When we think about heart problems, we usually picture adults dealing with cholesterol or high blood pressure. But here’s the thing, some kids are actually born with heart conditions, called congenital heart diseases (CHDs). It simply means the heart didn’t develop exactly as it should before birth. And while that sounds scary, it’s more common than you might think, CHDs are the most common type of birth defect in the US.Now, these conditions can vary a lot. For some kids, it might just be a small hole in the heart that closes on its own. For others, it can be something more serious that needs surgery or long-term care. Symptoms can show up as fast breathing, trouble feeding, bluish skin, or poor weight gain. But sometimes, doctors only catch them later with routine checkups.We spoke to Dr. Shyamdeep Borgohain, Sr. Consultant – Paediatric Cardiac Surgery Dr L H Hiranandani Powai, Mumbai on congenital heart conditions.Dr. Shyamdeep Borgohain explains, (CHD) is the most common congenital anomaly, affecting about 8 to 12 per 1,000 live births worldwide (Indian Pediatrics, 2018). It includes a wide range of structural problems present at birth. The most frequently reported types in various studies are ventricular septal defect (VSD), atrial septal defect (ASD), patent ductus arteriosus (PDA), and the cyanotic condition tetralogy of Fallot (TOF). Among these, VSD is the most common, making up 30 to 40% of all cases. ASD and PDA are also common, especially in infants and premature babies, while TOF is the leading cyanotic CHD. Less common but important defects include transposition of the great arteries (TGA), hypoplastic left heart syndrome (HLHS), and coarctation of the aorta. Notably, about one in four infants with CHD has a critical type that requires surgery or catheter intervention during the first year of life . CHDs can be detected at various times: before birth, in the newborn phase, or later in infancy and childhood. Prenatal detection relies on routine scans during the second trimester (18 to 22 weeks). Foetal echocardiography can identify problems even earlier, between 11 and 14 weeks in high-risk pregnancies, but its effectiveness differs by the type of defect. Major defects like TOF or HLHS are usually identifiable, but smaller issues such as VSD may not be recognized until later. Newborn detection combines physical exams with pulse oximetry screening. Signs like murmurs or cyanosis may point to structural issues, while low oxygen levels detected through oximetry can flag critical cyanotic CHDs within the first days of life. (However, a cyanotic or milder defects might still be missed in the beginning. Post-neonatal detection happens when asymptomatic defects show up later with growth delays, recurrent chest infections, or are found during Pediatric visits. Research indicates that many CHDs in resource-limited areas are diagnosed for the first time between birth and five years of age. Conclusion CHD includes a range from simple defects like VSD to serious conditions like TGA. Although many can now be detected before birth or in the newborn phase, universal screening guidelines are essential, as delayed diagnosis still impacts outcomes for children around the world.
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