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Understanding a Child’s Heart Health – What We Need to Know?

Marking the World Heart Day on 29 September, each year heart health is given significant focus and many initiatives promote early detection of cardiovascular diseases, tips to maintain a healthy heart and mind. While adults are most susceptible to the cardiac diseases, children also are impacted. We need to understand a few essential aspects to be able to monitor our child’s heart health.
Dr. Nilesh Oswal, Consultant Pediatric Cardiology at Zulekha Hospital Dubai and Dr. Fadel Khaled Husrom, Specialist Pediatrician at Zulekha Hospital Sharjah help us understand these aspects by answering some frequently asked questions.

What are some common pediatric cardiology diseases effecting children?

The pediatric cardiology diseases are as either congenital (present from birth) or acquired (developed after birth). As estimated one in every 100 babies born has congenital heart disease, the most common type are non-cyanotic congenital heart defects (ventricular septal defect (VSD), atrial septal defect (ASD), and patent ductus arteriosus (PDA)). Some of the most common acquired heart conditions include rheumatic heart diseases, kawasaki disease, arrhythmias and acquired cardiomyopathy.

What are some symptoms and common complaints parents have for children with cardiac disease?

Many children with heart defects appear healthy and have no symptoms or very few symptoms, and common complaints are:
- Blue colour around the lips and blue skin (cyanosis)
- Difficulty feeding (especially becoming sweaty during feeds)
- Shortness of breath
- Poor growth
- Pale skin
- Fatigue

How do you assess the cardiology issues in children? What types of investigations are carried out normally?

The clinical examination is very important in assessment and diagnosis of cardiology problems in children, and then many investigations can be done by the pediatric cardiologist to determine an accurate diagnosis including the following:
- Electrocardiogram (ECG)
- Echocardiogram
- Chest X ray
- Pulse oximetry
- Cardiovascular magnetic resonance imaging (MRI)
- Cardiac catheterization

What age groups do you accept to be operated and treated and what are some pre-requisites for a pediatric patient undergoing a cardiac surgery?

We accept children more than 8-10 kg weight for cardiac surgery or cardiac catheter intervention. We have even treated newborns that have acquired heart disease and did not require surgery or catheter intervention. Apart from confirming the diagnosis, patients need to have adequate hemoglobin, normal blood clotting, normal kidney and liver function and patient should be free from any infection prior to cardiac surgery.

What is a congenital heart disease?

A congenital heart defect is a problem with the structure of the heart. It is present at birth. The defects can involve the walls of the heart, the valves of the heart, and the arteries and veins near the heart. They can disrupt the normal flow of blood through the heart. The blood flow can slow down, go in the wrong direction or to the wrong place, or be blocked completely.

What is the ASD and what age groups can undergo this procedure?

ASD is abbreviation for atrial septal defect and it means there is a hole in the separating wall in between two blood collecting chambers in the heart, called atrium. Generally, patients can undergo a procedure for closure of this defect at around 4-5 years of age and that can be done by either open heart surgery or a keyhole procedure called cardiac catheterization.

If untreated, what can be the impact of the congenital heart diseases in individuals?

If untreated, depending on type of heart disease it can cause repeated chest infections, breathlessness on exertion, poor growth, high lung pressure, infection inside the heart, inadequate pumping of the heart, abnormal heart beat and sudden death.

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