Many of the most severe side effects associated with the use of  SSRI Antidepressants such as Zoloft (sertraline), Paxil (paroxetine), Prozac (fluoxetine), Lexapro (escitalopram) and Celexa (citalopram) are congenital birth defects,  including: Congenital Heart Defects, Congenital Lung Defects, Congenital Abdominal Wall Defects, Congenital Cranio-facial Defects,and other birth defects and malformations affecting various other areas of the child’s anatomy.

SSRI Antidepressant Heart Birth Defects

According to scientific studies, women who take SSRI Antidepressants such as Zoloft (sertraline), Paxil (paroxetine), Prozac (fluoxetine), Lexapro (escitalopram) and Celexa (citalopram) are at least twice as likely to give birth to children with serious congenital heart defects.  A congenital heart defect is a problem with the structure of the heart present at birth. Congenital heart defects are the most common type of major birth defect.  A baby’s heart begins to develop shortly after conception and during the first tri-mester. During development, structural defects can occur. These defects can involve the walls of the heart, the valves of the heart and the arteries and veins to and from the heart. Congenital heart defects can disrupt the normal flow of blood through the heart, lungs and body.

What is Hypoplastic Left Heart Syndrome (HLHS)?

Hypoplastic left heart syndrome occurs when parts of the left side of the heart (mitral valve, left ventricle, aortic valve, and aorta) do not develop completely. The condition is congenital (present at birth).

Causes

Hypoplastic left heart is a rare type of congenital heart disease. It is more common in males than in females.  As with most congenital heart defects, there is no single specific known cause. Approximately 10% of patients with hypoplastic left heart syndrome also have other birth defects.  The problem develops before birth when there is not enough growth of the left ventricle and other structures, including the:

• Aorta — the blood vessel that carries oxygen-rich blood from the left ventricle to the entire body
• Entrance and exit of the ventricle
• Mitral and aortic valves

This causes the left ventricle and aorta to be incompletely developed, or hypoplastic. In most cases, the left ventricle and aorta are much smaller than normal.  In patients with this condition, the left side of the heart is unable to send enough blood to the body. As a result, the right side of the heart must maintain the circulation for both the lungs and the body. The right ventricle can support the circulation to both the lungs and the body for a while, but this extra workload eventually causes the right side of the heart to fail.  The only possibility of survival is a connection between the right and the left side of the heart, or between the arteries and pulmonary arteries (the blood vesels that carry blood to the lungs). Babies are normally born with two of these connections:

• Foramen ovale (a hole between the right and left atrium)
• Ductus arteriosus (a small blood vesel that connects the aorta to the pulmonary artery)
• Both of these connections normally close on their own a few days after birth.

In babies with hypoplastic left heart syndrome, blood from the right side of the heart travels through the ductus arteriosus. This is the only way for blood to get to the body. If the ductus arteriosus is allowed to close in a baby with hypoplastic left heart syndrome, the patient may quickly die because no blood will be pumped to the body. Babies with known hypoplastic left heart syndrome are usually started on a medicine to keep the ductus arteriosus open.  Because there is little or no flow out of the left heart, blood returning to the heart from the lungs needs to pass through the foramen ovale or an atrial septal defect (a hole connecting the collecting chambers on the left and right sides of the heart) back to the right side of the heart. If there is no foramen ovale, or if it is too small, the baby could die. Patients with this problem have the hole between their atria opened, either with surgery or using heart catheterization.

Symptoms

At first, a newborn with hypoplastic left heart may appear normal. Symptoms usually occur in the first few hours of life, although it may take up to a few days to develop symptoms. These symptoms may include:

• Bluish (cyanosis) or poor skin color
• Cold hands and feet (extremities)
• Lethargy
• Poor pulse
• Poor suckling and feeding
• Pounding heart
• Rapid breathing
• Shortness of breath

In healthy newborns, bluish color in the hands and feet is a response to cold (this reaction is called peripheral cyanosis).  However, a bluish color in the chest or abdomen, lips, and tongue is abnormal (called central cyanosis). It is a sign that there is not enough oxygen in the blood. Central cyanosis often increases with crying.

Exams and Tests

A physical exam may show signs of heart failure, including:

• Faster-than-normal heart rate
• Lethargy
• Liver enlargement
• Rapid breathing
• Also, the pulse at various locations (wrist, groin, and others) may be very weak. There are usually (but not always) abnormal heart sounds when listening to the chest.

Tests may include:

• Cardiac catheterization
• ECG
• Echocardiogram
• X-ray of the chest
• Treatment

Once the diagnosis of hypoplastic left heart is made, the baby will be admitted to the neonatal intensive care unit. A breathing machine (ventilator) may be needed to help the baby breathe. A medicine called prostaglandin E1 is used to keep blood circulating to the body by keeping the ductus arteriosus open.

These measures do not solve the problem. The condition always requires surgery.

The first surgery, called the Norwood operation, occurs within the baby’s first few days of life. Stage I of the Norwood procedure consists of building a new aorta by:

• Using the pulmonary valve and artery
• Connecting the hypoplastic old aorta and coronary arteries to the new aortaemoving the wall between the atria (atrial septum
• Making an artificial connection from either the right ventricle or a body-wide artery to the pulmonary artery to maintain blood flow to the lungs (called a shunt)

Afterwards, the baby usually goes home. The child will need to take daily medicines and be closely followed by a pediatric cardiologist, who will determine when the second stage of surgery should be done.

Stage II of the operation is called the Glenn shunt or Hemifontan procedure. This procedure connects the major vein carrying blue blood from the top half of the body (the superior vena cava) directly to blood vessels to the lungs (pulmonary arteries) to get oxygen. The surgery is usually done when the child is 4 – 6 months of age.

During stages I and II, the child may still appear somewhat blue (cyanotic).

Stage III, the final step, is called the Fontan procedure. The rest of the veins that carry blue blood from the body (the inferior vena cava) are connected directly to the blood vessels to the lungs. The right ventricle now serves only as the pumping chamber for the body (no longer the lungs and the body). This surgery is usually performed when the baby is 18 months – 3 years old. After this final step, the baby is no longer blue.

Some patients may need more surgeries in their 20s or 30s if they develop hard-to-control arrhythmias or other complications of the Fontan procedure.

In some hospitals, heart transplantation is considered a better choice than the 3-step surgery process. However, there are few donated hearts available for small infants.

Prognosis

If left untreated, hypoplastic left heart syndrome is fatal. Survival rates for the staged repair continue to rise as surgical techniques and postoperative management improve. Survival after the first stage is more than 75%.  The size and function of the right ventricle are important in determining the child’s outcome after surgery.

Possible Complications Include:

• Blockage of the artificial shunt
• Chronic diarrhea (from a disease called protein losing enteropathy)
• Fluid in the abdomen (ascites) and in the lungs (pleural effusion)
• Heart failure
• Irregular, fast heart rhythms (arrhythmias)
• Strokes and other neurological complications
• Sudden death

When to Contact a Medical Professional

Contact your health care provider immediately if your infant:

• Eats less (decreased feeing)
• Has blue (cyanotic) skin or mucus membranes
• Has new changes in breathing patterns

Prevention

There is no single known prevention for hypoplastic left heart syndrome. As with many congenital diseases, the causes of hypoplastic left heart syndrome are uncertain and have not been linked to a mother’s disease or behavior.  In 2005 The US FDA linked HLHS with the use of certain antidepressant SSRI drugs like Zoloft (sertraline), Paxil (paroxetine), Prozac (fluoxetine), Lexapro (escitalopram) and Celexa (citalopram) during pregnancy.

Alternative Names

HLHS

SSRI Class Action Lawsuit vs. Individual SSRI Lawsuit

There are distinct differences between an SSRI Antidepressant (Zoloft – sertraline, Paxil – paroxetine, Prozac – fluoxetine, Lexapro – escitalopram and Celexa – citalopram) class action lawsuit and a more typical individual SSRI lawsuit. A SSRI class action lawsuit would be a form of SSRI lawsuit in which a large group of people (plaintiffs) collectively bring a lawsuit to court in the form of a “class action” against the manufacturers of the SSRI antidepressant (defendant). In a class action lawsuit involving personal injury, resulting from defective products such as antidepressant SSRI drugs like Zoloft (sertraline), Paxil (paroxetine), Prozac (fluoxetine), Lexapro (escitalopram) and Celexa (citalopram), all SSRI lawsuit plaintiffs would typically be grouped together into a single SSRI class action lawsuit, regardless of the degree or severity of their birth defect injuries. In this type of SSRI class action lawsuit, plaintiffs with injuries ranging from minor heart murmurs not requiring surgery, all the way to the most severe congenital heart defects, requiring multiple surgeries or a complete heart transplant, would be grouped into one single SSRI class action lawsuit. All plaintiffs in the class would equally share any award or settlement resulting from the SSRI class action lawsuit.

In SSRI antidepressant lawsuits involving catastrophic injury or death, an individual lawsuit, in most cases, is more appropriate and in the plaintiff’s best interest. SSRI antidepressants like Zoloft, Prozac, Celexa, Lexapro and Paxil, have been linked to some of the severe congenital heart defects listed above, including: atrial septal defects (ASD – hole in the heart), ventricular septal defects (VSD – hole in the heart), tetrology of fallot (ToF), hypoplastic left heart syndrome (HLHS), transposition of the great arteries (TGA or TOGA), patent ductus arteriosus (PDA), total anomalous pulmonary venous return (TAPVR), double outlet right ventricle (DORV), and coarctation of the aorta (CoA). SSRI antidepressant cases such as these are better suited to an individual SSRI antidepressant lawsuit because of the severity and degree of injury to the plaintiff. In an individual SSRI lawsuit, each plaintiff’s case is filed, presented and considered individually, based on its own strength and degree of injury.

In many cases involving SSRI antidepressants like Zoloft, Prozac, Celexa, Lexapro, Paxil and the serious congenital heart defects related to these SSRI antidepressants, surgery is required. Heart surgery will typically be required when a child is an infant or toddler and then again, potentially multiple times, as the child grows to maturity. In many cases, with surgery and medical care, children may be able to lead mostly normal and productive lives. An individual SSRI lawsuit allows each SSRI victim, their injuries and their future needs to be considered on an individual basis when determining damages, awards and settlement amounts, and not as part of a class action lawsuit.

Speak to an SSRI Lawyer about an SSRI Birth Defect Lawsuit

If you took Prozac (fluoxetine), Paxil (paroxetine), Zoloft (sertraline), Celexa (citalopram), Lexapro (escitalopram) or any another SSRI antidepressant drug during pregnancy and your child was born with a congenital heart, lung or other birth defect, we encourage you to contact an SSRI Antidepressant Lawsuit Attorney at our law firm immediately. It may be too late to recover from the devastating effects of Prozac, Paxil, Zoloft, Lexapro and Celexa but an experienced pharmaceutical products liability lawyer at the Willis Law Firm can assist you in legal action against the makers of these dangerous antidepressant drugs. You are not alone. Join other birth defect victims and their families in speaking up and fighting for your legal rights.

Please fill out our free online legal evaluation form and we will contact you within 24 hours, or call our offices at 1-800-883-9858 for immediate help. Please keep in mind that certain states have statutes of limitation that limit the amount of time you have to file a lawsuit or seek legal action. Contact our law firm immediately so that we may explain the rights and options available to you and your family.