What Parents Should Know About Heart Conditions in Newborns & Children

WORDS LIM TECK CHOON

FEATURED EXPERT
DR ANG HAK LEE
Consultant Paediatric Cardiologist
Sunway Medical Centre
CONGENITAL HEART DISEASE IS THE MOST FREQUENTLY DIAGNOSED CONGENITAL DISORDER

Congenital disorder is an abnormal condition that is present at birth.

When a child is born with heart disease, therefore, they are said to have congenital heart disease or CHD.

Dr Ang Hak Lee explains to us: “The symptoms of this condition are often silent, but the risk increases significantly when there’s a family history of congenital heart disease.”

He shares that the risk triples if the mother has the condition; if the father has it, the risk doubles.

EARLY DETECTION OF CONGENITAL HEART DISEASE IS CRUCIAL

Dr Ang shares that, should congenital heart disease is not detected soon after birth, the child may not survive the first few years of life.

“One of the significant challenges the healthcare community faces are that symptoms in infants are usually subtle, making it easy to miss,” he says.

POSSIBLE SIGNS OF CONGENITAL HEART DISEASE
  • Feeding difficulties.
  • Poor growth.
  • Low birth weight.
  • Bluish discolouration of the skin and lips.
  • Nail clubbing, which is a deformity of the finger and toe nails—frequently, the nails curve down to look like an upside-down spoon.
  • The baby or child tires easily.

Parents often attribute symptoms of congenital heart disease to those of common illnesses, which can lead to delays in the child getting a proper diagnosis.

Further complicating matters is that not every child with congenital heart disease will show symptoms at birth. Some children only develop symptoms later in their childhood or even during adolescence.

FORTUNATELY, DETECTION METHODS HAVE BECOME MORE ADVANCED & MORE ACCURATE

“One of the major components for early detection a simple bedside test called pulse oximetry,” says Dr Ang.

A pulse oximeter measures blood oxygen levels and pulse. A low level of oxygen saturation could be a sign that you may have certain health conditions.

This test is painless and takes only a few minutes, as a device called pulse oximeter is used to gently clip onto a child’s toe or finger to measure the child’s blood oxygen levels.

“A low oxygen reading can be a sign of critical congenital heart disease,” Dr Ang elaborates.

He adds, “While this method doesn’t replace a complete history and physical examination, it can detect critical heart defects before oxygen levels become too low, especially for newborns with other major congenital disabilities.”

Other non-invasive imaging methods, such as echocardiograms, and advanced screening tools have allowed paediatricians to detect even subtle heart abnormalities. “Amazingly, echocardiography can be used to detect CHD while the baby is still in the mother’s womb!” Dr Ang points out.

What Every Parent Should Know about Congenital Heart Defects in Children

WORDS DR CHOO KOK KUAN

FEATURED EXPERT
DR CHOO KOK KUAN
Consultant Paediatrician and Paediatric Cardiologist
Subang Jaya Medical Centre

The most common heart disease among children is known as congenital heart defects.

This condition occurs when the heart or the blood vessels near the heart do not develop normally before birth.

HOW COMMON IS THIS CONDITION?

According to our Ministry of Health, the incidence of congenital heart defects among children is about 8 to 10 per 1,000 live births.

With an average of 500,000 deliveries in Malaysia each year, the number of children born with congenital heart defects is about 5,000 a year, of which two-thirds will require surgical intervention.

THE CAUSES & RISK FACTORS

Most congenital heart defects have no known cause.

They may sometimes run in families.

Some congenital heart defects may be associated with genetic disorders, such as Down syndrome, Turner syndrome, Williams syndrome, etc.

Some children have a higher risk of developing congenital heart defects if the mother has diabetes or rubella, or has taken certain medications such as anti-epileptic drugs, during pregnancy.

DETECTION OF CONGENITAL HEART DEFECTS

Sometimes a heart defect can be diagnosed before a baby is born.

However, defects are usually identified days or even months after birth, when symptoms become obvious.

Less serious congenital heart defects may not show any noticeable signs or symptoms, so they may only be diagnosed later in childhood.

It is also possible to have a heart defect and show no symptoms at all.

POSSIBLE SIGNS THAT A BABY OR YOUNG CHILD MAY HAVE CONGENITAL HEART DEFECTS
  • Rapid breathing
  • Bluish discolouration commonly noticed around the lips, fingernails, palms of the hands, and soles of the feet
  • Shortness of breath during feeding, leading to poor weight gain
  • Poor growth
  • Recurrent lung infection
WILL A CHILD WITH CONGENITAL HEART DEFECTS BE OKAY?

As a result of medical advancements, the outlook for congenital heart diseases is increasingly positive.

Most children with this condition reach their adulthood.

In fact, children with simple conditions may lead completely normal lives, while those with more complex conditions usually face more challenges that can nevertheless be addressed with the right measures in place.

6 THINGS THAT EVERY PARENT OF CHILDREN WITH CONGENITAL HEART DEFECTS SHOULD KNOW AND DO
  1. Heart medications can be very strong and dangerous if not given correctly. Parents must understand how much medicine to give and how to give it. If the child takes a blood thinner, parents must have clear instructions on how to give this medicine safely.
  2. Ensure the child eats well and receives adequate nutrition. They often tire when eating, so they eat less and may not get enough calories.
  3. Prevention of infections is crucial. Although an infection in the heart (endocarditis) is uncommon, children with heart defects have a greater risk of developing this. Good dental hygiene goes a long way toward preventing endocarditis by reducing the risk of tooth or gum infection. Parents can get more information from cardiologist about the latest guidelines on antimicrobial prophylaxis against infective endocarditis. These children must also get all the recommended vaccinations.
  4. Most children with a congenital heart defect can be physically active without restrictions. In fact, children are encouraged to be physically active to keep their hearts fit and to avoid obesity, unless they have a few specific heart conditions.
  5. Emotional support will help children who may have self-esteem issues because of how they look. They may have scars from surgery, and they may be smaller, or have limits on how active they can be.
  6. As children transition to adulthood, parents can gradually teach them about their heart defect and guide them in how to care for their own health without being overly protective.