What are the heart diseases of children?
Heart diseases of children are either congenital or acquired
What is Congenital Heart Disease?
It is a defect in the heart structure the baby is born with.
Types:
According to its effect on the heart:
- Small (minor- not needing intervention)
- Large (major-needing correction)
According to its position:
Septal defect:
- Atrial septal defect (a hole between small heart chambers)
- Ventricular (a hole between large heart chambers)
- Between the arteries (ductus arteriosus)
- Multiple (more than one defect)
Valve disease:
A heart valve is like a door which opens and closes allowing blood to go from one place to another. Valves can be too tight (stenosed/obstructed) or too loose (regurgitant), both conditions can be associated with disease.
Abnormal connections or position:
Abnormal connections e.g transposed great artries (aorta from right ventricle)
The heart can be on the right of the chest (dextrocardia): by itself this may not cause any problem; some cases are associated with other structural abnormality.
Abnormal size of the heart chambers
Absent or small part of the heart: e.g hypoplastic left or right heart : this group is considered a major heart disease , treatment is usually palliative (only helping than curing).
How do I know that my child has a heart disease?
- The infant can have fast breathing associated with interrupted feeding and frontal sweating.
- Slow weight gain.
- Change of the color of the tongue and nails to blue
How does physician know?
- Examination of the baby
- Doing special tests: chest X ray, electrocardiogram and echocardiogram
What is echocardiogram?
It is an ultrasound machine for the heart, it is safe and accurate
What is the treatment of heart disease?
- Many heart disease don’t require treatment, the doctor will ask you to come for follow up
- Some heart disease need medications , heart surgery or cardiac catheterization.
Common Heart Medications:
1. Frusemide: increase urine output so improves tightness of breathing
2. Captopril and enalapril: relax the body vessels so heart pumps against low pressue
3. Beta blockers: propranolol: relax muscle spasm ,so relieves the Tet Spells (see below) in Tetralogy of Fallot.Lower blood pressure and heart rate
Common surgical procedures:
Open heart surgery: if the surgeon repairs a septal defect or a valve the heart needs to be incised so a machine called: heart- lung machine is connected to the patient to perform the job of the heart and lung and the patient’s heart is stopped till operation is done.The surgical opening is at the middle of the chest.
Closed heart sugery: operations in the vessels (e.g. aorta or pulmonary artery) can be done by opening the side of the chest (usually the left) without opening the heart itself. So there is no need for the heart-lung machine.