Risk factors

Maternal risk factors for congenital cardiac disease include infection, drugs and diabetes.

Infectious causes of congenital cardiac disease include maternal rubella infection during pregnancy.

Drugs that increase the risk of congenital heart disease include teratogenic medicines (e.g. thalidomide, isotretinoin, lithium) and substance misuse (alcohol, smoking).

Maternal diabetes increases the risk of congenital cardiac disease, although this only applies to poorly controlled type 1 and 2 diabetes, and not gestational diabetes.

Acyanotic - most common causes

• ventricular septal defects (VSD) - most common, accounts for 30%
• atrial septal defect (ASD)
• patent ductus arteriosus (PDA)
• coarctation of the aorta
• aortic valve stenosis

VSDs are more common than ASDs. However, in adult patients ASDs are the more common new diagnosis as they generally presents later.

Cyanotic - most common causes

• tetralogy of Fallot
• transposition of the great arteries (TGA)
• tricuspid atresia