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Is your child suffering from heart trouble?

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March 06, 2007

was your baby a 'blue' baby, ie born with a hole in the heart?  Parents with babies suffering from this condition need to know that it IS curable.

Though no medicine can close the hole, paediatric cardiologist Dr Swati Garekar says the condition can be cured either by spontaneous closure or closure in the cath lab or in the operation theatre.

She tackled questions on the 'blue' baby syndrome in a chat with readers on February 28.

For those who missed the chat, here's the transcript. 

 Dr Swati Garekar says, Hi! I am Dr Swati Garekar.

Rajesh Kumar asked, My son sometimes gasp very deep. He doesn't look lethargic to me as he is very fast in running and talking. He has a brown mark over sternum which is birthmark also. Is he having a heart problem. He sweats a lot

Dr Swati Garekar answers, I need to know how old your son is.

TR Niure asked, Dr Swati,do you know about Nutrilite, dietry food supplements?

Dr Swati Garekar answers, Nutrilite is a soy protein based food supplement. It has a good caloric and calcium content. but it cannot replace milk.

Lakshmi asked, How to recognise the Blue Baby Syndrome in children?

Dr Swati Garekar answers, Babies with Blue Baby Syndrome turn blue (lips, nails) when they exert themselves whether it is while feeding or playing. If it is a severe case they may even faint.

Ashish asked, Hello doc, my son is 11 months old and he is low in haemoglobin, I think its 8.2. The problem is that when he gets scared or hurt he cries out so wildly that he stops breathing momentarily. We then have to sprinkle water or pat his back a bit harder to get him back to normal. We consulted a doctor and he said that its because of low haemoglobin that puts pressure on his heart while he is crying, Is doctor correct? Please help and advice me accordingly. Do we need to do any diagnosis?

Dr Swati Garekar answers, Babies often stop breathing momentarily when they cry a lot. That is okay. No pressure on the heart.

Varsha asked, My daughter is three months old. She having 4mm hole left to right shunt. Is it any problem?

Dr Swati Garekar answers,  I need to know where is the hole? Is it an Atrial septal defect (ASD) or a Ventricular septal defect (VSD)?

Raj asked, heart beat of my 12-year old daughter seems little bit faster as of normal pulse rate. Is there any problem due to this?

Dr Swati Garekar answers, How fast is it? Is it fast even when she sleeps? Does she complain of her heart thudding in her chest even at rest?

Hey asked, What can I feed my four-year old daughter so she can build up her immunity?

Dr Swati Garekar answers,  I would recommend all food that you would include in a healthy adult diet. The only difference is the portions -- small. Does your daughter fall ill very often? If so, we need to investigate why.

Skjaiteerth asked, Hello doctor, My son 6 years old from 5-6 days takes deep breath through mouth (once in 2-3 minutes) Already shown to doctor. First they have given Azilide, then cold was controlled but wheezing sound was there. We referred another doctor who gave Metalukast and Sinarest-af. We used these for 4 days. After that only we developed deep breath in 2-3 minutes. Now we have discontinued these tablets. He is normal but taking deep breath in 3-4 minutes is going on. Please help me

Dr Swati Garekar answers, Ask your doctor if he thinks that your son has asthma. If yes and if the asthma is even moderately severe he needs daily prophylactic medication. Also, I would like to know whether the deep breathing prevents your son from engaging in his normal activities.

Shekar asked, Dear doctor, my daughter is suffering from Mitral Valve Prolapse. She is five years old. What is the reason for this condition and what does it mean?

Dr Swati Garekar answers,  I would like to know how severe is the MVP. Is there any mitral valve regurgitation? A person may have MVP and yet may be totally asymptomatic. Also, in children it is uncommon to make the diagnosis of MVP. Was your echocardiogram done by a pediatric cardiologist?

Rajesh asked, hi doctor, my child has a burning sensation and feels like something is hitting on his chest and he also has pain at the back and he sometimes feel like vomitting. Kindly let us know what to do about that. Is it a serious heart problem?

Dr Swati Garekar answers, How old is your child? When did he have the chest pains?

Kunal asked, sometimes I received some pain in my chest. Is this normal or any sign of heart attack?

Dr Swati Garekar answers, How old are you Kunal? When do have chest pains?

Pal asked, my son is 4.5-yrs old. Due to operation, my wife couldn't feed her at all. But since then the child has developed chest congestion problem. He is very prone to diseases like pneumonia and get chest congestion very easily. We were using nebolizer and later steam treatment.. But no significant improvement noticed.. Every month at least once he has chest congestion and breathing problem. Is there a permanent solution to this? We had been visiting different doctors for the complete remedy. But so far to no avail.

Dr Swati Garekar answers,  I request you to get a chest x-ray and an echocardiogram (ultrasound of the heart)of your son. It is possible that your son has a heart defect that is causing these problems. Please make sure that the echo is done by someone who is familiar with congenital heart defects (heart defects that occur in children). The x-ray will show if the heart size is large while the echocardiogram will tell us for sure whether there is a heart defect. Which city are you from? Maybe I can suggest a name.

Suresh CK asked, Hello doc, my daughter is 2.5-yrs old. She has got PDA problem. What is the right age to close the PDA problem? I have checked with different docs they confuses me. Please advice. She is very normal.

Dr Swati Garekar answers, That depends on the size of the Patent Ductus Arteriosus (PDA), which sometimes may have to be closed even in a newborn baby. It all depends on how big the PDA is. In general at your daughter's age, it is unlikely that the PDA will close on its own. I suggest that you get it closed in the next few months. A moderate sized or large PDA can cause the heart to enlarge. Even if your daughter appears normal, the PDA will affect the size of the heart. In addition, there is a danger that she might get a bad infection of the lining of the heart.Why let that happen when you can get the PDA closed easily in the cath lab without surgery?

Ramesh asked, My daughter has a small hole in the heart. At the moment she is 8 to 9 years old. Please tell us whether it is curable and what line of treatment to be taken. Thanks, Ramesh.

Dr Swati Garekar answers, It all depends on the where the hole is. Cure is either spontaneous closure or closure in the cath lab or in the operation theatre. No medicine in the world can close a hole in the heart. Also, even a small hole can damage the heart in certain situations. A pediatric cardiologist is the correct person to take the decision about what to do with the hole.

Anil asked, My child,a Down Sysdrome has big hole,AVSD do you have any remedy?

Dr Swati Garekar answers, Atrioventricular Septal Defects (AVSD) in a child with Down Syndrome can be closed surgically. Ideally this should be done at four to six months of age. For an older child, there is the danger that the lung artery pressure may increase. In such cases it may not be possible to do anything about the AVSD (hole). A cath procedure will help to decide if surgery is still possible.

Zeeshan asked, i have a three month old baby. She was born just around 7 months. She has a slight murmur in her heart from childhood. Is it serious? Doctors say that they will monitor after six months. Please advise.

Dr Swati Garekar answers, How is your daughter otherwise? Is she growing well? Are the doctors happy with the weight gain? Or does she fall ill frequently? The easiest thing to do is to get an echocardiogram (ultrasound of the heart). Please get it done at a centre where the person doing the echo is very familiar with heart defects in the child. The ideal person to do this echocardiogram is a pediatric cardiologist.

Ashish asked, Is there anyway we can maintain his haemoglobin level which currently stands at 8.2? The doc said it has to be somewhere around 12-13.

Dr Swati Garekar answers, Your son must be on iron supplements. Also make sure that he is not drinking more than 32ounces (4 glasses) of milk daily. He has to eat maintain a healthy diet.

Tomorrow: Part II of the transcript

-- Dr Swati Garekar is a consultant paediatric cardiologist with Wockhardt Paediatric & Congenital Heart Centre, Mumbai. A graduate from Seth GS Medical College, Mumbai, she obtained her post-graduate degree in paediatrics from the Children's Hospital of Michigan, USA. She has a three-year old fellowship in paediatric cardiology from the same institute and has had exposure in the latest management strategies of all possible congenital heart defects.

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