Congenital heart disease in kids: An expert answers FAQs

A recent study shows that every year more than 2,00,000 children in India are born with congenital heart disease, one-fifth of whom are highly likely to be in a serious condition requiring surgery within a year of birth.

By Dr Nischal R Pandya

Heart diseases have been on the rise across the world and a major factor for the same is changing lifestyles. According to the World Health Organisation (WHO), 17.7 million deaths in India are due to heart-related problems. A substantial number involves the younger population, which is why it is important to be aware of congenital heart diseases (CHD) in children.

The term ‘congenital’ means ‘present from birth’. Congenital heart disease, one of the most common birth defects, is a set of defects that affects the way in which the heart develops and functions from birth and has the capacity to change the way blood flows through a person’s heart. They may be acyanotic CHD (pink babies) or cyanotic CHD (blue babies).

A recent study shows that every year more than 2,00,000 children in India are born with congenital heart disease, one-fifth of whom are highly 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 CHD in children?

There could be several symptoms relating to CHD, especially in children. Some of the key symptoms are:

Repeated respiratory tract infections

Rapid heartbeat and breathing

Swelling of legs, tummy, or around the eyes

Fatigue

Bluish discolouration of skin/nails/lips/tongue, known as ‘Cyanosis’

Fast breathing/ easy fatigability while feeding

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

What are the factors that could increase the risk of a child developing CHD?

Most CHD issues occur early as a child’s heart begins developing before birth. Even though the exact cause of CHDs may be unknown, there are some risk factors that could play a role:

Smoking and drinking alcohol during pregnancy

Certain medications consumed during pregnancy

Diabetic mother

Mother affected with Rubella (German measles) during pregnancy

Smelling or consumption of harmful substances during pregnancy

Genetic factors/syndromes

What is the cure for CHD?

Various treatment options are available to diagnose and treat congenital heart defects at present. They include medicines, catheter procedures and surgery to treat and cure many conditions. Some defects require multiple staged procedures and some need staged palliative procedures.

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

Is there any way to diagnose these defects during pregnancy?

Yes, getting an anomaly scan/foetal echocardiography at 18-20 weeks of pregnancy (fifth month of pregnancy) helps to pick up and diagnose heart defects while the child is in the mother’s womb. This is very important and helps the treating team and parents to decide on steps to take in the future regarding these defects. Some children may need a surgical procedure soon after birth and thus it is important that the delivery takes place at a centre with paediatric cardiac services (paediatric cardiology and paediatric cardiac surgery) for backup.

Are children with CHD more prone to getting affected by COVID-19?

Children with CHD or post-operative cases of CHD are known to have a higher predilection for severe disease. Extra care to avoid infection and treat respiratory infections early on is imperative.

How can children suffering from congenital heart diseases be protected from COVID-19?

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

Regular health checks and teleconsultations with your doctor can prove to be useful. Also, it is advisable to consult your doctor before getting your child vaccinated and complete immunization of your child as per schedule.

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

(The writer is Consultant – Paediatric and Adult Cardiovascular Thoracic Surgeon, Fortis Hospitals, Bannerghatta Road.)

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