KUALA LUMPUR, Sept 29: The survival rate of children with congenital heart disease (CHD) has seen a dramatic increase in the past 50 years and they are more likely to survive into adulthood following surgery with timely interventions due to advancements in diagnostic techniques.
Consultant paediatric cardiologist at Sunway Medical Centre, Sunway City Dr Ang Hak Lee said one of the major components for early detection in the field of CHD is a simple bedside test called pulse oximetry, a painless test that only takes a few minutes to measure the amount of oxygen in a newborn’s blood.
“A low oxygen reading can be a sign of critical CHD. While it 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,” he said in a statement.
Meanwhile, Dr Ang said that non-invasive imaging methods like echocardiograms and advanced screening tools allow paediatric cardiologists to identify even the subtlest heart abnormalities, adding that fetal echocardiography can detect CHD during prenatal life.
“Although we recommend this test as one of the initial screening steps for high-risk patients, especially those with a family history of CHD or congenital disabilities, it greatly enhances the chances of early detection and timely intervention,” he said.
-Dr Ang said CHD, an anomaly affecting the heart that originates during an individual’s birth, is the most frequently diagnosed congenital disorder that affects approximately 0.8 to 1.2 per cent of live births globally despite no family history or apparent symptoms.
He, however, noted that CHD risk increases significantly when there is a family history of CHD, specifically the risk triples if the mother has CHD and doubles if the father has CHD.
“In critical cases, if CHD is not detected soon after birth, it can cause fatality, some within the first year or a few years of a child’s life. This is why early detection and awareness, particularly among those with a family history of CHD, are crucial for managing this condition effectively,” he said.
Dr Ang said that locally, an estimated 5,000 newborn babies are diagnosed with CHD every year of which about two-thirds require surgical intervention, adding that one of the significant challenges that the healthcare community faces is that symptoms in infants are usually subtle, making them easy to miss.
He added that the signs could range from difficulty feeding to bluish discolouration of the skin and lips, and a lot of times, symptoms may not appear early or asymptomatic in the first few days of the newborn’s life.
Dr Ang cautions parents to be watchful in identifying CHD-related symptoms in their newborn, especially if there is a family history of this condition.
“Parents often attribute these indicators to common illnesses, delaying the diagnosis. To make matters worse, even though CHD is present at birth, not all patients produce signs or symptoms until later, sometimes in adolescence or within two weeks of birth, such as ventricular septal defect (VSD) or atrial septal defect (ASD) known as ‘hole in the heart’. Also, there’s no telling when or even if they will become apparent,” he said.
He said upon diagnosis, paediatric cardiologist’s primary goal is to rectify all issues related to the malfunction of the heart, adding that sometimes the defect may be minor and not require treatment but vigilant monitoring is needed to evaluate any disease progression.
“In some cases, medical treatment is needed, such as blood pressure and heart rhythm drugs. If a child or infant faces a critical diagnosis, a heart procedure or surgery may be required to repair the heart defect.
“This includes innovative medical devices and medical interventions which are now available to minimise the risk for the patient as much as possible,” he said.’
Dr Ang also advises parents to equip themselves with the proper knowledge to help their child throughout the medical condition, adding that parents must take solace in remembering that progress in medical research, improved screening programmes and a growing understanding of this condition offer better outcomes for those affected.
“Also, remember that your paediatric cardiologist can be your beacon of support during this time. Prepare a list of questions on any areas of concern you may have and have a thorough conversation with them. We are here to help you through this journey to give your child the chance for a healthier and brighter future,” he said.
— BERNAMA