Wednesday, June 26, 2019

All Details You Want To Know About Congenital Heart Disease

Congenital Heart Defect, also known as a Congenital Heart Anomaly or Congenital Heart Disease (CHD) is a problem in the structure of the heart that is present at birth. CHDs are the most common types of birth defects. These defects can be in the walls of the heart (resulting in hole in the heart), the valves of the heart (resulting in blockage or leakage), the arteries and veins near the heart, which disrupts the normal flow of blood through the heart. The blood flow can slow down, go in wrong direction or to the wrong place.

Congenital Heart Defects effect a large number of new born in India and accounts for a high proportion of infant mortality nationally. There are regional differences in the prevalence and distribution pattern of Congenital Heart Defects. The majority of CHD cases are diagnosed between the age group of 0 to 5 years. The lack of experts and specialist in Pediatric Cardiology severely affects the accessibility and early detection of cases of Congenital Heart Disease.

The signs and symptoms of Congenital Heart Disease are as follows 

  • A bluish tint to the skin, fingernails and skin(The medical term used by doctors is Cyanosis – a condition caused by lack of oxygenated blood)
  • Fast breathing and poor feeding 
  • Poor weight gain 
  • Recurrent Lung infections 
  • Inadequate blood circulation
    The different test for diagnosis of CHDS are as follows 

    • Echocardiogram: A type of ultrasound that takes pictures of your heart. There are different kinds, so ask your doctor what you can expect.

    • Cardiac catheterization: A doctor guides a very thin, flexible tube (called a catheter) through a blood vessel in the child’s arm or leg to reach the heart. Dye is put through the catheter and then X-ray videos are used to see inside of heart.

    • Chest X-ray: These can reveal signs of heart failure.
      1. Lack of awareness and delay in diagnosis: A substantial proportion of births in India occur at home, and the infant is likely to die before the critical, ductus-dependent CHD is diagnosed. Fortunately, the rate of hospital deliveries have significantly increased due to several incentivized schemes by the Government of India. However the general masses are ignorant about the prognosis of the disease and number of them believe that a child with CHD is doomed and will never be able to lead a fruitful life, even if intervened. Delay in referral results in poor outcomes as complications and co-morbidities (such as under- nutrition) may have already set in.
      2. Lack of Infrastructure and resources: The resources for treatment of CHD are not only inadequate but also seriously mal-distributed. The geographical distribution of the treatment centers is very uneven. Poverty, which is the greatest barrier to successful treatment of CHD is more common in states with little or no cardiac care facilities. Transport of newborns and infants with CHD is another neglected issue in India. There is practically no organized system for safe transport of newborns and infants with CHD. 
      3. Financial Constraints: In most instances, families are expected to pay for the treatment out of their pocket, which they can barely afford. Approximately half of the families borrow money during the follow-up period after surgery .Many families lose their wages as they are away from work during care of these children. The number of public hospitals which provide care at a low cost are very few. Most cardiac centers, especially those set-up more recently, are in the private sector and may not be affordable for the majority. Public hospitals are faced with a very large number of patients and have waiting lists ranging from months to years

Patient Story of Tejas Who Needs Your Help in Getting Treatment of Tetrology of Fallot

Congenital Heart Diseases are the most common types of birth defects. Approximately 1 in 100 children are born with Congenital Heart Disease(CHD) and around 1, 80,000 to 2, 00,000 children are born with CHDs in India each year.

This is the story of a child who was diagnosed with Congenital Heart Defect.
Tejas, a two and a half months old child, as a new born only seemed abnormal to his parents. Monu Sonalia(Father) and his wife, first-time parents were scared when their new born baby didn’t act like a normal baby. Initially when the bathed the baby, his skin had a bluish tint to it and the baby had constant shortness of breath. 

After seeing these symptoms, they went to a local doctor in Gurhana(Uttar Pradesh) who then recommended to them to visit a specialist doctor in Meerut. After checking Tejas, the doctor in Meerut sent them straight to AIIMS, New Delhi. From there, they found their way to Child Heart Foundation where they met Dr.Vikas Kohli who diagnosed the child with Tetralogy of Fallot.

The prognosis was open-heart surgery. Monu Sonalia being a laborer and his wife a house-wife cannot raise such funds. Child Heart Foundation is now working hard to give this family a new life.

If you wish to contribute in changing a two year old's life, click on this: 


Monday, June 10, 2019

PH Life Care Program - A New Initiative of Child Heart Foundation Provides Financial Assistance for People with Pulmonary Hypertension

Pulmonary Arterial Hypertension

Pulmonary Hypertension (PH) is a severe, rare lung disease characterized by high blood pressure in the pulmonary arteries. Due to the condition, the pulmonary arteries, which are responsible for transporting the blood from the right heart ventricle to the lungs, become narrowed and thickened. In order to properly pump the blood, the heart needs to work harder, which can lead to enlargement and weakening of the organ, as well as potential right heart failure. The World Health Organization recognizes 5 groups of pulmonary hypertension (PH), categorized by pathogenesis or comorbidity: 1-pulmonary arterial hypertension 2-left-heart disease, 3-lung disease and hypoxia 4-chronic thromboembolic disease, and 5-miscellaneous. 

  • Pulmonary hypertension is a substantial global health issue.
  • All age groups are affected with rapidly growing importance in elderly people, particularly in countries with ageing populations.
  • Present estimates suggest a pulmonary hypertension prevalence of about 1% of the global population, which increases up to 10% in individuals aged more than 65 years.
  • In almost all parts of the world, left-sided heart and lung diseases have become the most frequent causes of pulmonary hypertension.
  • According to the Centre for Disease Control and Prevention the number of deaths from PH has increased over the past one decade.
  • 80% of patients live in developing countries where PH is associated with Congenital Heart Disease with an estimated prevalence ranging from 10 to 52 cases per million.
Healthy Pulmonary arteries of the lungs are elastic. They expand and contract with evert heartbeat. In cases of Pulmonary Hypertension the arteries stiffen and become thick. This results in increasing resistance to blood passing through thereby leading to increasing pressure. Higher pulmonary may lead to symptoms of pulmonary hypertension. The symptoms of pulmonary hypertension directly affects the functioning of the heart. The common symptoms may include: 
  • Shortness of breath 
  • Low oxygen levels 
  • Chest pain or pressure 
  • Fatigue 
  • Heart palpitation
  • Swelling of the ankles or abdomen 
  • Heart failure in advanced cases 

The diagnosis of Pulmonary Hypertension may be difficult and is generally diagnosed at an advanced stage. One the reasons been that the symptoms of pulmonary hypertension is misinterpreted with other health ailments such as asthma, lung diseases etc. When diagnosing pulmonary hypertension, an ultra sound of the heart or echocardiogram can provide an estimate of the pressure in the heart. Only a procedure called right heart catheterization (RHC) can directly measure blood pressure in the lungs and determine if pulmonary hypertension is present. A right heart catheterization can also be used to determine if pulmonary hypertension is responsive to intravenous vasodilator medication. This will help determine whether or not a person is a candidate for chronic medication treatment. 

Other test are performed to screen associated diseases, including blood test, EKG, Chest X rays, pulmonary function testing and a test for lung blood clots called ventilation/perfusion scan. A six minute walk is typically performed to assess a person’s exercise capacity and need to oxygen therapy. 

Treatment of Pulmonary Hypertension is directed towards improving symptoms, improving exercise capacity and delaying progression of the disease. The treatment used for pulmonary hypertension depends upon its underlying cause. Pulmonary Hypertension can improve with treatment of associated hearts or lung disease.

Important non medication treatment includes: 
  • Oxygen therapy 
  • Quitting smoking 
  • Removal of deleterious drugs 
  • Routine exercise (with the guidance of your pulmonary hypertension doctor)

People whose pulmonary blood pressure responds to intravenous vasodilator treatment during right heart catheterization may be candidates for calcium channel blocker therapy. People with idiopathic pulmonary arterial hypertension that does not respond to vasodilator challenge during right heart catheterization or who do not improve with calcium channel blocker treatment, or people who have inherited or connective – tissue associated pulmonary hypertension are candidates of oral medications.