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Baby and childhood heart disorders: congenital heart disease BABY AND CHILDHOOD HEART DISORDERS: CONGENITAL HEART DISEASE
Congenital heart disease occurs in six to eight babies for every 1000 born. Nobody is certain why it happens. In some cases, the mother may have suffered from a bout of rubella in the early days of pregnancy. But with widespread use of vaccination this is becoming much less common.
So-called chromosomal abnormalities may take place. This means there has been damage to the fine filaments in the cells, occurring soon after conception. Once more, the reason why this happens is usually elusive. If a parent or other member of the family has this disorder, there may be an increased risk for future babies. Certain drugs taken during pregnancy may cause some cases. X-rays of the mother during pregnancy may in some cases be responsible. But in most, there is no known obvious cause.
Severe cases may result in the baby perishing during the first year of life. However, in recent years enormous progress has been made in medical research, and many cases can be surgically corrected to allow the child to develop into normal adulthood.
There are many and varied symptoms, but as a general guide the following should alert a parent to seek medical advice promptly. It could indicate some kind of heart disorder.
The infant or child may show a poor weight gain, and there are commonly feeding problems. There may be attacks of fainting, or even blackouts. In young infants this may show up as sighing bouts, when the infant becomes pale.
The infant may have difficulty in swallowing and may have a tendency to regurgitate curdled milk. Or may have difficulty in breathing comfortably. Sometimes the mother finds that the little fellow is more comfortable if he bends backwards. Often the child may decline activity and normal exercises which are being enjoyed by his or her friends. The child may simply want to squat down and watch the others at play.
Some cases are accompanied by a bluish skin colour- called cyanosis. This may occur from a very early age. A check of the mother's case history may indicate that during pregnancy she suffered from rubella or had various other abnormalities.
Treatment
Any suspicious symptom needs prompt medical attention. The paediatrician has the facilities and knowledge for investigating all kinds of heart abnormalities. In the first instance this medical specialist will be seen because the parents feel their baby is not well or not normal. It is then up to the paediatrician to initiate the investigations and tests that will give the correct diagnosis.
Many different kinds of heart abnormalities exist, and because they are intricate and detailed we cannot here go into a minute study of them. But they involve various, single or multiple defects. There may be narrowing of the entrance to the different vessels; valves may be deficient and defective. One side of the heart may be connected directly with the other side via holes which should not be present. Similarly, the large heart vessels may interconnect in the wrong places. These will all lead to symptoms, and an increasing strain on the heart and on the child's health in general.
Left unchecked, many of these will cause a deterioration of health either rapidly or during a period of some years. The outlook, when untreated, is usually poor.
However, with correct therapy, which often involves surgery, the outlook has been revolutionized in the past few years and in many cases the future prospect is excellent.
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