Heart disease- When arteries switch places and roles

Sep 05, 2010

TRANSPORTATION of the great arteries, the condition Joel suffers from, is a rare heart defect in which the two main arteries leaving the heart are reversed. The “great arteries” in this anomaly are the Aorta and the Pulmonary Artery, which carry blood away from the heart.

TRANSPORTATION of the great arteries, the condition Joel suffers from, is a rare heart defect in which the two main arteries leaving the heart are reversed. The “great arteries” in this anomaly are the Aorta and the Pulmonary Artery, which carry blood away from the heart.

The Aorta arises from the right ventricle and the Pulmonary Artery from the left ventricle instead of vice versa. “In his case the artery that is supposed to carry blood to the lungs for oxygen instead carries it to the rest of the body,” explains Dr Tom Mwambu a heart specialist at the institute.

Transposition of the great arteries leaves a shortage of oxygen in blood flowing from the heart to the rest of the body. This means the oxygen-poor (blue) blood returning from the body to the right atrium and right ventricle is pumped out to the aorta and to the body, while the oxygen-rich (red) blood returning from the lungs to the left atrium and ventricle is sent back to the lungs via the pulmonary artery.

Unless there is some place in the circulation where the oxygenated and un-oxygenated blood can mix, all of the organs of the body will be deprived of necessary oxygen.

“Without an adequate supply of oxygen-rich blood, the body can’t function properly,” he says.

What causes it?
Dr Jamir Mugalu, a neonatologist at Mulago Hopsital explains that though many congenital heart defects may be associated with alcohol during pregnancy, the exact cause of transposition of the great arteries is unknown.

“It is a malformation of the child’s heart during the first weeks of pregnancy,” he says. Untreated, over 50% of infants with transposition will die in the first month of life and 90% in the first year according to a Cincinati children’s heart
institute publication.

Symptoms
Transposition is almost always diagnosed in the first hours or days of life due to low oxygen levels. Rapid breathing in response to the low oxygen levels is seen, though the infants don’t work excessive.

There is blue coloration of the skin and mucous membranes due to the presence of greater deoxygenated haemoglobin in blood vessels near the
skin surface.

Lack of appetite and poor weight gain are other underlying symptoms.

Treatment
The treatment for the condition is surgery. According to Dr Mwambu, surgery of such cases needs to be done within the first two weeks to realise the best results.

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