Dr. Murtaza Kamal
Every year approximately 1, 80,000 babies in our country are born with congenital heart disease, i.e. a condition in which these babies are born with a defect in the heart. The overall prevalence of these defects is 8-10/1000 live births according to western data. In simple words, 1 in every 100 babies born has a defect in the heart. It is the most common birth defect presently. These defects can present soon after birth or any time later in the life.
Congenital heart diseases can broadly be classified as those in which the baby turns blue i.e. cyanotic congenital heart diseases and acyanotic congenital heart diseases in which the babies do not turn blue. In these defects basically, there is defect in the developmental process in utero and the babies are born with an abnormal structure of the heart. Naturally, as there is structural defect in these tender hearts, there will be abnormalities in blood flow too i.e. haemodynamics which will produce the problems leading to a constellation of symptoms. These defects in the young hearts can be either inherited from their parents, have genetic basis, can have environmental factors influence and can be due to infections to the mother when the foetus is in the womb. Certain drugs taken during pregnancy can lead to these defects. Maternal smoking and alcoholism also have important influence on the development heart.
The babies with congenital heart disease have varied presentations and at different times too. They can present soon after birth and can even be asymptomatic till late adulthood. These babies can present with feeding difficulties, failure to grow well, excessive sweating, repeated chest infections including pneumonia, turning blue as such or during crying etc. Recognition of these early signs and symptoms both by the parents and the primary care giver is very much essential. These babies demand thorough evaluation by the paediatricians and if suspected of having heart diseases should be referred to a “Paediatric Cardiologists,” who are especially trained in the care of these hearts, unlike the adult cardiologists.
The paediatric cardiologist along with proper history and examination gets chest x-ray and ECG of these babies. These babies are then subjected to an Echocardiographic examination, by especially trained cardiologists. When a diagnosis of a congenital heart defect is made the plan of management is decided by a team comprising of Paediatric cardiologist, Paediatric cardiovascular surgeon, Paediatric cardiac intensives and paediatrician. This plan of management is separate for each of the babies and depends on the type of defect they have.
Our country, in which we are still trying our best to make all the deliveries in institution, has a long way to go in this field. Many of these babies have critical defects in the hearts, which needs to be surgically palliated or corrected within the first few days of life. So, the early recognition of these defects by primary care givers and paediatricians is the need of the hour. More and more paediatricians are needed to be given special paediatric cardiac training, to combat this problem. We are lagging almost 5 decades in the field of Paediatric Cardiology from the western countries. There is need to create awareness in the public regarding these defects and also that these defects are curable.
Is a resident DNB Super Speciality (pediatric cardiology) at Star Hospitals, Hyderabad.