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Paediatric Cardiology

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FAQ

What are the different kinds of heart defects?

Holes in the heart: These are the most common kind of heart defects.  If present between the upper two chambers of the heart, they are called ASDs and if present between the lower two chambers of the heart, they are called VSDs.

Narrowing of vessels or valves: The main arteries leaving the heart may be narrow at a point or one of the 4 valves of the heart may not open completely. 

Wrong connections of vessels with chambers:  Each part of the heart has a specific function. The left heart deals with receiving pure blood from the lungs and pumping it to the body. The right side of the heart receives impure (blue) blood from the body and pumps it to the lungs where with each breath blue blood becomes red and returns to the left heart. In certain heart defects (transposition, TAPVC) the vessels that enter or leave the heart are connected abnormally. Hence pure blood may end up going back to the lungs or impure blood may be carried to the body.
Malformed Chambers: of the 4 chambers of heart, 2 upper and 2 lower, any may be small and non-functional. Hypoplastic left heart syndrome is an example where the left sided chambers and vessels are small.

Why do babies get Heart Defects?

A lot of research has been done on this. The truth is that there seem to be too many factors involved, such that no single factor can be blamed in most cases. The heart is formed in the first 2 months of pregnancy. Hence what happens in that period alone determines how the heart is formed. Some factors thought to play a role include genetic mutations, maternal diabetes, certain medicines taken in first trimester and invitro fertilization.

Can heart defects be picked up in pregnancy?

Since the heart is formed early on in pregnancy, it seems logical that sonography of the unborn baby’s (fetus) heart after the third month of pregnancy should detect heart defects. However, at present there is limit to resolution of the sonography machines. Sonography of the Foetal heart is called Fetal echocardiography. World over, major heart defects can be detected by 18-22 weeks of pregnancy (4th to 5th month). Specially trained radiologists and paediatric cardiologists perform this test. However many minor heart defects may not be picked up in this manner. Knowledge about the heart defect prior to birth of the baby may allow the would-be parents to plan for the delivery and further treatment in a timely manner. In India, this test is underutilized. This test is available at Fortis.

What are the Tell-tale signs of a congenital heart defect in a child?

  • Major defects may be life threatening after birth. Usually the newborn looks bluish or cold and lethargic after the 1st day of life. There is no interest in feeding and there is rapid breathing.

  • Babies with large holes in the heart get tired while breast feeding. This starts to happen usually after 1 month of age. They gasp for breaths and sweat in between feeds. 

  • The weight gain of the baby falls below expected for age (GROWTH CHART).

  • The baby may get frequent cold and cough and pneumonias.

  • Some babies turn blue with crying or cold exposure or with exertion. 

  • Older children get tired with exertion.