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Wednesday, September 28, 2022

Spectrum of Heart Diseases in Infants

Congenital heart defects are one of the main causes of infant mortality. A congenital heart defect is a problem with the structure of the heart that child is born with. Congenital heart disease in children (CHD) is of different types. Some heart disorders in children are simple and do not need treatment while some may require multiple surgeries done over a period of a few years.

Early detection of heart disorders in children are important as this ensures the child receives timely intervention and is able to grow and develop with minimum challenges.
In India more than 220,000 children are born with CHD. Out of these children, roughly 70,000 children are born with critical heart defects, meaning they require some sort of intervention before one year of their birth, otherwise they will not survive.

As mentioned above, congenital heart disease in children can be of different types depending on the severity.

Some of the serious congenital defects mostly get noticed at the time of birth itself. Typically, these defects will have symptoms like:


• Rapid breathing
• Pale grey or blur lips, fingernails or tongue
• Poor feeding leading to poor weight gain
• Shortness of breath

Some heart disorders in children remain asymptomatic and may get diagnosed only in later childhood. The less serious types of CHD will have the following symptoms:


• Getting tiered easily during an activity or exercise
• Shortness of breath
• Poor wight gain

Broadly speaking, Congenital Heart Defects in children can be classified as Acyanotic and Cyanotic. Acyanotic defects are those where the oxygen content of the body is not reduced. Thus, there will be no bluish discoloration of lips or nails. Some of the common types of Acyanotic heart defects are Atrial Septal Defect, Ventricular Septal Defect and Coarctation of Aorta among others.

Cyanotic heart defects are those where the oxygen content of the body is reduced leading to a bluish discoloration of the lips or nails. Cyanotic heart disorders in children would require immediate treatment (surgery / intervention) while those with Acyanotic heart defects would require treatment (surgery / intervention) depending on the severity of the defect and age of the child.


The exact cause of congenital heart disorders in children cannot be pinpointed. Some of the leading causes of CHD are as follows:


• Family History
• Genetic
• Exposure to certain virus like Rubella during pregnancy
• Gestational Diabetes
• IVF
• Consanguineous marriage
• Smoking


Some of the common types of congenital heart disease in children are as follows:

Atrial Septal Defect(ASD): Hole in between the upper chambers of the heart. This causes an abnormal blood flow through the heart. The severity of ASD is dependent on the size of the hole.


Ventricular Septal Defect: Hole in between the lower chambers of the heart. Due to this the blood from the left ventricle flows back into the right ventricle leading to an increased blood flow into the lungs by the right ventricle. This can lead to an increase in pressure in the lungs.


Patent Ductus Arteriosus: Abnormal connection between Aorta and Pulmonary Artery leading to extra blood flowing from the aorta into the lungs.


Tetralogy of Fallot: This condition is a Combination of four defects in heart. These are as follows: in between lower chambers of the heart (VSD), Pulmonary Stenosis (narrowing of Pulmonary Valve), overriding of Aorta and Pulmonary Artery and thickening of right ventricle


Transposition of Great Arteries: The position of the two main blood vessels of the heart, Aorta and Pulmonary Artery is reversed. Due to this most of the blood less in oxygen which returns to the heart from the body is pumped back without going to the lungs. Also, the oxygen rich blood coming from the lungs is sent back to the lungs.


Total Anomalous Pulmonary Venous Connection: The pulmonary veins from the lungs get terminated at the right ventricle in place of the left ventricle


Ebstein’s Anomaly: Displacement of Tricuspid valve from its original position


Aortic / Pulmonary Stenosis: Narrowing of Aortic / Pulmonary Valve making it difficult for the heart to pump blood into the body.


Bicuspid Aortic Valve : Aortic Valve with two leaflets, in place of three leaflets

Heart disorders in children are treated by pediatric cardiologists. If you notice any signs or symptoms, it is vital to get your child evaluated by a good doctor.

Genesis Foundation (www.genesis-foundation.net) is a not for profit supporting the treatment of Congenital Heart Disease in Children

References:


Common Types of Congenital Heart Defects – Children’s Health (childrens.com)
Congenital Heart Disease (stanfordchildrens.org)

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