HEALTH : Congenital Heart Disease

Adults are known to suffer from cardiac diseases due to obesity, alcoholism, hypertension, e.t.c. causes. But young children also suffer from heart diseases due to no fault on their part, what is classified as congenital heart diseases. Mostly children develop this problem in uterus during pregnancy. Alcohol or some drugs taken during pregnancy, infections like German measles, all these are causes of heart diseases in children. These defects can be of various types. There can be a defect in the septum separating the atrium or ventricles (chambers of the heart), patency of the tube involved in foetal circulation after birth (PDA), narrowing of the pulmonary valve, narrowing of the aorta, e.t.c. If the problem is mild, the affected child may well grow into an adult with few or no symptoms. But in severe cases, the child may not survive a few months after birth. With these congenital abnormalities in the heart, its functioning is impaired leading to cardiac failure. Symptoms of heart diseases in children are the same as those for adults. A small baby may be unable to suckle on the breast because of breathlessness. In an older child, initially the child may get breathless on severe exertion, then gradually the amount of exertion at which it becomes breathless is reduced. In advanced stages, he becomes short of breath even while resting. He is unable to sleep well and gets tired very easily. Along with this it develops swelling all over the body, beginning with the feet. In those kind of diseases where there is intermixing of pure and impure blood, the child may become cyanotic (bluish discoloration of tongue and lips) on even light activity. The affected child is more prone to develop infections of the lungs like pneumonias. It tends to eat less as it has almost no appetite due to reduced blood flow to the gut, this results in malnourishment. Gradually, there can be kidney and or liver failure because of reduced blood flow to these parts. Not only are these children unable to play with their friends, but are also unable to study because of chronic sickness. Many of these unfortunate children have other associated physical abnormalities because the agent inflicting damage to the heart also damages other parts of the body. Some of the children remain physically and mentally retarded. There is much ignorance regarding these diseases among public. Unless a child becomes very sick with cardiac failure, parents do not suspect any problem. When the child complains of breathlessness and early fatigue, it is brushed off by saying that, “you play very much.” Swelling coming on face and feet is unfortunately mistaken by the family as, “ child is getting healthy and putting on weight.” Sometimes the diagnosis of heart disease may be mistaken in a very young child as that of kwashiorkor, a condition of protein malnutrition. Diagnosis of heart disease is done clinically and confirmed by X-rays, cardiac echo and other imaging techniques. After diagnosing a congenital heart disease, the definitive treatment is surgical correction of the defect. But this is feasible only in children who are fit enough to undergo major surgery. Even after surgery, heart function does not become normal. Minimum maintenance dose of drugs of cardiac failure is required. Children who are not fit for surgery are given these drugs for life. children being young are more prone to develop adverse effects of these drugs like nausea, vomiting, visual disturbances, muscular cramps, kidney toxicity, e.t.c. Every pregnant woman has to be very vigilant so as to avoid drugs and substances that can harm the unborn baby. It is her moral and ethical duty to protect the baby in her womb. Any child showing signs of any abnormality in feeding, walking, running or sleeping, even doubtful should be investigated for congenital heart disease. The child should be encouraged to take up as much physical activity as its condition permits so that it does not feel alienated from its colleagues. There are surgical teams coming as volunteers to King Faisal hospital, every 6 months or so to operate on cases of congenital heart disease and needy people can make use of their help. The author is a specialist in Internal MedicineE-mail: rachna212002@yahoo.co.uk