The majority of congenital anomalies are isolated i.e. the patient has normal intellect, no dysmorphic features, and no other congenital malformations or chronic illness. Most isolated congenital anomalies are multifactorial in etiology, meaning that they are caused by a combination of genetic and environmental factors. These typically occur sporadically, and the chance for the affected person's child to be similarly affected is slightly increased over the background population incidence. However, if there are multiple members of the same family affected, there may be more of a genetic component and a higher chance for recurrence.
If there is a family history of a first degree relative to the fetus with a congenital heart defect, your patient may be eligible to have a screening fetal echocardiogram (or a detailed fetal ultrasound with extended heart views at a tertiary centre) in her pregnancy. This can be booked directly with the ultrasound department at BC Women's Hospital or Jim Pattison Maternal Fetal Medicine.
A Medical Genetics consult is only indicated if there is a conotruncal cardiac malformation such as: tetralogy of Fallot, truncus arteriosus, interrupted aortic arch-B, or a conotruncal VSD. These specific conditions can be associated with higher recurrence chances in a family. A referral to Medical Genetics for assessment of the individual with the cardiac malformation may be warranted to determine if genetic testing is indicated. This can help inform the chance for recurrence in the pregnancy.