KOCHI: Congenital heart disease in Kerala follows a similar pattern to the rest of the world. Unlike in heart disease in adults, congenital heart disease means the presence of structural defects in the heart. These result due to abnormal development of the heart, when the child is still in its mother’s womb.

In this time and age, these defects can be identified in the womb itself as early as the 4th month of pregnancy. A fetal echocardiogram can reveal most defects when performed by an expert. In underdeveloped places without access to such tests, children are often diagnosed on routine examination, or when they present with symptoms.

Poor feeding, the increased effort of breathing, and persistent cough, poor weight gain and even delay in milestones are some of the symptoms shown. There are lots of doubts associated with the disease:

Many a time in our outpatient department, parents ask whether these defects would close on their own. Well, it’s true they do close but are limited to a few factors. It depends on the age of the child, the size of the hole and where it is located. Small atrial septal defects (ASD) are known to close spontaneously up to 1 year of age.

Beyond that, close follow up and closure may be required. Children with critical congenital heart disease may require intervention even as early as the first day of life. This depends on the nature and severity of the disease; and the condition of the baby. After the surgery, the child can do normal activities like other children of their age. The stigma ‘heart patient’ does not apply to them once their treatment is complete. Another important cause for concern for most parents is diet. Children with structural heart disease have no dietary restrictions.

There are a few rare diseases in the spectrum of congenital heart disease that are not entirely correctable. The may need either palliation or heart transplantation. The reason is simply due to the complicated distortion of the heart structure. Prevention of congenital heart disease may not be always possible. What expectant mothers could do is to follow a healthy lifestyle, attending regular checkups and avoiding unnecessary medications and high-risk situations. Whenever CHD, a major contributor to infant mortality in Kerala, is suspected, the help of a pediatric cardiologist should be sought.

(The author is Senior Consultant, Cardiac Surgery, Aster Medcity, Kochi. Views expressed are his own.)

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about Dr sajan koshy
Pediatric Cardiac Surgeon

Dr Sajan Koshy MS MCh is currently heading the unit of Paediatric & Congenital heart surgery at Aster Medicity. Prior to joining Aster, he was working as senior consultant and head of the department of paediatric cardiac surgery at MIMS Calicut. He started his professional career from alleppey medical college in 1988. He also functioned as a co- convener in first and second symposia on perioperative care of congenital heart disease held in Kochi in the year 2002 and 2004 respectively & as the scientific committee chairman for the national CME of cardio thoracic surgery held at Calicut in September 2007. He has Conducted many lectures in all the districts of North Kerala for the benefit of medical professional bodies to create awareness about congenital heart disease.

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