Heart Defects in Children and its Treatment
Birth defects or Congenital heart diseases are a group of gross structural abnormalities in the heart, are present at birth and manifest at any stage immediately after birth or during childhood.
Out of every 1000 newborns, about 8 neonates are born with congenital heart diseases. It is responsible for 28% of all congenital diseases. With this incidence, about 1.35million babies are born with congenital heart disease every year globally.
They can be genetic, due to intake of medication, alcohol or drug abuse during pregnancy or various viral infection during pregnancy.
Most of the patients become symptomatic immediately after birth or at any stage during the first year of life. Few of them present at a later stage during childhood or at an adult stage too.
Most of the children with heart disease presents with shortness of breath, fast breathing, poor feeding, poor weight gain, bluish discoloration of skin, nail beds, lips, undersurface of tongue, repeated cough, cold, fever, multiple hospitalisation with chest infection or Pneumonia, unable to suck breast milk, sweating over the forehead during feeding. The symptoms can present in isolation or in combination. Sometimes even these kids remain asymptomatic.
There are various types of congenital heart diseases but are broadly divided into two categories as cyanotic and acyanotic heart diseases. The babies with cyanotic heart diseases present with severe cyanosis ( bluish discolouration of the body) and acyanotic presents without cyanosis. Acyanotic diseases represent almost 2/3rd of total congenital heart diseases.
Most of them are diagnosed by ECG, Chest Xray, and Echocardiography. Few cases where echocardiography does not provide complete information, CT Angiography or Cardiac catheterisation is the alternative modes of diagnosis.
Yes. Two-third patients can be given treatment, cured and lead a normal life after treatment. Another third ( complex congenital heart diseases)can be palliated to give them a better quality of life and near-normal life expectancy.
They are treated by either closed heart surgery or open-heart surgery. Sometimes, it can be treated with interventions without surgery.
Of course risk of open-heart surgery in children is higher than adults. But with advanced technology and science, the mortality and morbidity have reduced significantly. On average, the risk of surgery ranges from 1% to 10%.
Majority of them lead a normal life and they can actively participate in sports, academics as their disease gets cured at a very early stage of growth phase after treatment.
They can be treated immediately after birth upto any age, depending on the subset of disease they are suffering from. Most of them are treated during the first year of life.
These diseases are can be detected as early as during pregnancy. There is a test known as Fetal Echocardiography. It is done by an experienced Paediatric cardiologist. It is done on pregnant mothers at the 18th to 24th weeks of pregnancy and if required, can be repeated at the 28th week of pregnancy. It is indeed a very safe procedure. Detection of heart problems in the fetus at this stage gives the flexibility of planned delivery and immediate treatment at a tertiary hospital after delivery.