KUALA LUMPUR, Sept 29 – Congenital heart disease (CHD) can dishearten parents looking to welcome a new addition to their family.
Taking its position as the most frequently diagnosed congenital disorder, it affects approximately 0.8 to 1.2 per cent of live births globally, despite no family history or apparent symptoms.
Dr Ang Hak Lee, consultant paediatric cardiologist at Sunway Medical Centre shares his insights on the impact of CHD, treatments available and the importance of early detection of CHD.
“Congenital heart disease itself signifies that the condition or trait was present at birth, making CHD an anomaly affecting the heart that originates during an individual’s birth.
“The symptoms of this condition are often silent and can affect anyone, but the risk increases significantly when there’s a family history of CHD. Specifically, the risk triples if the mother has CHD; if the father has CHD, it doubles.
“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 explained.
CHD Diagnosis: A Lot More Common Than You Think
Locally, an estimated 5,000 newborn babies are diagnosed with CHD every year. Among them, about two-thirds require surgical intervention.
It is worth noting that the prevalence of CHD is not confined to Malaysia alone.
CHD Masked As Normal Paediatric Illness
“One of the significant challenges the health care community faces are that symptoms in infants are usually subtle, making it easy to miss.
“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 asymptotic in the first few days of the newborn’s life. 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,” said Dr Ang.
A Silver Lining
Fortunately, advancements in diagnostic techniques have led to improved detection, allowing timely intervention. In the past 50 years, survival of patients with CHD has seen a dramatic increase, and they are more likely to survive into adulthood following surgery.
“One of the major components for early detection in the field of CHD is a simple bedside test called pulse oximetry.
“This painless test 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.
“A paediatric cardiologist will use this test and other screening methods to confirm a diagnosis.
“Non-invasive imaging methods like echocardiograms and advanced screening tools allow us to identify even the subtlest heart abnormalities. Amazingly, foetal 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,” added Dr Ang.
Vigilant Efforts Against CHD
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.
“There’s no doubt that early detection improves a CHD patient’s road to recovery and general wellbeing.
“Upon diagnosis, your paediatric cardiologist’s primary goal is to rectify all issues related to the malfunction of the heart.
“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.
“On the contrary, 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 that are now available to minimise the risk for the patient as much as possible.”
Facing CHD In Your Child
Dr Ang advises parents to equip themselves with the proper knowledge to help their child throughout the medical condition.
“Yes, of course, seeing your child undergo a complex heart condition at such a tender age will be emotionally challenging.
“However, 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.”