Congenital heart disease in children: an expert answers the FAQ

Heart disease is on the rise around the world and one of the main factors is changing lifestyles. According to the World Health Organization (WHO), 17.7 million deaths in India are due to heart problems. A significant number relate to the younger population, which is why it is important to be aware of congenital heart disease (CHD) in children.

The term “congenital” means “present from birth”. Congenital heart disease, one of the most common birth defects, is a collection of malformations that affect the way the heart develops and functions from birth and has the ability to change the way blood flows through the heart. one person. These can be acyanotic CHD (pink babies) or cyanotic CHD (blue babies).

A recent study shows that each year more than 2,000,000 children are born in India with congenital heart disease, of which one-fifth are very likely to be in a serious condition requiring surgery within a year of birth. Some of the questions that are regularly asked about CHDs are:

What are the symptoms of coronary heart disease in children?

There could be several symptoms related to coronary artery disease, especially in children. Some of the key symptoms are:

Repeated respiratory infections

Rapid heartbeat and breathing

Swelling of the legs, stomach or around the eyes

Tired

Bluish discoloration of the skin / nails / lips / tongue, known as “cyanosis”

Fast breathing / easy fatigability during feeding

Inability or reduced ability to exercise or play (compared to peers in the same age group)

What factors might increase a child’s risk of developing coronary artery disease?

Most coronary artery disease problems start early because a child’s heart begins to develop before birth. Although the exact cause of coronary heart disease may be unknown, certain risk factors may play a role:

Smoking and drinking alcohol during pregnancy

Certain medications taken during pregnancy

Diabetic mother

Mother with rubella (German measles) during pregnancy

Smell or use of harmful substances during pregnancy

Genetic factors / syndromes

What is the cure for coronary heart disease?

Various treatment options are currently available to diagnose and treat congenital heart defects. They include drugs, catheter procedures, and surgery to treat and cure many conditions. Some defects require multi-step procedures and others require multi-step remedial procedures.

According to the Centers for Disease Control and Prevention (CDC), about 97 percent of babies born with non-critical coronary artery disease are likely to survive for up to a year and about 95 percent of babies born with non-critical coronary artery disease are likely to survive to age 18. However, it is very important that these children are monitored regularly.

Is there a way to diagnose these defects during pregnancy?

Yes, examination for fetal abnormalities / echocardiography at 18-20 weeks gestation (fifth month of pregnancy) helps to detect and diagnose heart defects while the child is in its mother’s womb. This is very important and helps the healthcare team and parents decide what to do with these defects in the future. Some children may need surgery soon after birth and it is therefore important that the birth takes place in a center with pediatric cardiac services (pediatric cardiology and pediatric cardiac surgery) for support.

Are children with coronary artery disease more likely to be affected by COVID-19?

Children with coronary heart disease or postoperative cases of coronary heart disease are known to have a greater predilection for severe disease. Extra precautions to avoid infections and treat respiratory infections early on are imperative.

How can children with congenital heart disease be protected from COVID-19?

The important measures that should be adopted are masking, social distancing and good hand hygiene.

Regular check-ups and teleconsultations with your doctor can help. In addition, it is advisable to consult your doctor before having your child vaccinated and to complete your child’s vaccination according to the schedule.

Thus, it is of the utmost importance that these congenital heart defects are detected early on. Discussing with a multidisciplinary team about treatment options and planning the procedures at the right time is very important for a positive and healthy outcome.

(The author is a consultant – Pediatric and Adult Thoracic Cardiovascular Surgeon, Fortis Hospitals, Bannerghatta Road.)

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