Congenital heart defects in children: Things you must be aware of as a parent

Congenital heart defect (CHD) is a problem or abnormality that occurs when a baby’s heart is developing while inside the mother’s womb. The term ‘congenital’ refers to a defect present at birth and is one of the most common birth defects. CHD indicates a problem in the structure of the heart which can affect the heart walls, heart valves or blood vessels.A baby’s heart starts forming during conception but is fully developed, eight weeks into the pregnancy. CHD originates during the first six weeks of pregnancy when the heart of the foetus starts taking form and shape.
Congenital heart problems can range from simple to complex and while the simpler ones can be managed with minimal medication and regular follow ups with the doctor, some of the more complex ones may require an intervention or surgery within the first few days of life.
Risk factors
Diabetes: Diabetes is a chronic disease that occurs when your blood glucose level is persistently high. It is important for women to keep their blood sugar levels in control before planning to conceive and also during pregnancy since diabetes can propel CHD in the new-born.
Infections during pregnancy: Many infections, especially viral infections like rubella during pregnancy may affect the baby's heart development.
Radiation: Exposure of a pregnant lady to X-rays can lead to development of heart defect in the foetus.
Medications: Consumption of certain medications during pregnancy may increase risk of CHD. Hence it is important to share a list of all medications that one is consuming with the doctor when the pregnancy is planned / detected.
Smoking and consumption of alcohol during pregnancy
Genes: CHD has association with certain syndromes and can also run in the family, though in rare cases.
Warning signs
The symptoms can be classified basis the age of the child:
Post birth or during the first few months of life
Interrupted feeds (Suck-rest-suck cycle)
Pale grey or blue skin colour (cyanosis)
Rapid breathing
Recurrent chest infections
Poor weight gain
Swelling in the legs, abdomen or areas around the eyes
Later in childhood:
Experiencing shortness of breath during exercise or activity
Fainting
Getting tired or exhausted easily
Experiencing fast or irregular heartbeats (Arrhythmia)
Chest pain
Sudden loss of consciousness (Syncope)
Treatment options
Some CHDs may only require regular medical follow up and resolve spontaneously over a period of time
Certain other CHDs can require surgical intervention to correct the congenital defect of the heart
Many CHD’s can be treated non-surgically using cardiac interventional techniques with good results
Most of the patients who have been treated for CHD’s can live a normal and productive life through regular consultation with a paediatric cardiologist.
Complications that CHD can lead to if not treated in time
Congestive heart failure resulting in poor weight gain, breathing complications.
Stunted growth and development as compared to other children of that age .
Heart rhythm problems also known as cardiac arrythmia .
Stroke due to blood clots traveling through a hole in the heart and on to the brain.
Cyanosis, a condition which indicates the skin colour turning greyish blue due to the mixing up of oxygen-rich and oxygen-poor blood .
Emotional stress or mood swings due to insecurity because of physical growth, activity restrictions, frequent hospital visits.
Preventive measures
Since it is difficult to determine the exact cause of CHDs, it is challenging to prevent this condition. However, the following measures can be undertaken to reduce the overall risk of birth defects and heart defects:
Get yourself vaccinated for rubella ahead of conceiving .
Control chronic medical conditions like diabetes, epilepsy etc.
Avoid exposure to harmful substances during pregnancy. Do not consume any drugs, herbs or medications without the doctor’s approval.
Avoid smoking and consumption of alcohol
Avoid exposure to radiations
Take a multivitamin with folic acid 2-3 months prior to conception and continue during pregnancy as folic acid can help reduce birth deficiencies .
Dr. Amit Mishri Senior Consultant - Paediatrics Cardiology Clinical and Preventive Cardiology, Heart Institute, Medanta Hospital