UNS — The Basic Health Survey (Riskesdas) 2018 reported the increasing number of heart disease sufferers. This phenomenon is caused by the low community awareness on the early detection of congenital heart diseases. dr. Risalina Myrtha, Sp.JP., Heart and Vascular Specialist of Universitas Sebelas Maret (UNS) Surakarta Hospital shared the knowledge around congenital heart disease through @rumahsakituns Instagram live stream and UNS Hospital YouTube channel to commemorate the congenital heart disease awareness week on Friday (11/2/2022).
Congenital heart disease is a structural and functional abnormal condition of the heart from birth. It covers various types and abnormalities that could be categorized into two main conditions, critical and non-critical abnormalities. The critical abnormalities require immediate intervention in the first month to a year of one’s life to ensure survival. Examples of critical heart abnormalities are tricuspid atresia, coarctation of the aorta, dan Hypoplastic Left Heart Syndrome (HLHS). As a comparison, the non-critical abnormalities could be further clinically categorized into significant and non-significant abnormalities. Examples of non-critical abnormalities are Atrial Septal Defect (ASD) and Ventricular Septal Defect (VSD). Another classification for this condition is whether it causes cyanosis.
Another speaker in the event, dr. Maria Galuh K. S, Sp. A, M. Kes, UNS Hospital Pediatrician, explained that congenital heart condition could be detected as early as pregnancy through Ultrasound (USG) detection. An early symptom of this condition in infants is shortness of breath when breastfed and discomfort that makes them stop. However, dr. Galuh reminded that people should not self-diagnose and conclude that all shortness of breath is due to heart issues. The real issue should be analyzed. It is merely a symptom that parents should be aware of. “Another symptom is (baby’s) weight that does not match the recommendation,” she added. Other symptoms that are often found in clinical practice are recurring cough, cold, and inflammation.
Ninety percent of congenital heart condition has no clear causes or risk factors. However, research has determined several most common risk factors, such as genetic factors or the factor from pregnant mothers who have diabetes mellitus, consume alcoholic beverages, smoke, and consumption of a certain type of drugs, such as lithium that is used in mental disorders treatment. Exposure to cigarette smoke is also detected as the cause of congenital heart defects. Research has found that nicotine could cause a decrease in oxygen level up to 30-40%, interfering with nutrient absorption that plays a crucial role in an infant’s heart formation in the first trimester of pregnancy. In newborns or children, nicotine could lead to problematic weight and stunting, and at a later age, preventing the bones growth.
As one of the most common causes of newborn death, critical heart abnormalities could be detected using oximetry screening on 24-48 hours old babies’ right hand and feet. However, in some cases, there are no detectable signs that are only detectable later in life. “Often time, people with congenital heart abnormalities only realize their condition during their pregnancy, they found the symptoms, and echocardiographic examination revealed ASD and high lung pressure,” dr. Myrtha explained. dr. Galuh added that there are cases that congenital heart defects could be detected in newborns from the mentioned symptoms. However, many are quiet and undetected by a physician during the early examination.
There are diverse therapies and interventions for congenital heart defects depending on the types of abnormalities. In several cases, abnormalities like a hole in the heart could recover naturally at a certain age. However, in the case that such natural recovery does not occur, surgery and non-surgery options are available to treat the condition. There are also additional screenings for the condition, such as chest echocardiography, CT scan, or MRI. Children diagnosed with congenital heart defects need continuous monitoring of their condition, the severity of their symptoms, discipline in medication, and other available therapy. Some heart defects only require oral medicines to ease the symptoms; others require serious intervention. In any case of heart defects, parents are suggested to monitor their children’s growth through available growth graphics or through PrimaKu app from www.idai.or.id. Any mismatch between children’s growth and suggested growth criteria demands further attention from parents and routine health screening to receive early treatments.
There is no difference in terms of vaccination for children with congenital heart defects. However, more screening on their current condition before the vaccination is needed. Some vaccinations with active viral components such as BCG, polio, Measles and Rubella (MR), varicella vaccine, and Japanese Encephalitis (JE) need to be postponed for children with severe symptoms. Humas UNS
Reporter: Erliska Yuniar Purbayani
Editor: Dwi Hastuti