While major congenital heart defects are sometimes diagnosed before birth through imaging studies like a fetal ultrasound, in most cases, doctors only diagnose a congenital defect after the newborn or infant begins to develop symptoms. In many cases, the first sign of a congenital heart defect in a newborn is the presence of a heart murmur that can be heard through a stethoscope. Murmurs are simply sounds—an extra or unusual sound that is part of the heartbeat. However, many children with healthy hearts also have murmurs, so only a doctor can tell if it is a concerning finding.
There are other signs and symptoms that parents can look for and should report right away to their pediatricians.
While congenital heart defects don’t usually cause painful symptoms, such as chest pain, newborns with heart abnormalities might show signs that their hearts are not functioning optimally. These include: breathing difficulties (including rapid breathing) from lung congestion; cyanosis, a condition resulting in a bluish tint to the skin, fingernails, and lips (sometimes called “blue baby”); unusual tiredness; and poor circulation.
Some signs of congenital heart defects may become more obvious with time. Babies with heart abnormalities might not gain weight or grow at normal rates (e.g., failure to thrive). After all, the healthy heart fuels growth and development by providing oxygen-rich blood throughout the body. Another reason congenital heart defects can affect growth and development is babies with excessive fatigue and other symptoms may not feed as well as their healthy counterparts.
As children age, congenital heart defects might become apparent when children tire too easily or experience shortness of breath with physical activity. In severe cases, congenital heart defects can cause such strain on the heart that children experience heart failure. Symptoms of heart failure, which is caused when the heart can’t pump enough blood to support the body’s needs, include: breathing difficulty or shortness of breath; fatigue with exercise; fluid buildup in the lungs; swelling of the lower body, and enlarged neck veins.
Reviewed by Dr. Sara Connolly, August 2019
- Congenital heart defects don’t always cause symptoms, but sometimes they do.
- Heart murmur is often the first sign of a possible congenital heart abnormality (but healthy kids have heart murmurs, too).
- Symptoms of congenital heart problems in newborns and children include: shortness of breath, a bluish tint to the skin, fatigue, and poor circulation.