Congenital heart defects symptoms vary depending on the type of heart defect, its severity and also on the child’s age
Not all babies are born healthy, some are born with birth anomalies or defects of which the most common are congenital heart defects (CHD). Congenital simply means ‘present since birth’. CHD refers to abnormalities in the structure of the heart or the blood vessels attached to it. It affects nearly 0.8 per cent to 1.2 per cent of live births globally. According to the Indian Pediatric Academy, nine out of every 1,000 live births suffer from CHD. This translates to nearly 200,000 children being born with CHD every year in our country. In 20 per cent of these cases, intervention is needed before the baby’s first year of life.
Your baby’s heart
A baby’s heart is divided into four major sections or chambers. Four valves or gates help in controlling the flow of blood through the heart and around the body. CHD can occur when any of these chambers or valves don’t develop properly while the baby is in the womb. CHD can be classified into two major types—non-cyanotic CHD or pink babies where the baby’s blood has normal oxygen levels and cyanotic CHD or blue babies. This is also known as critical congenital heart disease (CCHD), where there is less oxygen in the baby’s blood. CCHD can restrict the flow of blood from the heart to the rest of the body or to the lungs or both. Some common CHDs include septal defects (a hole between two of the heart’s chambers), pulmonary valve stenosis (where the pulmonary valve is narrower than normal), PDA or patent ductus arteriosus (an opening between two major blood vessels leading from the heart), tetralogy of Fallot (a condition caused by a combination of four heart defects that affect the structure of the heart) and many others.
Signs and symptoms you must be aware of
CHD symptoms vary depending on the type of heart defect, its severity and the child’s age. Many CHDs are diagnosed in the foetal stage, allowing physicians to map out a treatment plan. However, in less severe cases, symptoms are not visible at birth and may develop later in life. Some of the symptoms to look out for include difficulty in breathing, rapid heartbeat, low blood oxygen level, a blue tinge to the skin or lips, fingernails or lips, extreme tiredness, breathlessness, or fatigue while feeding, and poor weight gain. Many defects are also detected when the child gets admitted repeatedly for lung infections. In this era, while it is important to be aware of the persistent symptoms that lead to life-threatening diseases, a patient should be given urgent basis, because in the end only diagnosis and treatment can save a life under critical condition.
Opportunities for CHD prevention
Since the exact cause of CHD is still not known, it is tricky to prevent it. However, some preventive measures can be taken during pregnancy to lessen the risk of birth defects. These include vaccination against rubella and flu, avoiding drinking alcohol or smoking, proper management of blood sugar and weight, evading exposure to harmful substances and regular checkups with doctors. Parents who already have a child with a CHD need to be alert and prepared since the chances of their second child suffering from the same condition is higher.
Treatment paths for CHD
Over the past decade, there has been a significant improvement in CHD therapy. With new heart-saving technologies and modalities, the mortality rate has reduced considerably with an improved quality of life for these children. Some CHDs can be treated with medication while children with severe CHDs are recommended for surgeries. Earlier open-heart surgery was the sole option to save lives, but with the onset of minimally invasive surgery options, treatment has become simpler. Today, one of the most common CHDs is PDA which occurs chiefly in premature babies. The hole in PDA is blocked by implanting an occluder that is smaller than a pea with a minimally invasive procedure. The tiny umbrella-like device is inserted through a small incision in the baby’s leg and steered through blood vessels into the heart. This device can be implanted in the tiniest babies, weighing as little as 700 gms, thereby breaking barriers to treatment.
Innovation with care
The treatment approach for CHD is chosen according to the child’s age, the severity of the condition, and medical history. The safety and efficacy of the procedure and overall quality of life after it is also assessed. The significant advancement in minimally invasive technologies has not only improved surgical outcomes in CHD therapy but also reduced the patient’s trauma with minimal scarring, less blood loss and enhanced recovery while maintaining a high standard of treatment. So, be alert and look out for any unusual signs and symptoms in your child, and do not hesitate to reach out to your doctor.
The author is a professor in Cardiology, PGIMER, Chandigarh. Views are personal.
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