We are all going through difficult times due to the COVID-19 pandemic. Our entire focus, resources, and energy are directed towards battling this deadly disease. But unfortunately, other diseases, infections, and disabilities continue to prevail or attack the population at their own rate. Children especially neonates and pregnant women are a very vulnerable section of our population who need special care and attention. We all know that congenital heart diseases (heart problems present from birth) are major malformations that contribute significantly to the deaths of neonates and infants. Approximately 1,30,000 to 2,70,000 new cases of heart diseases are added to the general population every year. 25% of these cases require immediate treatment in some form immediately in the first month of life or else may die.
DIAGNOSIS AND TREATMENT OPTIONS:
Nowadays, heart defects can be detected as early as 16-20 weeks of pregnancy by performing a special test called fetal echocardiography. After birth, they can be easily detected by clinical suspicion and then performing echocardiography by a trained pediatric cardiologist. Across all major centers now heart problems have a solution (open heart surgery or interventional procedures that treat heart problems through blood vessels using various devices, stents, and balloons).
WHEN TO SUSPECT CONGENITAL HEART DISEASE:
Critical congenital heart diseases present in the first month of life frequently with severe symptoms like severe cyanosis (bluish discoloration of tongue, lips, nails) or sudden sickness with poor blood circulation and pale appearance of the child that rapidly progresses to listlessness and lethargy. Infants may present with poor feeding, sweating on feeding, poor weight gain, or cyanosis. Older children and adults may experience breathlessness on exertion or increased activity of heart observed by parents or felt by the child himself.
COVID-19 AND CONGENITAL HEART DISEASES:
Children with congenital heart diseases may be increasingly susceptible to this virus as they are to other common flu viruses with increased risk of complications. This virus is known to mainly injure lungs causing a severe lack of oxygen availability. In addition, the virus is known to injure cardiac cells directly. It is also known to damage the blood vessels that supply the heart muscle itself.
Therefore, all precautions must be taken to protect this special population like avoiding outside exposure, social distancing, and use of masks and sanitizers with frequent hand washing. As cases and clinic visits may be postponed, parents and cardiac teams should work in unison to chalk out a long-term plan frequently through telemedicine. It is recommended that all cardiac medications previously being taken by the child to be continued during COVID-19 illness unless a clear contraindication develops. In addition, it is recommended that the children be adequately immunized as per standard guidelines also.
We as team NH are committed to the continued service and betterment of these children with special cardiac needs.
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