Global Health Asia-Pacific September 2020 September 2020 | Page 40
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Congenital Heart Disease: Its Risks,
Symptoms and Treatments
Dr. Leong Ming Chern, Deputy Head and Consultant Paediatric Cardiologist of Paediatric & Congenital Heart Centre (PCHC)
talks about the condition
“There are two
types of ‘blue
babies’ – one
can gain back
near to 100 per
cent oxygen
concertation
with treatment,
and the other
may not even
reach up to
90 per cent
despite surgery
and other
interventions.
Congenital heart disease, also known as congenital
heart defect is a heart complication present at
birth.
According to Deputy Head of Paediatric and Congenital
Heart Centre at the National Heart Institute (IJN) Dr Leong
Ming Chern, the condition is the commonest disease
among children and it affects one per cent of their population
globally.
It ranges from mild, simple conditions that don’t cause
symptoms to complex illnesses that may lead to severe
life-threatening issues.
Dr Leong said congenital heart disease is a spectrum
with dominantly milder conditions than the serious ones.
Fortunately, he added that most cases can be treated
and cured. “But for a small percentage of children with
complex heart disease, we still can do procedures and
improve their quality of life,” he said.
Dr Leong also said that some children with mild conditions
can even resolve spontaneously as they grow older.
However, he advised that those with symptoms to seek
medical attention to avoid any risks.
The dreading “blue”
When babies are born, they should exude a natural pink
colour to indicate their body has enough oxygen.
But if their colour is bluish at birth, Dr Leong said that
may be the alarming sign that the infant’s body doesn’t
have enough oxygen.
“There are two types of ‘blue babies’ – one can gain back
near to 100 per cent oxygen concertation with treatment,
and the other may not even reach up to 90 per cent despite
surgery and other interventions.
“The second group are often diagnosed with complex
complications such as having one pumping chambers or
one main blood vessels instead of two.”
Dr Leong also pointed out that there are numerous
types of heart defects and not all children necessarily present
the symptoms at birth. “Children with severe heart
disease tend to show symptoms much earlier but another
group of them with critical heart disease usually fall ill
within the first month of life.”
Dr Leong stressed that early detection is the key to the
child’s survival rate and longevity.
“Preferably, we want to catch the disease before the
child is being discharged from the postnatal ward.”
He added that about 85 to 90 per cent of the children
with heart defects are detected before six months of age.
“But the milder ones may be diagnosed at the later
stage after they experience complications.”
Symptoms
According to Dr Leong, with today’s technology, congenital
heart disease can often be detected during a pregnancy
ultrasound.
“If doctors hear abnormal heart rhythm, they may
further investigate the issue through follow up tests and
screenings.”
However, he added that in some cases, the symptoms
may not be so apparent until birth or shortly after that.
He noted that it’s imperative for the parents to equip
themselves with basic knowledge on how to detect if the
child is showing some symptoms of heart complications.
“The colour of the child is very important. “The child
must be as pink as possible; and if the child has a darker
colour, try to look at the tongue to see if it’s as pink as
ours.” He added that another common sign of congenital
heart disease is breathlessness especially during
breast-feeding. “They also tend to sweat excessively when
they are being fed.
“It takes a lot of effort for them to be fed, just like they
are running in a marathon.” Dr Leong also noted that children
with heart disease are more prone to becoming sick,
getting chest infection and pneumonia.
Diagnosis
The diagnosis of congenital heart defects involves a series
of steps – from the very basic to most sophisticated tests.
Dr Leong said in Malaysia the commonest method
would be through oxygenation test to examine the child’s
oxygen levels. “If they don’t have enough oxygen, we
observe for six to 24 hours before the child is tested again
to see if the oxygen content is improved.”
If not, Dr Leong said the child would have to undergo
further tests such as electrocardiogram, X-ray, echocardiography,
magnetic resonance imaging and CT scan.
What causes congenital heart disease?
According to Dr Leong, the cardiac condition occurs as
a result of an early developmental defects in the formation
of the heat’s structure when the infant is still in the
mother’s womb.
“The actual cause of the defect is still unknown, but we
know that some medications, some diseases like uncontrolled
diabetes and genetic disorder may cause abnormal
formation of the heart,” he said.
To narrow it down, Dr Leong said Asians tend to have
more of right-side heart disease, while the people of white
ethnicity seem to have more of left-side heart defects.
He also pointed out that in most cases, the doctors
don’t see a genetic trend when it comes to congenital
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