Some children are born with defects in their heart which is frequently referred to as ‘hole in the heart’. These defects are, however, of many different types depending upon their location in the heart and the size of the defect. Unfortunately, there is a common perception that these defect close spontaneously as the child grows which is not the case usually. The disease of ‘hole in the heart’ can be classified into 2 categories
- Acyanotic heart disease: This is a condition wherein the hole in the heart usually allows abnormal intracardiac flow of oxygen rich blood into the oxygen depleted blood. This does not cause any lack of oxygen supply to the body but causes extra flow of blood into the lungs which become flooded. These children usually suffer from frequent lung infections which can many a times be life-threatening. The other major risk over time is of developing high lung pressures which can lead to life-threatening right heart failure.
- Cyanotic heart disease: This is a condition wherein the hole in the heart allows flow of oxygen depleted blood into the oxygen rich blood thereby decreasing the oxygen concentration in the blood. This poorly oxygenated blood then flows through the entire body leading to bluish discolouration of the nails, tongue and lips and poor development of the vital organs since oxygen supply is poor.
What is important is to realize that some of the defects in the acyanotic heart disease category can close spontaneously with age but some of them and all the cyanotic heart disease would need surgical intervention. It is of prime importance to consult a trained physician to understand as to which defects need surgical intervention.
The most important aspect of surgical closure of these cardiac defects is to decide the right time for surgery. These are internationally accepted guidelines to help in the decision making and a pediatric cardiologist or pediatric cardiac surgeon should be consulted. What is important for the parents is to understand that if these defects are left untreated there are very high chances of having irreversible damage to the heart or lungs or both. This would transform a potentially treatable disease into an untreatable condition and these children die prematurely. Therefore, for all kinds of ‘hole in the heart’ take a proper medical advice and follow it religiously.
Dr. Rachit Saxena is a Senior Consultant Cardiac and Aortic Surgery at Narayana Superspeciality Hospital in Gurugram
