New Delhi: According to the World Health Organisation (WHO), 17.7 million deaths in India are due to heart-related issues. These numbers also involve congenital heart (CHDs) in children. Experts explained about CHDs signs in newborn babies.
“A structural problem in the heart which is present since birth is known as congenital heart disease (CHD). It is the most common congenital disorder in newborn babies. These groups of diseases have a variable presentation – some may present immediately after birth, some present in the first week of life after your newborn is discharged from the hospital, and some manifest later on in life,” said Dr Naveen Prakash Gupta, Senior Consultant Neonatology, Madhukar Rainbow Children’s Hospital (New Delhi).
Swelling of the legs, tummy, or around the eyes, extreme tiredness, fatigue, or a blue tinge to the skin or lips (cyanosis) – are some of the symptoms to look out for, according to Dr Dhiren Gupta, Senior Consultant, Gangaram hospital (New Delhi). He believes all newborn babies should be screened by a pulse oximeter.
As most of the time parents are not aware about heart problems in newborn babies, Dr Naveen emphasised, “If your baby is having difficulty in feeding or fast breathing especially after feeding or excessive sweating after feeding or he/she looks blue, you should suspect heart problems. Sometimes only the hands and feet are blue and the body is pink, that may be due to cold surroundings also. So it is important that lips or tongue should be blue to suspect heart disease.”
“Many structural problems of the heart can be diagnosed in the routine antenatal scan. An antenatal scan done at 20-22 weeks of gestation usually picks important structural problems in the heart.” he added.
Heart problems in newborn babies are classified into two types: those in which the baby is blue (called cyanotic heart disease) and those in which the newborn is pink but has other issues such as feeding difficulties, excessive perspiration, reduced urine, and inability to gain weight. This condition is known as acyanotic heart disease.
Many problems occur later in life (after newborn babies are discharged), and parents are unaware of them.
According to Dr Naveen, “A simple test called pulse oximetry screening may help to diagnose heart problems in your new born. A pulse oximeter is a device which measures oxygen saturation in the blood.”
He believes, “All newborns born in the hospital should undergo pulse oximetry screening. At 24 hours of life, oxygen saturations should be measured on the right hand and either of the foot in all newborns. If the saturation level at either place is more than or equal to 95%, it is called a negative screen (meaning a newborn doesn’t have a heart problem). If the saturation level at either place is less than 90 per cent, it is called a positive screen (meaning there is a probability that the baby may have a heart problem). When the screen is positive, we should do a definitive test echocardiogram (ultrasound of heart) before discharge to confirm or refute structural heart disease.”
“If the saturation level is between 90-94 per cent, it should be repeated twice at one hour intervals. If saturation is more than or equal to 95% on any of the repeat measurements, it is a negative screen. If saturation is less than 90% on any of the repeat measurements, it is a positive screen. If saturation levels persist between 90-94 per cent on repeat measurements, take it as a negative screen and get an echocardiogram done. Also if the saturation difference is more than or equal to 4 per cent between the upper and lower extremities on two to three measurements, each separated by one hour, take it as a positive screen,” he explained.
Experts recommend that parents consult a paediatric cardiologist. He will perform echocardiography and explain the condition to you. Not all heart problems require medical attention. However, a paediatric cardiologist will explain the procedure and give a timeline of when the echocardiography can be repeated. If your infant or child has a heart condition that requires treatment, a cardiologist can be of great help, he can admit the baby and perform the necessary intervention.
