Cardiac defects causing respiratory infection in kids can be corrected if detected early

However, when undetected at an early age, cardiac issues appear in an older child or a young adult who has had an unidentified cardiac defect present from birth itself. 

When consulted by a paediatrician for regular evaluation after birth, the new-borns need to be evaluated for cardiac issues as it will certainly identify all major defects. However, lack of awareness and resources leads to these unidentified symptoms.

All mothers should be aware that poor feeding in a new-born is a cause for concern. If breastfeeding tires the child quickly and produces forehead sweating with fast breathing, then an echocardiography is a must. Some new-borns tire up immediately on breast-feeding and stop only to restart feeding again.

“Bluish discoloration around the lips and fingertips is a sign of either heart or lung disease. This is easily observed in Whites and fair skinned children. In others this may be only observed as an unusual darkening of lips and fingertips. Bluish discoloration in cardiac diseases is due to mixing of pure (Oxygenated blood) with impure blood (De-oxygenated blood). In new-borns this means that there is either a hole between the chambers of the heart or abnormal connections. Immediate evaluation by a paediatric cardiologist is mandatory,” said Dr Ajeet Arulkumar, Consultant Cardiologist, Frontier Lifeline Hospital. 

Episodes of total or partial unresponsiveness (fainting, breath holding, seizures, posturing) also need immediate evaluation both by paediatrician and cardiologist. Frequent respiratory tract infections in childhood is another symptom of heart disease causing lung congestion. A simple echocardiogram will identify the problem. 

Cardiac defects causing frequent respiratory infections can be easily corrected if identified early. However, if left uncorrected these defects can cause irreversible lung damage (Pulmonary Hypertension) and become inoperable. Rarely cardiac defects may be truly free of any symptoms and only identified by a doctor because of “murmurs”, or abnormal X-ray or ECG patterns, added Dr Ajeet.

The doctors recommend screening procedures such as Echocardiogram, ECG and Chest X-ray, Cardiac MRI, Cardiac CT and very rarely cardiac catheterization. Once the exact problem is identified, treatment and planning begins.

 “The cardiac defects are becoming more common in the State with common symptoms being breathlessness, cyanosis, on palpation and murmurs. Murmurs are identified by stethoscope and there are symptoms that can be missed during echo, but identified later in life. The surgery scan can be complex requiring open chest surgery with major intra-cardiac corrections. Even after complete repair these children require lifelong follow up with a paediatric cardiologist,” said Dr Mohan Kumar, Paediatrician, Institute of Child Health.

Doctors say that in rare instances children are born with extremely complex congenital heart disease which cannot be medically or surgically corrected. These include hearts with single ventricle, absent valves, absent vessels and other major anomalies. Although they cannot be fully corrected, surgical palliation is frequently possible. Some of these children can be considered for heart transplantation if feasible.