SAFEGUARDING TINY HEARTS
Dr R Shanthipriya
Congenital Heart Disease one of the most common birth defects. Congenital Heart Defects (CHDs) affect approximately 8 to 10 out of every 1,000 live births worldwide. In India alone, nearly 2.4 lakh children are born each year with congenital heart defects.
Medical studies indicate that in nearly 85% of cases, the exact cause of these defects remains unknown. Genetic factors account for only about 10–15% of cases. However, the encouraging fact is that early detection and timely treatment—especially within the first year of life—can significantly improve survival and long-term outcomes.
In the Telugu States, an estimated 20,000 children are born annually with congenital heart defects. Protecting these fragile hearts requires greater public awareness, early screening, and access to specialised paediatric cardiac care. To highlight this need, Congenital Heart Defects Awareness Week is observed every year from February 7 to 14.
How do congenital heart defects develop?
The human heart is an extremely delicate and complex organ. In the developing foetus, the heart begins to beat and circulate blood as early as the 21st day of pregnancy. The four chambers of the heart are formed within four weeks, and complete development occurs by the 12th week. Any disturbance during this critical phase can result in structural abnormalities.
Common congenital heart defects include holes in the heart (septal defects), abnormalities in the heart chambers, defects in major blood vessels, and valve-related problems.
Recognising the warning signs
Infants with holes in the heart often show signs such as breathlessness, poor feeding, and recurrent respiratory infections like pneumonia. When there are openings between heart chambers, oxygen-rich and oxygen-poor blood mix, leading to excessive blood flow to the lungs. This causes congestion and breathing difficulties.
In certain defects, poor oxygen circulation causes bluish discoloration of the lips, tongue, nails, and fingertips—a condition known as cyanosis. Children with valve problems may experience fatigue, lethargy, poor activity levels, lack of interest in play, sleep disturbances, and difficulty breathing.
Parents should be alert if a newborn is unusually inactive, feeds poorly, breathes rapidly, or shows bluish discoloration of the lips or nails. These could be early indicators of congenital heart disease. In such cases, an echocardiogram is essential for accurate diagnosis.
In many developed countries, newborns routinely undergo pulse oximetry screening soon after birth to measure oxygen saturation levels. Low oxygen levels may indicate underlying heart defects. This simple, non-invasive test should ideally be performed for all newborns to ensure early detection.
Why do congenital heart defects occur?
Although no single definitive cause has been identified, a combination of genetic and environmental risk factors plays a significant role.
Genetic factors:
Certain genetic abnormalities can interfere with normal heart development. Conditions such as Down syndrome can be identified during pregnancy through genetic testing and are often associated with congenital heart defects.
Rubella (German measles):
If a pregnant woman contracts rubella, especially during the first trimester when the foetal heart is forming, it can severely affect heart development and lead to congenital defects.
Diabetes: Mothers with Type 1 or Type 2 diabetes have a higher risk of giving birth to children with heart defects. Poorly controlled blood sugar levels during pregnancy further increase this risk.
Medications: Certain drugs taken during pregnancy can increase the likelihood of congenital heart defects. These include medications such as lithium (used for bipolar disorder) and isotretinoin (used for acne treatment), among others.
Smoking and alcohol consumption: Tobacco use and alcohol intake during pregnancy can disrupt foetal heart development and contribute to structural abnormalities.
Nutritional deficiencies: Deficiency of essential nutrients, particularly folic acid and vitamin B12, during early pregnancy is a significant and preventable risk factor for congenital heart defects.
Consanguineous marriages: Children born to parents in consanguineous (blood-related) marriages face a higher risk of genetic disorders, including congenital heart defects. Studies suggest that among such families, 40–50 out of every 1,000 children may be affected.
The way forward
Congenital heart defects are not always preventable, but they are increasingly treatable when diagnosed early. Public awareness, antenatal care, nutritional support, vaccination, newborn screening, and timely referral to specialised centres can save thousands of young lives each year.
Protecting a tiny heart begins with awareness—and early action can make all the difference.
Dr R Shanthipriya is Consultant Paediatric Cardiologist at KIMS Cuddles, Visakhapatnam
