Congenital Heart Disease (CHD) Treatment in Delhi, India
Overview
Congenital heart disease is a common term used for defects or abnormalities in the heart's structure since birth. These defects can range from mild to severe, depending on whether it is a small hole or some missing parts in the heart. Some cases in children are uncomplicated, while others require multiple surgeries and medication.
Associated Organ of CHD
The organ affected by CHD is the heart ,mainly along with the aorta pulmonary trunk.
Congenital Heart Disease Causes
CHD can be caused due to several factors, though the exact cause is not yet known.
- Down syndrome occurs due to alteration in genes or chromosomes in children during the first six weeks of pregnancy, which marks the development of the heart.
- Maternal diabetes – Females with Type 1 and Type 2 diabetes have higher chances of childbirth with CHD babies. High insulin levels in the blood may hinder the normal development of the foetus.
- Excessive alcohol consumption and smoking – Foetal alcohol spectrum disorder usually affects the foetus when the mother drinks excess alcohol during pregnancy, leading to atrial septal defects or ventricular septal defects. Another cause is smoking.
- Rubella virus – A viral infection that may cause CHD in babies if the mother carries the virus during the first 8 to 10 weeks of pregnancy.
- Medication – Several medicines like thalidomide, angiotensin-converting enzyme (ACE) inhibitors, and statins can be dangerous.
Congenital Heart Disease Symptoms
They include the following:
- Pale blue or grey lips, fingernails or tongue, also known as cyanosis.
- Repeated cough and colds.
- Rapid heartbeat and breathing.
- Swelling in the legs, belly or around the eyes.
- Shortness of breath during feeding activity.
- Extreme fatigue and exhaustion.
- Limited ability to do exercise.
- Poor growth and shunted growth.
- Abnormal sound of heartbeat (diagnosed by a physician).
Congenital Heart Disease Diagnosis and tests
After birth, the doctor will check the baby’s heart as part of the newborn physical examination. However, some defects do not show up for several years. There are several additional tests like echocardiography, electrocardiogram (ECG), X-ray chest, pulse oximetry, cardiac catheterisation CT and heart magnetic resonance imaging (MRI). These tests can either confirm or rule out a diagnosis.
Congenital Heart Disease Treatment
The Congenital Heart Disease treatment will be initiated based on the type and severity of the disease. At times, the condition does not have any long-term effect on children and can go untreated. In most cases, treatment includes the following:
Medications
Blood pressure drugs, diuretics and antiarrhythmics are common for treatment.
- Blood pressure drugs like angiotensin-converting-enzyme (ACE) inhibitors, angiotensin II receptor blockers (ARBs) and beta-blockers
- Diuretic drugs reduce the body's fluid content, reducing the strain on the heart.
- Antiarrhythmic drugs help to normalise the irregular heartbeat.
Surgical interventions
Few of the special procedures:
- Cardiac catheterisation - Cardiac catheterisation is useful when some heart defects can be fixed using thin, flexible tubes (called catheters) without open-heart surgery.
- Open-heart surgery - Open heart surgery, Complete correction or palliative.
- Heart transplant - Heart transplant comes into action when the defect is severe and irreparable by other methods.
Risk Factors of Congenital Heart Disease
Various risk factors associated with CHD are:
- Lack of multivitamins and folic acid in the diet during pregnancy.
- Maternal diabetes.
- Systemic lupus erythematosus (SLE) in the mother is an inflammatory disorder in which the immune system attacks its tissues.
- Febrile illnesses.
- Previous history of abortions and stillbirths
- Advanced paternal or maternal age
- Maternal drug exposure.
- Alcohol and tobacco use.
- Phenylketonuria.
- Viral Fever.
Complications of Congenital Heart Disease
Possible complications of CHD are developmental issues in children like impaired memory, problems understanding the language, respiratory tract infections, endocarditis, shortness of breath, pulmonary hypertension (extreme fatigue, chest pain), heart failure, heartbeat issues, blood clots leading to pulmonary embolism or stroke.
Congenital Heart Disease Preventions
Primary Prevention of Congenital Heart Disease
The following may prevent the occurrence of the disease:
- Vaccination against Rubella virus and flu.
- Avoid alcohol and do not take medication without a doctor’s advice.
- Intake of 400mcg of folic acid supplement a day during the first trimester of pregnancy.
- Staying away from people who have an infection.
- Controlling diabetes.
- Keeping away from organic solvents.
Secondary Prevention of Congenital Heart Disease
These may prevent the recurrence of the disease:
- Use of preventive antibiotics - Sometimes, CHD may increase the risk of infection in the lining of the heart or valves, so the child’s cardiologist can recommend antibiotics.
- Regular clinical and lab examination and detection of any early pathology.
Epidemiology of Congenital Heart Disease
- Gender - The number of new cases is high in males than in females.
- Causes - Both genetic and environmental, with the genetic factors being the primary ones
- Socioeconomic status - Countries with high socioeconomic status have slightly high CHD on account of screening newborns and exceptional medical infrastructure. Deaths are highest in low and middle-income countries.
Prognosis of Congenital Heart Disease
An average of 1-year survival of babies with severe CHD has been found, with survival rates gradually decreasing this adulthood. The percentage of 1-year survival was the highest, followed by 5-year and 10-year ones.
Natural Progression of Congenital Heart Disease
Disabilities like infective endocarditis, arrhythmia, pulmonary hypertension, liver disease, and several others might increase and worsen over time if left untreated. Diabetes, obesity or atherosclerosis might worsen the condition. Eventually heart failure sets in.
Pathophysiology of Congenital Heart Disease
Most CHD patients have a shunt, which is an abnormality that allows blood to flow directly from one side of the heart to the other without the involvement of the lungs for oxygenation.