Dr. C. Aparna
Senior consultant and Head Department of Neonatology,
Congenital heart disease (CHD) or heart defects present from birth, is the most common type of birth defect, with an overall prevalence of approximately
1 percent. Critical CHD, defined as requiring surgery or catheter-based intervention in the first year of life, accounts for approximately 25 percent of CHD.
Infants with critical CHD may present during the birth hospitalization, often with serious and life-threatening clinical findings that require immediate intervention. However, some infants with CHD may appear normal on routine examination and signs of critical CHD may not be apparent until after discharge. The timing of presentation varies with the underlying lesion.
Two tools have revolutionized the early detection of congenital heart defects – Fetal echocardiography and neonatal pulse oximetry screening. Clinicians skilled at fetal echocardiography are able to identify most critical congenital heart defects. Referrals for fetal echocardiography are typically prompted by the presence of risk factors or suspicion on obstetrical ultrasounds, typically performed in the second trimester.
The second tool – universal newborn screening with pulse oximetry improves the identification of patients with critical CHD compared with physical examination alone. Prior to the routine use of pulse oximetry screening, approximately 30 percent of patients with critical CHD were discharged from the birth hospitalization undiagnosed.
The next important question is what happens after diagnosis? Procedures done through cardiac catheterization — such as balloon angioplasty or valvuloplasty — can widen an obstructed blood vessel or valve. Another procedure, transcatheter device occlusion, can close abnormal openings or holes within the heart or blood vessels without surgery.
Some problems, such as small- or moderate-sized ventricular septal defects, may close or get smaller as a child grows. While waiting for the hole to close, the child might have to take medicines. Complex defects found early might need a series of operations that are finished when a child is about 3 years old.
One of the important preventive steps we need to know is : Infective (or bacterial) endocarditis is an infection of the tissue that lines the heart and blood vessels. Babies with heart defects must get antibiotics before procedures that could let bacteria get into the bloodstream, such as dental work surgery in body areas where bacteria tend to grow, such as the mouth or gastrointestinal tract.
In all, early detection and prompt treatment is effective in reducing morbidity and improving survival in newborn babies with birth defects in the heart.