Docyard | Be alert and safe

Of all birth diseases, congenital heart disease (CHD) is the most frequently occurring congenital disease. Several reports indicate that around 8 babies out of 1000 births are detected with congenital heart diseases which make it 1.35 million babies every year across the world. With the boon of advanced science and medical technologies, most cases of CHD in the developed and high-income countries get treated effectively. But low and middle-income countries like India have a tough time dealing with it.

As per  the National Family Health Survey, about 1.5 lakh infants are born with CHD in the country every year and that has become a serious matter of concern.

It is a problem that has to do with the structure of the heart. Either the walls or the valves or the arteries of the heart or the veins near the heart can be involved and act as a disruptor in the normal flow of blood through the heart which may cause the fatal defect. The first eight weeks of pregnancy are considered crucial for so many reasons and the baby’s healthy development is one of them. CHD happens when a baby’s heart is not formed correctly in those first eight weeks into pregnancy.

• Types: Congenital heart diseases are broadly classified into two types — Acyanotic and Cyanotic. Acyanotic congenital heart defect is the type that does not typically interfere with the amount of oxygen or blood that reaches the tissues of the body. In this type, the baby’s skin does not commonly develop a bluish tint, however in some exceptional cases when a baby struggles for more oxygen that too may occur. Acyanotic heart diseases include: ventricular septal defect (VSD), atrial septal defect (ASD), atrioventricular septal defect, patent ductus arteriosus (PDA), pulmonary valve stenosis, aortic valve stenosis and  coarctation of the aorta.

On the other hand, in Cyanotic heart disease, the heart lets the oxygen-rich and oxygen-poor blood to mix and the less oxygen-rich blood reaches the tissues of the body. This is the reason why the baby’s lips, fingers and nail beds develop a bluish cyanosis tint.  Cyanotic Heart Diseases include: tetralogy of fallot, transposition of the great vessels, pulmonary atresia, total anomalous pulmonary venous return, truncus arteriosus, hypoplastic left heart syndrome, tricuspid valve abnormalities.

nHow to detect: Not all heart diseases are deadly. Some get cured on its own with the passage of time. Screening is an important tool to ensure no babies die due to lack of a proper screening mechanism. CHD which are serious usually come into notice soon after birth or during the initial months of life. It can be detected by its obvious signs, which include:

• Pale gray or blue skin color (cyanosis)
• Rapid breathing
• Unusual swelling in the legs & stomach and puffiness around the eyes
• Struggle in breathing, especially during feedings, leading to poor weight gain
• Treatments: Not all cases of congenital heart diseases (CHD) need treatment. Some may become fine just by visiting a cardiologist and staying under observation. Surgery or cardiac catheterisation is the usual procedure to reduce the effects or to repair it. Sometimes, even if the defect is treated in childhood there are possibilities of a recurrence where additional medical treatment proves beneficial. Nowadays, due to advancement in the field of medical sciences it can also be treated without surgery. There are several non-surgical procedures available for certain heart defects that are not serious enough to require surgery.

The writer is Dr rn kalra Cardiologist, Medical Director & CEO at KALRA HOSPITAL (SRCNC)