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3.8. CHD = congenital heart disease

Some hearts come with mistakes.

Some are missing parts or have extra holes in them. Some are boot-shaped. Some have arteries connected to the wrong side, so that each side of the heart/circulation keeps its own blood, and once the connections that shunt blood between them close there is no more oxygenated blood available to the body.

Hearts may not literally break, but they can fail, or stop.

Inside Mom's body, Baby receives free oxygenated blood that moves through extra, functional holes and blood vessels, but once born, the umbilical cord (with its artery and two veins) is clamped and it's up to Baby's new lungs to breathe in oxygen and Baby's heart to deliver that oxygen (in blood) to every part of a tiny new body.

After birth, the hole between atria should close within hours, while the duct between major arteries turns into a ligament in a few weeks. Ideally, all the walls are walls (no Pyramus and Thisbe action) and valves are not sealed shut or prolapsed. Otherwise, varying degrees of blue can appear, lungs may struggle with increased or decreased flow of blood, and Baby might experience spells ranging from pink to cyanotic.

These spells are definitely not magic.

Some baby hearts form outside of their chests. Some are ineffective and grow larger, practically filling fragile ribs, in an attempt to compensate for minimal function.

Maybe there is no such thing as a mistake, because every baby is perfect, but without (surgical) interventions, certain variations on the archetypal heart eventually become incompatible with life.

No one wants to see a tiny coffin with a ribbon tied around it, cold and too light, morning dew on a fallen leaf, incandescent tears fading fall into winter.


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