By Dr Yogesh Dwivedi:
Congenital Heart Defect refers to the defects a baby is born with within their heart structure and great vessels. It is estimated that at least 1 in 125 babies are born with this defect in India making it one of the most common birth defects. Late presentation of these defects primarily due to a lack of health awareness or health facilities is one of the main reasons for the 10% infant mortality rate due to Congenital heart defects in India.
Many of these children have curable conditions and good long-term prognosis. Nearly 30% of these defects are critical, requiring intervention in early infancy How can parents suspect their child for this condition? 1. Blue babies – Blueness is a very important indicator of heart disease, and blue babies usually have severe form of congenital heart defect. Blue babies are most of the time prone to episodes of cyanotic spells that cause an increase in the depth and rate of breathing with an increase in blueness, leading to limpness, convulsions, or unconsciousness.
Repeated chest infections – Frequent chest infections may be the only feature of heart disease in a child. Upper respiratory infections like the common cold, mild cough, or hoarseness are not related to heart disease. Chest infections usually manifest with fever, fast breathing, and the drawing of the chest and usually require antibiotics for recovery. 3. Inability to breastfeed at a stretch – The inability to take mother feed at a single stretch, especially when associated with sweating is an early manifestation of congenital heart disease. Feeding difficulty is considered to be present if the baby cannot suck from the breast at a stretch for five minutes and becomes breathless during feeds.
Poor Weight Gain – Infants with congenital heart disease have poor feeding patterns and unsatisfactory weight gain. With cardiac defects, their metabolic rate is high, requiring more calories but due to feeding problems, their intake is poor leading to poor weight gain. In addition, frequent chest infection leads to further weight compromise. 5. Exertion and fatiguability – A child around the age of 3-4 years if feels exertion during competitive sports with their peers, or complains of fast heartbeat, decreased exercise tolerance, and early fatiguability as a grown-up child, are indications of urgent intervention. Timely intervention is the key to healthy living (Longevity) Parents should not lose hope or feel worried if the child is diagnosed with a congenital heart defect.
With recent advancements in the field of cardiac sciences, most heart defects are completely treatable and the child grows into a healthy adult. Children and adults living with a congenital heart defect need to see a heart doctor regularly throughout their lives. Though the causes for congenital heart defects are still unknown, studies suggest that it might be due to changes in the chromosomes, or genetic defects.
The Centers for Disease Control and Prevention’s National Birth Defects Prevention Study has found that women who are obese, have diabetes, or smoke during pregnancy increase their chances of having a baby born with a heart defect. Certain precautionary measures including a healthy diet, controlling diabetes, smoking cessation, and taking folic acid during pregnancy can reduce the risk of congenital heart defects. With the advent of fetal echocardiography, some of the congenital heart defects can also be diagnosed before birth. Congenital Heart defects are treatable Over the last three decades there has been a great advancement in facilities for congenital heart defects in India. Many centers have come up with treatment facilities for children with congenital heart defects. Even newborns with critical congenital defects are being treated successfully at these centers with good results. The need of the hour is to make people aware of the problem, its treatment facilities, and good outcomes if treated on time.
Author is a Consultant – Intervention & Paediatric Cardiology, Yatharth Super Specialty Hospital, Jhansi