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What is structural heart disease & defects?

Structural heart disease and heart defects refer to a defect or abnormality in the heart’s valves or vessels. Some structural heart diseases are congenital (present at birth) while others can develop with age. These defects can involve the interior walls of the heart, the valves inside the heart, and the arteries and veins that carry blood to the heart or out to the body. Congenital heart disease defects change the normal flow of blood through the heart. Some are undetectable, and their effects aren’t felt until adulthood. One in every 150 adults has some form of congenital heart disease.

The most common adult congenital heart diseases are:

  • Atrial septal defect — a hole in the septum (wall) that separates the two upper (atrial) chambers of the heart
  • Ventricular septal defect — a hole in the septum that separates the two lower (ventricular) chambers of the heart
  • Patent foramen ovales — a structural heart defect that occurs when the small flap-like opening that separates the two upper (atrial) chambers of the heart prior to birth fails to seal after birth.
  • Aortic valve stenosis — a buildup of calcium deposits on the aortic valve that causes narrowing and prevents the valve from opening properly


Congenital heart defects and disease are usually recognized during the first few months after birth. Symptoms include:

  • Bluish skin (cyanosis)
  • Very low blood pressure shortly after birth
  • Difficulty breathing and feeding
  • Poor weight gain

Risk factors

According to the National Heart, Lung and Blood Institute, congenital heart defects are the most common type of birth defect, affecting eight out of every 1,000 newborns. Each year, more than 35,000 babies in the United States are born with congenital heart defects. It is unknown why congenital heart defects occur, but they tend to run in families.

Adult structural heart disease can be caused by several factors, including:

  • High blood pressure
  • Atherosclerosis
  • A previous heart attack
  • Aging
  • Certain medications
  • Other infections and disorders including cardiomyopathy (diseases of the heart muscle)
  • Rheumatic fever and endocarditis (a bacterial infection)


Heart defects may be diagnosed with tests that include:

  • Electrocardiogram (EKG or ECG) to test the heart’s electrical activity
  • Chest X-ray
  • Echocardiogram (ultrasound film of the heart)
  • Blood tests
  • Cardiac catheterization and angiography, where an X-ray records blood pressure and blood flow in a cardiac chamber or major blood vessel
  • Magnetic resonance imaging (MRI)
  • A computed tomography (CT) scan, which uses X-rays to create detailed pictures of the heart and its blood vessels
  • Holter monitor that records your heart rate, worn for 24 hours or up to two weeks
  • Stress testing, in which your heart is tested during “stress” — that is, during exercise or drug stimulation

Heart defects in children may be discovered because of the symptoms described above or during a baby’s checkup.