they can still generally be categorised into two types:

If a child is diagnosed with congenital heart disease, parents will inevitably worry that the condition may affect their child’s future life, or even be life-threatening. Fortunately, advances in modern medicine mean that 90% of congenital heart disease cases can be treated. According to statistics from the U.S. Centres for Disease Control and Prevention (CDC), 81% of patients with congenital heart disease can live to at least 35 years old. Their survival rate mainly depends on the severity of the condition, when it is diagnosed, and the treatment approach.

At present, there are mainly three treatment options for congenital heart disease: 

Cardiologists have pointed out that a heart valve leak itself is not difficult to treat. Even if it cannot heal naturally during growth, it can generally be sealed through minimally invasive surgery or open-heart surgery to close the “hole” between the left and right sides of the heart. However, a small number of patients with congenital heart disease have heart structures that are too complex to be corrected through surgery, or their condition is discovered too late, leading to complications such as pulmonary hypertension and heart failure. In such cases, they must wait for a heart transplant.

Expectant mothers least want to be careless during pregnancy and leave their child with long-term health problems after birth. Although the causes of most congenital heart defects are unknown, according to the advice of the Centre for Health Protection, the following methods may help prevent children from developing congenital heart defects:

• Girls and women of childbearing age should receive the rubella vaccine
• Do not take medication indiscriminately during pregnancy; consult a doctor before taking any medicine
• Diabetes must be properly controlled during pregnancy

In addition to treatment, daily care is also very important in improving and stabilising congenital heart disease. The Children’s Heart Foundation recommends that parents:

• understand their child’s condition so they can clearly inform doctors if their child needs to see a doctor for other illnesses
• keep a close eye on their child’s condition at all times and seek follow-up care early if there are signs of deterioration
• pay attention to whether their child is taking the correct dose of medication on schedule
• ensure their child has sufficient and balanced nutrition
• encourage their child to do an appropriate amount of exercise in accordance with the doctor’s advice, etc.

The structure of the heart is complex, and surgery costs are also relatively high. If the operation is performed at a private hospital, the final bill is generally in the hundreds of thousands of dollars. Taking Union Hospital as an example, the package fee for atrial or ventricular septal defect repair surgery is close to HK$400,000. Taking out medical insurance early can help reduce the financial burden of medical expenses.

In the past, medical insurance products generally did not cover pre-existing conditions, meaning illnesses that had already been diagnosed, had obvious symptoms, or had already been treated at the time of application. Congenital conditions were also not covered. However, this has changed in recent years.

Among them, the Voluntary Health Insurance Scheme, which is regulated by the Government, must extend coverage to congenital conditions that arise or are diagnosed at the age of 8 or later. This means that a policyholder who takes out insurance and is only diagnosed with congenital heart disease after turning 8 may be covered. In addition, according to 10Life statistics, there are currently at least four whole-life critical illness insurance products that allow applications starting from the 22nd week of pregnancy, meaning that babies can be covered from birth, including some congenital conditions, as well as ADHD, Tourette syndrome, autism and other conditions that parents are particularly concerned about.

Different insurance products cover different conditions and have different terms and conditions. Expectant parents who would like to know more can refer to 10Life’s article on bb critical illness insurance, or contact 10Life’s professional insurance consultants.

Source: Centre for Health Protection, Children’s Heart Foundation, Heart To Heart, Voluntary Health Insurance Scheme webpage, media reports 
Last updated on: 20 October 2023

This English version of this article has been generated by machine translation powered by AI. It is provided solely for reference purposes. In the event of any discrepancy or inconsistency between this translation and the original Chinese version, the Chinese version shall prevail.