‘Heart Disease In Children Needs Early Medical Attention’



Dr. Oseyi Dawodu is the Registrar, Department of Surgery, University of Benin Teaching Hospital (UBTH). He speaks to IJEOMA OPARA on the causes and symptoms of a hole in the heart in infants, while dismissing myths surrounding the disease.
WHAT does ‘hole in the heart’ mean?
The terminology is a layman’s way of describing a group of heart diseases characterised by an abnormal communication between the left and right sides of the heart. Essentially, we are speaking of such conditions as atrial septal defects, ventricular septal defects and patent ductus arteriosus, just to mention the common ones. A simple way of looking at it is to think of the human heart as a box with four chambers, an upper and a lower chamber on the right and left. Normally, blood enters the upper chamber on each side, flows to the lower chamber on the same side and then flows out through the lower chamber. So, it is immediately obvious that under normal circumstances blood does not flow directly from the left to the right side or vice-versa whether between the two upper chambers or the two lower chambers. If however there is an abnormal opening that allows blood to flow between the left and right sides, then one can describe it as a hole in the heart.

What causes this condition in infants and is it peculiar to young children?
In infants, it results from the abnormal formation of the heart, while the baby is still in the womb and so they are born with the problem, so we say it is a congenital defect of the heart. There are certain things that put a woman at risk of having a child with these conditions some of which are; taking certain drugs or alcohol during pregnancy, especially in the first trimester, some viral infections like Rubella also in the first trimester of pregnancy and then some genetic abnormalities like Down’s syndrome, which is more common among women who have children after the age of 40 years. A hole in the heart is really not peculiar to young children. It can occur in adults who previously had no such problem with their heart and so, it is said to be acquired. However there may be individuals, who have the problem from birth, but it is not discovered until they are teenagers or even adults.

Is there a lifestyle or eating habit that causes it?
Drinking alcohol by the mother during pregnancy, especially in the first trimester can predispose to this condition. Also, taking some drugs not prescribed by the doctor during pregnancy could put the foetus at increased risk of the condition. However, it does occur commonly even in the absence of these risk factors.

Is it hereditary? What are the chances of infants having this condition?
In many of the children that have this condition, it is not hereditary. However, it is more common in the offspring and siblings of individuals, who have the condition or did so as children. As much as one per cent of all newborn have a heart abnormality from birth and the group of conditions that may be referred to as ‘hole in the heart’ form about 50 per cent of these congenital heart diseases. In Nigeria, it is estimated that 6.5million babies are born each year. Therefore as much as 65, 000 babies are estimated to be born with heart abnormalities and 32, 000 of them will have a ‘hole in their heart.’

What symptoms should the parents look out for?
It is good practice to have every newborn baby examined by a health care provider soon after birth in order to check generally for any abnormality. Parents may also look out for such features as difficulty with breathing, poor suck, recurrent respiratory tract infections and failure to gain weight.

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