Monday, 28 December 2015

Know Your Child’s Heart

Every year, at least 3 to 8 out of every 1000 babies are born worldwide with defective heart. In addition, a small proportion of children who are born with normal heart acquire heart conditions such as Rheumatic heart disease, Kawasaki disease, Myopathies etc.

Rheumatic heart disease usually follows a simple throat infection caused by the bacteria called beta-haemolytic streptococcus, which in some children damage the heart valves causing their malfunction.
Kawasaki disease starts as a fever, subsequently affecting the coronary arteries leading to complications such as heart attacks in children.

Myopathies are diseases of the heart muscle usually caused by some viral infections. The heart muscle weakens and becomes ineffective in its function as a pump, resulting in heart failure.

It is very important to suspect and diagnose these heart defects early. All these defects CAN be corrected with appropriate treatment. It IS possible for you to protect your children from these illnesses and help them live normal and full life.




Who is a paediatric cardiologist?
A Paediatric Cardiologist is a Children’s Heart Specialist who specializes in diagnosing heart diseases in children and offers solutions for normal life and growth.

When do parents need to take their children to a paediatric cardiologist?
  • When either of the parents OR a previous child OR a close relative in the family has been diagnosed with a heart defect previously
  • When the parents suspect that their child may have a heart problem

When should the parents suspect a heart problem in their child?
When the child shows any of the following symptoms:

As a baby: Breathing fast (tachypnoea), very slow interrupted feeding (suck-rest-suck cycle), sweating over the head while feeding (diaphoresis), poor weight gain (failure to thrive), going blue or dusky all over the body while crying (central cyanosis).

As an older child: Getting tired easily while playing (exertional fatigue), getting frequent chest infections (pneumonia), complaining of chest pain (palpitation), complaining of giddiness (syncope) and bluish discolouration (cyanosis).

How does the Paediatric Cardiologist check the baby’s heart?
The Paediatric Cardiologist checks the baby clinically for abnormal discolouration (cyanosis), abnormal pulse (rhythm disturbances and heart function) and abnormal heart sounds (murmurs). The common tests undertaken are Chest X-Ray (to see the position and size of the heart), ECG (to check the heart rhythm) and Echocardiography (to check for any structural problems in the heart and assess the heart function).

Can heart problems of babies be detected during pregnancy?
Yes, it can be done by using Foetal Echocardiography at 16-20 weeks of pregnancy. Elderly diabetic mothers, those with birth defects of the heart, and those who have previously given birth to babies with heart defects are advised foetal echocardiography.

What are the heart problems usually seen in children?
Heart problems in children may be CONGENITAL: these are defects at birth which are of two kinds – simple and complex.

Simple defects are those such as holes in the heart (ASD, VSD, PDA) and blocked valves (Aortic stenosis, Pulmonary stenosis, Coarctation of Aorta).

Examples of complex defects are blue baby conditions (TOF -Tetralogy of Fallot, TA -Truncus Arteriosus, TGA - Transposition of Great Arteries).

Heart problems in children may also be ACQUIRED: children have a normal heart at birth and then their heart becomes diseased (Cardiomyopathy, Rheumatic heart disease, Kawasaki disease).

Can these heart problems in children be cured?
About 95% of heart problems in children can be treated successfully. Majority of the simple problems can now be cured without operations by device closures and Angioplasty. Conditions cured without surgery are ASD, VSD, PDA, Coronary fistulas, Aortic stenosis, Pulmonary stenosis, Coarctation of Aorta. These procedures are carried out first by inserting small tubes called catheters into the heart through the blood vessels in the leg. Next with careful manoeuvres through the catheter, the holes in the heart are closed with devices; or the blockages in the heart are opened up with balloons and stents.

The advantages of these procedures are:
  • complete cure of the heart without a visible scar on the body
  • without blood transfusions
  • without pain
  • minimal hospitalisation period (usually 2-3 days)
  • without a need for post-procedure resting period.

The complex blue baby conditions also have very good surgical solutions these days, providing the growing child with an excellent quality of life.

For more details on these procedures log on to www.hxplain.com

Article by Dr. R. Prem Sekar, Senior Consultant Interventional Paediatric Cardiologist, Kauvery Hospital, Chennai

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