Rainbow Children Hospital has a legacy of 19 years where it has provided high standards of health care to mothers, fetuses, newborns, and children. We have the best cardiologist in Hyderabad who can provide treatment for a wide range of conditions including congenital heart defects.
A congenital heart defect in your child means that they were born with an issue with their heart’s structure. In some cases, these defects might be simple and won’t require any treatment. In others, these are more complicated and might need multiple surgeries over a period of several years. To help cope better and help your child through these tough times, it is important for you to have an understanding of their condition and what should be expected in the future. Knowledge along with treatment from the best cardiologist in Hyderabad will ensure that your child receives the best care.
In this article, we will provide you with a guide to Pediatric and Congenital Heart Disease that will help you prepare better to deal with your child’s condition.
Symptom
If your child has serious congenital heart defects, you will be able to see the signs and symptoms soon after birth. Here are a few examples:
- Rapid breathing
- Shortness of breath while feeding that results in poor weight gain
- Cyanosis (blue skin colour)
- Swelling in the abdomen, legs, or around the eyes
In cases of less severe congenital heart defects, the condition might not be diagnosed until your child is a little older. This is because there won’t be any noticeable symptoms. As your child grows old, they might display the following signs:
- Swelling in feet, handles, or ankles
- Fainting while exercising
- Getting easily tired during exercising or any physical activity
- Shortness of breath while exercising or any physical activity
Causes
To understand the causes of congenital heart disease, you first need to understand how the heart functions.
The heart is made up of four hollow chambers, two on either side. Both, the left and right sides have different tasks that eventually aid in pumping blood throughout the body. The right side is responsible for moving blood through the pulmonary arteries to the lungs. This blood picks up the oxygen from the lungs and flows back to the left side of the heart through pulmonary veins. The blood is pumped by the left side through the aorta.
The heart starts taking shape and beating in the first six weeks of pregnancy. The blood vessels running to and from the heart will be formed during this time as well. It is at this point when the heart defects might start developing in your baby. The exact cause of congenital heart defects is not known. However, researchers believe that genetics, certain medications, medical conditions, and environmental factors might play a role.
Types of congenital heart defects
Here are the different forms of congenital heart defects:
- Holes in the heart – It is possible for the walls between the heart chambers and between the blood vessels exiting the heart of your child to develop holes. In some cases, these holes give way for oxygen-poor blood which then gets mixed with oxygen-rich blood. As a result, your child’s body will receive less oxygen. If the hole is big in size, the lack of oxygen might cause the skin and fingernails of your child to appear blue. It might also cause congestive heart failure.
An example of such a defect is the ventricular septal defect in which there is a hole between the walls of the left and right chambers on the ventricles (lower part of the heart). Another example is the atrial septal defect occurring when there is a hole in the walls of the upper heart chambers (atria).
- Obstructed Blood Flow – When a heart defect causes the heart valves or blood vessels to get narrow, the heart has to work harder for pumping the blood. This results in an enlarged heart and thickened heart muscle. Aortic stenosis or Pulmonary stenosis are a few examples of such forms of defects.
- Abnormal Blood Vessels – There are several heart defects where the blood vessels running to and from the heart are not formed correctly or they are incorrectly positioned. One example of such a defect is the Transposition of the great arteries where the aorta and pulmonary aorta are on the wrong side. Another condition known as Total anomalous pulmonary venous connection is a defect occurring when the blood vessels from the lungs are attached to the wrong part of the heart. Coarctation is a defect that occurs when the blood vessel that supplies blood to the body is narrow.
- Heart valve abnormalities – In some defects, the heart valves are unable to correctly open and close that results in disruption of the blood flow. An example of this is the Ebstein’s anomaly where the tricuspid valve, located between the right ventricle and the right atrium, is malformed and leaks. Pulmonary atresia is another example where the pulmonary valve is not present resulting in an abnormal flow of blood to the lungs.
- An underdeveloped heart – In some cases, a part of the heart is not developed properly. For example, hypoplastic left heart syndrome is a condition where the left portion of the heart is not developed. As a result, the heart is not able to pump blood effectively throughout the body.
- A combination of defects – It is also possible for your child to be born with multiple heart defects. For example, Tetralogy of Fallot involves four defects – a narrowed passage between the pulmonary artery and right ventricle, a hole in between the walls of the heart’s ventricles, thickened right ventricle’s muscles, and a shift in the connection of heart and aorta.
Risk Factors
Usually, congenital heart defects are caused because of unknown problems in the early heart development of your child. However, there are certain genetic and environmental risk factors that play a role. Here are a few examples:
- German Measles (Rubella) – Having rubella while being pregnant can interfere in the development of your baby’s heart. That is why it is important to get tested for immunity against this condition before getting pregnant. If you are not immune, you must get vaccinated immediately.
- Diabetes – It is possible to decrease the risk of your kid having a congenital heart defect by controlling your diabetes before and during pregnancy. Please note that gestational diabetes doesn’t increase the risk of a heart defect
- Medications – There are certain medications that, if taken during pregnancy, can result in birth defects and congenital heart defects. So, before you attempt to get pregnant, you need to give the complete list of medications to your doctor.
- Smoking and drinking alcohol – You need to stop smoking and drinking alcohol during pregnancy as it increases the risk of your baby developing a congenital heart defect.
- Heredity – Congenital heart defects can be associated with a genetic syndrome. For example, if your child has down syndrome (caused by the extra 21st chromosome), he/she is more likely to have a heart defect. Another cause of heart defect can be the deletion or missing of genetic material on the 22nd chromosome. These disorders can be detected through genetic testing during fetal development. If one of your children has a congenital heart defect, you must seek the help of a genetic counselor to find the odds of your next child having one as well.
Complications
There are certain complications associated with congenital heart defects including:
- Congestive Heart Failure – This is a serious complication your child can develop if he/she has a significant heart defect. Common symptoms of congestive heart failure are rapid breathing, gasping breaths, and poor weight gain.
- Slow development and growth – If your child has a serious congenital heart defect, they will grow and develop slower than other children. They will be smaller and weaker than children of the same age. Also, if the defect has affected their nervous system, they might learn to talk and walk later.
- Heart rhythm problems – Arrhythmia is a heart rhythm problem that is caused by a heart defect or from scarring formed by the procedure for correcting the congenital heart defect.
- Cyanosis – Cyanosis is a condition in which your child will develop a blue-grayish skin colour. It is caused when the oxygen-rich blood is mixed with oxygen-poor blood in the heart because of the congenital heart defect.
- Stroke – Even though this is an uncommon complication, it is possible that your child with the congenital heart defect has an increased risk of stroke. This is because of the blood clots flowing through the hole present in the heart and to the brain.
- Emotional issues – If your child has a congenital heart defect, he/she might feel insecure leading to the development of emotional problems. They will face issues because of their size, learning difficulties, and activity restrictions. If you are worried about your kid’s mood, you must talk to a counselor or a therapist.
- Lifelong follow-up – Since your child has a heart defect, they will have to take extra care of their heart and be mindful of the defect their entire life. Having a congenital heart defect increases the risk of heart valve problems, heart tissue infection (endocarditis), or heart failure. Your child will have to consult a cardiologist regularly throughout their life.
Prevention
As mentioned above, the exact cause of congenital heart defects is not known. That is why preventing these conditions is not possible. However, it is possible to reduce the risk of birth defects and even heart defects in your child by taking care of a few things like:
- Get the rubella vaccination – Getting infected by rubella while being pregnant can affect the heart development of your child. So, before you try conceiving, it is important that you get vaccinated.
- Control chronic conditions – Controlling your blood sugar level is important for reducing the risk of congenital heart defects. If you have any other chronic conditions like epilepsy that require medication, you have to discuss the benefits and risks of the drugs on your child.
- Avoid all harmful substances – While you are pregnant, you need to stay away from strong-smelling products used for cleaning and painting. Also, consult your doctor before taking any drugs, dietary supplements, or herbs. Avoid smoking or drinking alcohol during pregnancy.
- Take a multivitamin every day with folic acid – If you consume 400 mg of folic acid daily, it can reduce the risk of birth defects in the spinal cord and brain. It also helps in reducing the risk of heart defects.
Diagnosis
At Rainbow Children’s Heart Hospital, we have the best cardiologist in Hyderabad with access to state-of-the-art equipment to detect congenital heart defects in your child. Initially, they might suspect that there is a problem because they heard a heart murmur in a routine exam. A heart murmur is a sound caused when the blood flows so fast through the blood vessels or heart that it makes a sound.
In most cases, heart murmurs are harmless. There is no underlying heart defect and there is no danger to the health of your child. However, in some cases, the murmur might mean that your child’s heart has an abnormal blood flow because of a heart defect. If this is the case, our doctor will order tests to confirm whether your child has a congenital heart defect or not. Here are some diagnostic tests for the same:
- Fetal Echocardiogram – Through this test, the doctor will be able to check if your child has a congenital heart defect or not. This will allow us to create a better treatment plan. The test involves performing an ultrasound where the sound waves are used for creating a picture of your child’s heart.
- Echocardiogram – This is a regular echocardiogram that is performed after your baby is born for diagnosing a heart defect. It is a noninvasive test where the doctor will be performing an ultrasound for producing the images of your child’s heart. The echocardiogram helps the doctor in seeing your baby’s heart in motion and check if there are any abnormalities in the heart valves and muscles.
- Electrocardiogram – It is a noninvasive test that involves recording the electrical activity of your baby’s heart and diagnosing any rhythm problems or heart defects. For the test, electrodes connected to a printer and computer are placed on your child’s chest. These electrodes will be displaying waves indicating the beating of your child’s heart.
- Chest X-ray – A chest X-ray of your child can be used for seeing if he/she has an enlarged heart. Or if their lungs have extra fluid or blood in them. These can be signs of heart failure.
- Pulse Oximetry – This test is used for measuring the oxygen levels in your baby’s blood. The test involves placing a sensor on your baby’s finger and recording the oxygen level in the blood. If your child has too little oxygen, it might be a sign of a heart problem.
- Cardiac Catheterization – This test involves inserting a catheter (a thin, flexible tube) into the blood vessel through your baby’s groin and leading it to the heart. This might become a necessary procedure if the doctor wants a detailed view of your baby’s heart. Also, Cardiac Catheterization can be used as a treatment procedure for heart defects as well.
- Cardiovascular Magnetic Resonance Imaging (MRI) – This is an imaging test that is used for diagnosing and evaluating heart defects in adolescents as well as adults. Through the MRI technology available at Rainbow Child Heart Hospital, you will get higher resolution and faster imaging than any other diagnostic methods.
Treatment
There are some congenital heart defects like small holes that don’t require any treatment as they don’t have any long-term effect on your baby’s health. These defects might even get corrected on their own as your child grows old. However, there are some defects that are serious and need immediate treatment. Here are a few treatment options used by the best cardiologist in Hyderabad to treat congenital heart defect:
- Catheterization – For some children and adults, congenital heart defects can be repaired through catheterization techniques. This method allows doctors to repair the defect without opening the chest. It is a common procedure used for fixing areas of narrowing or holes. During the procedure, the doctor will be inserting a catheter into the leg vein and using X-ray images to guide it to your baby’s heart. After the catheter reaches the site of the defect, the defect is repaired through the tiny tools threaded through the catheter.
- Open-heart surgery – Your child might need surgery for repairing the congenital heart defect. The procedure involves opening the chest and repairing the heart. In some cases, it might be possible to treat the defect using a minimally invasive heart surgery where small incisions are made between the ribs and instruments are inserted through them for repairing the defect. In either case, you need not worry as the procedure is handled by the best cardiologist in Hyderabad.
- Heart transplant – In some cases, the heart defect might be so severe that it couldn’t be repaired. For this, heart transplant might be your only option.
- Medications – If your child has a mild congenital heart defect, it might be treated with medications. These might also be used as part of a combination treatment with surgical or catheter procedures.
As a parent, it is natural for you to be worried about the health of your child, even if they have received treatment from the best cardiologist in Hyderabad. Although there are many children who can resume their normal life after the procedure, you have to keep a few things in mind. Your child will face some developmental and emotional difficulties because of the long recovery period and multiple restrictions. You can talk to the specialists at the Rainbow Child Heart Hospital, the best cardiologist in Hyderabad, who will help you with any difficulty related to the heart condition of your child.