Congenital Heart Defect, also known as a Congenital Heart Anomaly or Congenital Heart Disease (CHD) is a problem in the structure of the heart that is present at birth. CHDs are the most common types of birth defects. These defects can be in the walls of the heart (resulting in hole in the heart), the valves of the heart (resulting in blockage or leakage), the arteries and veins near the heart, which disrupts the normal flow of blood through the heart. The blood flow can slow down, go in wrong direction or to the wrong place.
Congenital Heart Defects effect a large number of new born in India and accounts for a high proportion of infant mortality nationally. There are regional differences in the prevalence and distribution pattern of Congenital Heart Defects. The majority of CHD cases are diagnosed between the age group of 0 to 5 years. The lack of experts and specialist in Pediatric Cardiology severely affects the accessibility and early detection of cases of Congenital Heart Disease.
The signs and symptoms of Congenital Heart Disease are as follows
- A bluish tint to the skin, fingernails and skin(The medical term used by doctors is Cyanosis – a condition caused by lack of oxygenated blood)
- Fast breathing and poor feeding
- Poor weight gain
- Recurrent Lung infections
- Inadequate blood circulation
- The different test for diagnosis of CHDS are as follows
- Echocardiogram: A type of ultrasound that takes pictures of your heart. There are different kinds, so ask your doctor what you can expect.
- Cardiac catheterization: A doctor guides a very thin, flexible tube (called a catheter) through a blood vessel in the child’s arm or leg to reach the heart. Dye is put through the catheter and then X-ray videos are used to see inside of heart.
- Chest X-ray: These can reveal signs of heart failure.
-
- Lack of awareness and delay in diagnosis: A substantial proportion of births in India occur at home, and the infant is likely to die before the critical, ductus-dependent CHD is diagnosed. Fortunately, the rate of hospital deliveries have significantly increased due to several incentivized schemes by the Government of India. However the general masses are ignorant about the prognosis of the disease and number of them believe that a child with CHD is doomed and will never be able to lead a fruitful life, even if intervened. Delay in referral results in poor outcomes as complications and co-morbidities (such as under- nutrition) may have already set in.
- Lack of Infrastructure and resources: The resources for treatment of CHD are not only inadequate but also seriously mal-distributed. The geographical distribution of the treatment centers is very uneven. Poverty, which is the greatest barrier to successful treatment of CHD is more common in states with little or no cardiac care facilities. Transport of newborns and infants with CHD is another neglected issue in India. There is practically no organized system for safe transport of newborns and infants with CHD.
- Financial Constraints: In most instances, families are expected to pay for the treatment out of their pocket, which they can barely afford. Approximately half of the families borrow money during the follow-up period after surgery .Many families lose their wages as they are away from work during care of these children. The number of public hospitals which provide care at a low cost are very few. Most cardiac centers, especially those set-up more recently, are in the private sector and may not be affordable for the majority. Public hospitals are faced with a very large number of patients and have waiting lists ranging from months to years
