Dr. Neri M. Cohen, M.D.

Although it sounds very scary to hear that your child may have a problem, congenital heart defects are common and are frequently easily correctable. If the hole hasn’t closed on it’s own by a certain age, the recommendations usually are to close the hole to prevent complications and avoid delays in growth and development. Depending on the location and size of the ‘hole’, it may be correctable with catheter based technology by a pediatric interventional cardiologist, or may require surgery. You certainly should have your child seen and evaluated by a pediatric cardiologist, even if that entails travel to a major medical center, who can better explain the problem and options forward therapy.

Not knowing the details of your wife’s general medical or OB history, I would talk to your OB to get a more complete answer to your question.
In general, however, mild tachycardia (increased heart rate) is very common in pregnancy, especially in the later stages, is not dangerous and, in fact, is expected. It is usually caused by a combination of changes in blood volume distribution between the mom, placenta and baby, and a loss of capacity to increase the stroke volume of each heartbeat as the uterus rises out of the pelvis increasing intra-abdominal pressure and pushing the diaphragm up so the heart compensates the demand for increased output by beating faster.

Tachycardia can be caused by many things, some related directly to your heart and some because of other, more systemic issues - infection, inflammatory processes, abnormal hormone levels, etc.
With regard to your specific query, 65% blockage of a coronary artery is usually not enough obstruction to be blood flow limiting and typically would not be clinically significant to require correction other than interventions to prevent further progression - diet modification, exercise, control of blood pressure, glucose levels and inflammation.

Chest pain can be caused by many things - some life threatening like heart attack and some annoying but completely benign like pleurisy.
Typically, chest pain of a cardiac origin is described more as pressure (‘an elephant sitting on my chest’) and can also radiate to the arm or jaw, and may be more commonly induced by increased cardiac demand like exercise, anxiety or stress. Chest pain as a result of inflammatory conditions in the chest, such as pleurisy or costochondritis, is described as sharp and stabbing, is very short lived, and is induced by situations that increase intrathoracic pressure - deep breath, cough or sneeze.

Irregular heartbeat, especially in children, can be caused by many things, only one of which is congenital heart defect and only rarely would that require transplantation. I would talk to your doctor(s) about what the specific diagnosis of the irregular heartbeat is, before jumping directly to questions about transplantation. If indeed the irregular heartbeat is caused by congenital heart disease, frequently that can be repaired and your child would be expected to have a completely normal life.
Transplant immunology - what you asked about regarding rejection - is a very complicated subject - and for solid organs - liver, kidney, pancreas, heart, lung - is a life-long risk, and although it diminishes over time, requires long-term anti-rejection medications.

Many factors contribute to the risk factors for myocardial infarction (MI). Currently, we believe that it a combination of narrowed coronary arteries from atherosclerosis with damage to the inner lining of the blood vessel that leads to turbulent flow and attraction of inflammatory cells and proteins to the damaged artery. When the blood flow is slow and turbulent enough, and the inflammation significant enough to attract enough platelets, a plug is formed in the artery which blocks the blood flow to that area of heart muscle, causing the muscle cells to die (infarction).

Angioplasty is done to relieve narrowing in an artery because of atherosclerosis. Atherosclerosis causes the narrowing by stimulating the body to respond to inflammation which leads a plaque that is made up of tissues or varying hardness. Angioplasty is done by inflating a balloon inside the artery at the area of plaque formation to compress the softer tissues and crack and reduce the harder tissues in the plaque, thereby opening up the lumen of the blood vessel to allow for better blood flow. Frequently, a stent is inserted after the balloon angioplasty to keep the treated area of the blood vessel open.

There are many different types of “growths” in the esophagus, some benign some malignant, some causing symptoms others asymptomatic. Yes you should consult with a cardiothoracic surgeon to better understand what the nature of the growth is, and whether it requires surgical therapy.