September 29 is ” World Heart Day” and we have with us, Dr. Gopi Nalliayan a Paediatric Heart Surgeon who explains the importance of knowing the symptoms, signs, and risks of heart disease in babies and children.
Every year about 1.5 Lakh infants are born with congenital heart disease in India and about half of them die due to lack of proper diagnosis and treatment.
Early detection and treatment may save the lives of many babies. So it is important for the parents to know the signs and symptoms of heart disease in babies for prompt treatment.
1 ) What are the symptoms of Heart disease in children?
Symptoms of Heart disease in newborn babies up to 6 months.
- Breathing difficulty.
- Excessive forehead sweating during breastfeeding.
- Bluish discoloration of the lips and fingertips during crying.
- Repeated attacks of respiratory tract infection with fever, cough and nasal discharge.
- Decreased weight gain according to age
Symptoms in older children,
- Difficulty in breathing.
- Bluish discoloration while playing or doing normal activity
- Fast heart beat felt by the child or their parents.
- Swelling in the legs may be the initial symptom.
In such situation, you should consult with a cardiologist to rule out the Congenital Heart disease.
2) What is congenital heart disease?
Congenital heart disease is a condition which occurs at the birth of the child in the heart. It has to be detected as early as possible and treated according to the condition to prevent it from progressing further.
3) What are the types of Congenital heart disease?
There are different types of congenital heart disease.
In general, it is classified into
- Conditions with increased pulmonary blood flow ( blood flow to the lungs ) – Increased blood flow to the lungs may be due to the hole in the upper or lower chamber of the heart.
- Conditions with decreased blood flow to the lungs – Decreased blood flow to the lungs may be due to various conditions causing obstruction to the blood flow to the lung.
4) When to treat the Congenital heart disease if identified?
It depends on the type of the congenital heart disease.
Certain conditions have to be treated within 21 days of life. For some other type of conditions, we can wait for 1 or 2 years with follow up and treat symptomatically with medicines and finally correct when the child is older.
5) What are the types of treatment available for congenital heart disease?
In the current Pediatric Heart surgery scenario, facilities are available to treat babies of weight even below 2kg.
So if needed, the defect has to be corrected immediately after the birth of the baby to ensure the normal growth of the baby.
Apart from routine open heart surgeries, today’s technology has developed to an extent that we can close the hole in the heart with a button type of device through the vessel in the leg without the burden of major surgery or anesthesia.
Also, certain surgeries can be done without stopping the heart ( beating heart surgery ) and with a small incision in the side of the chest wall to prevent scar in the center of the chest.
6) What are the problems if the heart disease was not detected in the childhood?
Since diseased heart will consume a lot of energy, children with heart disease may not gain weight as per the age and there will be a gross limitation of activities.
If it is not detected and appropriately treated earlier, as the baby becomes old we may not be able to correct it at all, as the disease may progress to such an extent that it will affect the lungs and other organs also. So it is very important to detect early and treat accordingly.
7) Whether the children will be normal after surgery?
It depends on the type of the disease and its time of treatment.
But most of the children can undergo a normal life if treated at the correct age. To prevent complications the child must be on regular follow up as advised by the consultant.
8) What is the cause of congenital heart disease?
This is a developmental anomaly that occurs during the development of the baby in the uterus of the mother.
It may be due to various reasons like genetic, environmental, intake of teratogenic substance ( certain drugs, alcohol, smoking, radiation) infections during pregnancy and Increased Maternal age is one of the proven risk for the developmental anomaly.
9) How to prevent this developmental anomaly and is there any method to identify it before the birth of the baby?
This can be prevented by taking certain precautions like
- Avoiding radiation exposure during pregnancy ( x- ray, CT scan, metal detectors and X-ray scanners in airport and recreation malls also emit radiation.
- Consult your Gynecologist before taking any drug during pregnancy even for common cold, body pain etc
- Vaccination for Rubella infection before pregnancy.
- Folic acid supplementation as soon as the missed period and confirmation of pregnancy.
10. Tests to know heart disease of baby in-utero
Nowadays, a lot of tests are available to detect the abnormality in utero itself and decide the mode of management before the birth of the baby. They are,
- TORCH profile for the diagnosis of dangerous infections during pregnancy to be done as soon as the pregnancy was confirmed.
- Antenatal ultrasound scan at 20 weeks of pregnancy will detect the type of congenital heart disease and appropriate management can be done either in utero or after birth.
- Amniotic fluid examination at 20 weeks pregnancy can reveal the various syndromes that may cause the congenital heart disease.
These facilities will help us to diagnose the condition of the heart disease in the baby and manage it with certain drugs during the pregnancy itself and anticipate it during delivery and treat as soon as the delivery of the baby if necessary.
Even if the chances of a baby having congenital heart disease is minimal, it is always good to be aware of the disease and create awareness among our friends and family.
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Dr. Gopi Nallaiyan M.S, M.ch, DNB is a Pediatric Heart Surgeon of more than a decade of experience in the pediatric cardiac field and has operated on simple and complex congenital heart defects in new born babies and adult congenital disorders.
Images courtesy – FreeDigitalPhotos.net