Health:Heart Diseases in Children

“World Heart Day”, falls on 26th September. This day has been earmarked for creating awareness among people regarding heart diseases. The rising prevalence of heart diseases among adults is a growing concern for experts the world over. Many adults develop diseases of the heart due to various reasons like sedentary lifestyle, obesity, alcohol and smoking, e.t.c. But sadly many children also suffer from heart diseases for no fault of their own.Many children develop defects in the heart while in their mother’s womb. Alcohol, smoking, or some drugs taken during pregnancy induce physical defects in the heart. Infections like German measles, syphilis, e.t.c, occurring during pregnancy can also cause heart diseases in the babies born. These defects can be of various types. There can be defect in the septum separating the chambers of the heart, patency of the tube involved in foetal circulation after birth (PDA), narrowing of the heart valves, e.t.c. If the problem is mild, the affected baby can grow into an adult with few or no symptoms. But in severe cases the child may not survive after few months of birth. With these congenital abnormalities, functioning of the heart is impaired leading to cardiac failure. In older children, rheumatic fever is the most common cause for heart disease. It is a sequel to sore throat caused by Group B- haemolyticus streptococcus viridians. Hypertension can occur in children due to kidney problems and result in cardiac failure. Myxedema (hypothyroidism in a child born to hypothyroid mother) is yet another cause for heart diseases in children. Severe malnutrition in children also affects the heart size and its functioning.Symptoms of heart diseases in children are the same as for adults. A small baby is unable to suckle on the breast because of breathlessness. In an older child, initially the child may get breathless on severe exertion. Gradually amount of exertion at which he becomes breathless is reduced and over some time, he becomes breathless even while resting. Along with this, he develops swelling all over the body, beginning on the feet. In those kinds of congenital diseases where there is intermixing of pure and impure blood like septal defects, the child develops bluish discoloration of tongue and lips along with breathlessness. The affected child is more prone to develop infections of the lungs like pneumonia, bronchitis, e.t.c. He tends to eat less as there is no appetite due to reduced blood flow to the gut resulting in malnourishment. Gradually, the kidneys and liver can fail because of reduced blood flow to these parts. Physical as well as mental growth of such children is retarded in many such cases.People at large are ignorant about heart diseases in children. Unless a child becomes very sick parents do not suspect any problem. When a child complaints of breathlessness and early fatigue, it is taken lightly by the parents. Swelling coming on face and feet is unfortunately mistaken by the family as, “child is getting healthy and putting on weight.” Diagnosis of heart disease in any child is made clinically and confirmed by X-rays, cardiac echo and other imaging techniques.The definitive treatment of heart disease in a child is surgical correction of the defect. But this is feasible only in children who are fit enough to undergo major surgery. Even after surgery till the heart function does not become normal, minimum maintenance dose of drugs is required for cardiac failure. Children who are not fit for surgery are given these drugs for life.Every pregnant woman has to be very vigilant so as to avoid drugs and substances that can harm the unborn baby. Any child howing signs of any abnormality in feeding, walking, running or sleeping, should be investigated for congenital heart disease. Rheumatic heart disease and kidney ailments in children can be prevented by early treatment of streptococcal throat infections. The author is a specialist in Internal medicine, Ruhengeri Hospital E-mail-rachna212002@yahoo.co.uk