Congenital heart disease is a cardiovascular malformation caused by abnormal or impaired cardiovascular development during fetal life, resulting in abnormal heart structure at birth, and is the most common heart disease in pediatrics. And a large number of patients with congenital heart disease in childhood enter adulthood because they fail to receive early correction, so adult congenital heart disease also occupies a high proportion. Congenital heart disease is the result of a complex interplay of genetic and environmental factors. Among these, babies born to mothers with viral or bacterial infections in the first trimester of pregnancy, especially rubella virus and, to a lesser extent, coxsackievirus, have a higher incidence of congenital heart disease. Other conditions such as amniotic lesions, maternal malnutrition, diabetes mellitus, the use of radiation and cytotoxic drugs in the early stages of pregnancy, and the mother’s advanced age all have the potential to cause congenital heart disease in the fetus. There is also a tendency for some degree of familial morbidity in individuals. The most common congenital cardiovascular malformations are ventricular septal defect and atrial septal defect, with patent ductus arteriosus in second place; followed by simple pulmonary stenosis, tetralogy of Fallot, aortic stenosis and aortic constriction, the above seven malformations account for about 75% of all congenital cardiovascular lesions. Complex cardiac malformations include right ventricular double outlet, single ventricle, ectopic pulmonary venous drainage, atrioventricular canal malformation, tricuspid atresia, and transposition of the great arteries. In the last 20 years, due to the development of advanced modern examination techniques (such as cardiac catheterization, cardiovascular angiography, color Doppler echocardiography and cardiac tomography and magnetic resonance imaging, etc.) and advances in hypothermic anesthesia, extracorporeal circulation and cardiac surgery, many common congenital heart diseases can be accurately diagnosed and cured, and most complex heart malformations can also be treated surgically. The danger of congenital heart disease: Normally, the blood in the heart flows in one direction. In the case of congenital heart disease, the structure of the heart is changed and the hemodynamics are impaired. Firstly, there can be impaired blood supply to the tissues and organs of the body, causing tissue hypoxia and affecting the growth and development of the affected child; secondly, it can cause increased blood flow to the lungs and make it easy for repeated lung infections to occur; thirdly, abnormal hemodynamics can also increase the burden on the heart and cause heart failure, inducing malignant arrhythmias and even sudden death. Fourth, blood turbulence caused by structural abnormalities of the heart can cause damage to local endocardial structures, which can easily harbor bacteria and lead to infective endocarditis. In addition, in addition to the above physical damage, congenital heart disease can also cause psychological damage to the child. Congenital heart disease can cast a shadow on the happy life of the family and cause varying degrees of trauma to the child’s mind, affecting the child’s physical and mental health, and can cause personality defects in serious cases. The performance characteristics of congenital heart disease: Children with congenital heart disease often show difficulty in eating milk, blue lips and fingernails or blue after crying, palpitations, shortness of breath, easy fatigue, cough, hemoptysis, even fainting and right heart failure. Cyanosis of the lips and fingernails or after crying is the most easily detected symptom that is closely related to heart disease. When cyanosis is present after birth, it is often due to complex congenital heart disease such as tricuspid atresia, pulmonary atresia, transposition of the great arteries or severe trisomy of Fallot. If cyanosis appears a few months later, it is most likely to be tetralogy of Fallot. If cyanosis develops gradually after a few years, teens or adults, it may be a left-to-right shunt type of congenital heart disease, such as ventricular defect, unclosed ductus arteriosus with pulmonary hypertension (or Eisenmenger’s syndrome). In contrast, non-cyanotic congenital heart disease is often not easily recognized by parents in its early stages, and most congenital heart disease is superficially unexceptional at birth. As they get older, congenital heart disease may show symptoms such as frequent colds, fever, pneumonia, restricted activity, possible bruising of the lips and mouth after strenuous activity or crying, and slowed or stalled growth. On auscultation of the heart, systolic murmur can be heard at the left edge of the sternum. The murmur of ventricular septal defect is lower, louder and rougher than the murmur of atrial septal defect, which is widely conducted to the four bureaus; the murmur of atrial septal defect is left 2nd to 3rd intercostal space, softer and more limited; the murmur of unclosed arterial duct is higher, in the 2nd intercostal space, loud, rough and widely conducted, with a continuous murmur like machine rotation, which can be heard in both systole and diastole The location of the murmur in tetralogy of Fallot varies from high to low to loud depending on the malformation, but in severe cases the murmur is light. Diagnosis of congenital heart disease: Heart photographs, electrocardiogram and echocardiogram can be performed. Echocardiography has the greatest diagnostic value and can show the size, location, blood flow and other vascular malformations of atrial septum and ventricular septal defects; generally, cardiac catheterization and cardiovascular imaging should be performed before surgery to further clarify the diagnosis and prepare for surgery. Complications of congenital heart disease: atrial septal defect, ventricular septal defect and patent ductus arteriosus are often prone to pneumonia and heart failure; tetralogy of Fallot can often be complicated by cerebral thrombosis and brain abscess; the above congenital heart disease is prone to bacterial endocarditis except for atrial septal defect. Prevention of congenital heart disease: Since the causes of congenital heart disease are not clear, there is a lack of effective prevention methods, but experts suggest that the following can reduce the occurrence of congenital heart disease. Some viral infections in utero cause congenital malformations that are often associated with congenital heart disease, such as rubella virus syndrome. Therefore, prevention of viral infections during pregnancy, especially in the early stages of pregnancy, is an important measure. The use of certain drugs during pregnancy, for example, can also lead to heart malformations. The mother’s health care during pregnancy is important. Patients with diabetes, epilepsy and other diseases should decide on the time of marriage and pregnancy under the guidance of a doctor. Lesbians should increase nutrition and physical exercise before pregnancy to enhance the ability to resist disease. Those who are exposed to radiation for a long time or receive radiation treatment should get pregnant after six months of being free from radiation. Women who are frequently exposed to various pesticides and chemical drugs should strengthen protective measures and not use or use less tetracycline, sulfonamide, amphetamine, progesterone, estrogen, anticonvulsants and hormonal drugs, and not use cosmetics containing hormones. The mother’s alcoholism, the baby can suffer from alcoholism syndrome, often accompanied by ventricular septal defect, arteriovenous ductus arteriosus, atrial septal defect, tetralogy of Fallot, etc. Therefore, both spouses should quit smoking and alcohol. If the parents have had congenital heart disease or have had children with congenital heart disease, fetal echocardiography is advocated during further pregnancies to facilitate early detection of fetuses with congenital heart disease, and early induction of labor can be considered for complex or refractory congenital heart disease. The timing of surgery for congenital heart disease Half of the babies with untreated congenital heart disease will die by the age of one and two-thirds by the age of two. And the more complex the malformation, the more severe the condition the more death and the earlier death. The disease progresses rapidly in infancy and early childhood, and cases with left-to-right shunts, such as ventricular septal defects, are prone to complications of pulmonary hypertension. When the complication is mild to moderate pulmonary hypertension, surgical treatment can still be sought, but when it develops into severe pulmonary hypertension, the opportunity for surgery is lost and surgical treatment cannot be performed. Some congenital heart diseases must be operated early, otherwise good surgical opportunities are lost, such as large ventricular septal defect, arteriovenous ductus arteriosus, due to large left-to-right shunt, recurrent pulmonary infections in infancy with heart failure, which are difficult to control by simple medication, and often accompanied by severe pulmonary hypertension, so surgery should be completed early. In general, early detection, early diagnosis and early treatment are the keys to reduce the natural and operative mortality of precocious heart disease and improve the effectiveness of surgical treatment. Due to the advancement of technology, the success rate of surgical treatment for infantile precocious heart disease is currently over 98%. Interventional treatment requires puncture of the peripheral blood vessels to complete, so most require children weighing more than 5-8 kg. Except for ventricular septal defects of less than five millimeters without complications and under the age of six months, which can be temporarily observed, all patients need to be operated as early as possible. However, due to the uneven economic development in China, some children are forced to give up treatment at the best time of correction due to lack of financial support despite a clear diagnosis. On the other hand, some areas, especially remote rural areas, do not pay attention to the physical examination of infants and children after birth, which makes the diagnosis of precocious heart disease missed, resulting in many patients with precocious heart disease until adulthood or even old age before they can be detected or require treatment. For these patients, doctors still advocate active treatment as long as the conditions are suitable, rather than waiting, because a significant proportion of these patients still have a high cure rate and remission rate after treatment, so as to resume work, improve the quality of life and extend life.