Congenital heart disease is a birth defect where there is a structural defect in the heart/its blood vessels.
Incidence is estimated to be 10/1000 live births and accounts for approximately 300,000 children born with CHDs in India every year.
Approximately 10% of IMR is contributed by CHDs.
Not really. Though majority of the heart ailments in infants is because of CHD, in our country, as children grow older, rheumatic heart diseases also contribute to a significant proportion of heart ailments. Very infrequently, functional heart failures secondary to acquired infections are also encountered in children.
Genesis of CHD is polygenic -multi factorial and poorly understood. Maternal malnutrition, tobacco exposure, alcoholism, antenatal infections, unsupervised drug intake in antenatal period, elderly mothers, gestational diabetes, previous child born with congenital heart defect, previous still births are some of the factors which puts a mother at risk of giving birth to a child with CHD. Almost 30% of the Congenital heart defects have identifiable genetic cause.
Yes. Regular antenatal check-up with a foetal anomaly screening by antenatal ultrasound(Foetal Echocardiography) at 16 to 20 weeks of gestation helps in detection of CHDs.
The mother has to undergo regular antenatal visits without fail and be referred to a tertiary centre where delivery can take place and the neonate once delivered should be referred to a nearby cardiac centre where facilities to address CHDs are available.
Early detection not only helps the family to prepare themselves but also to plan for an optimal course of pregnancy and delivery.
A proper systematic clinical examination has a good sensitivity in picking up CHDs in neonates. Pulse oximetry neonatal screening for CHD-plays a vital role in neonatal screening of CHD.
Unexplained cyanosis on general clinical examination and murmurs on auscultation raising suspicion of CHD after initial neonatal resuscitative measures warrants referral to a tertiary care centre for a definitive diagnosis and further management.
A detailed transthoracic echocardiography by a trained pediatric cardiologist forms the cornerstone of CHD diagnosis. Further detailed imaging studies like cardiac catheterisation, CT and MRI may be required for complex anatomies.
Common CHDs encountered in clinical practice are Ventricular septal defects. Other simple defects include atrial septal defects, patent ducts arteriosus, pulmonary stenosis, co-arctation of aorta and so on. The commonest complex cyanotic heart disease that affects children is Tetralogy of Fallot.
CHDs are broadly classified into cyanotic and acyanotic heart diseases. Children with acyanotic heart diseases tend to have symptoms of repeated respiratory tract infections, failure to thrive, inadequate weight gain, forehead sweating, feeding difficulties, breathlessness and soon.
Cyanotic heart diseases present with varying degrees of cyanosis. Cyanosis is bluish discolouration of lips and nail beds. Some children go into repeated episodes of cyanotic spells and squatting episodes as they grow older.
Definitely. Most of the children born with CHDs are curable leaving these children to lead a normal life. Some children who cannot be cured can be subjected to undergo palliative procedures to improve their quality of life and reduce their suffering.
Open heart surgeries address almost every congenital heart defects today. A proportion of simple defects can be treated in a cardiac catheterisation laboratory without open heart surgery.
40 % of the children in infancy succumb to CHD. Critical Congenital heart disease accounts for close to 100,000 children born with CHD. Of those who survive beyond infancy, children fall prey to the natural history of CHDs where survival upto adulthood is unlikely but for a small proportion of patients with minor defects to reach adulthood.
A child born with congenital heart disease is understandably a burden for the family in terms of expenses incurred and social stigma faced by them. Due to concern of availability, accessibility and affordability issues, most of children fail to get timely treatment. Heart to Heart Foundation through its partner Hospitals provide totally free of cost treatment saving these tiny hearts and giving them new life.