Cardiovascular disease among children in Kashmir
Heart defects can be asymptomatic sometimes; Parents should know the red flags
FAIQA MASOODI
SRINAGAR, Jan 12: The joy and fulfillment of giving birth is sometimes accompanied by stress of having a baby with a weak heart. The foundations of cardiovascular risks can be laid before the birth of a child and cannot be detected till many years.
Heart diseases can be present from birth (congenital) or acquired later in childhood. So to know about your child’s heart health and the problems of a pediatric heart it becomes important to seek medical intervention at earliest.
To understand the functioning of a pediatric heart and intricacies of pediatric cardiology, Kashmir Despatch spoke to the renowned pediatric cardiologist of the valley, Dr. Adil Mohamad Lankar, Consultant Interventional Pediatric Cardiologist MD Pediatrics, Srinagar.
Q: What is the difference between a cardiologist and a pediatric cardiologist?
Dr AML: Heart problems in children are different from adults and pediatric cardiologists are heart doctors who deal with the heart diseases from fetal period to adulthood. They treat babies, infants and children with both Congenital Heart Diseases (CHDs) that are present in a pediatric heart from birth and the Acquired Heart Diseases (AHDs) that develop over time due to illness, infections etc. Earlier adult cardiologists used to treat all pediatric heart problems but now pediatric cardiologists work in association with specialized heart surgeons when heart surgeries and other such procedures are to be done.
Q: What age groups do pediatric cardiologists mostly deal with?
Dr AML: Pediatric cardiology deals with irregularities and heart ailments in kids below 18 or even 21 years. However, pediatric cardiology is not confined to any particular age group. Any adult, of any age group living with congenital heart defects since childhood is also treated by pediatric cardiologists.
Q: Can you please tell us about the symptoms that a parent should keep a track of in order to know about their child’s heart health? Also, when should one consider visiting a pediatric cardiologist?
Dr AML: Heart defects have a broad range spectrum and can be asymptomatic sometimes. However, some of the red flags that a parent should be aware of include,
In Infants:
§ Excessive sweating while breastfeeding the baby
§ Issues in gaining weight
§ Bluish discoloration while baby is crying
In Children/Adolescents:
§ Recurrent chest infections and chest pain
§ Fainting while exercising or at rest
§ Breathlessness while walking
If you notice any of these symptoms you should consult your general pediatrician. He will hear the heart sound (murmur) of the child with a stethoscope to rule out any possibilities of an underlying heart condition. If the heart murmur shows any type of abnormality he may tell you to perform some other tests that include Electrocardiogram (ECG/EKG), Echocardiogram, chest X-ray, MRI etc and from here a child can be referred to a pediatric cardiologist. It can be a stressful process for any parent but early medical help is any day beneficial for the better future of a child.
Q: How has pediatric cardiology developed in Kashmir over the years and what are the new technologies and popular treatments that have been introduced lately?
Dr AML: Though a new concept here in Kashmir, pediatric cardiology has been in vogue for around 15 years in India now and the domain has witnessed a sea change in all these years because of the advancements in technology.
Advances in Fetal Echocardiography or an echo done on a baby before birth, Electrocardiogram (ECG) done to diagnose irregular heart rhythms , MRI, Chest X- rays etc have made the early diagnosis and understanding of CHDs more transparent. With latest devices, Interventional cardiology has reduced the need for open heart surgeries thus improving overall patient care.
Earlier a patient with a hole in the heart required an open heart surgery which was time consuming and costly. It left a huge scar on the body and in the minds of the patients. However, same children can now get interventions with keyhole surgeries that are affordable and reduce the hospital stay. It leaves no scars and patients get discharged within a day.
Q: Does this mean that any extreme kind of heart condition can be successfully dealt with by the pediatric cardiologists in Kashmir?
Dr AML: Since 2018 I have dealt with around 400 such cases in Kashmir where we performed various procedures and surgeries in patients as young as one day old to adults of 60 years of age. All these procedures are covered under various government schemes thus making them very affordable to the common population and the success rate has been 100 percent.
A procedure that will cost you around 4 lacs outside is almost completely covered under the golden card scheme here in Kashmir. So, there is no need to panic and rush from pillar to post in search of better treatments. We are here at your disposal delivering successfully.
Q: What are the most common heart problems in children?
Dr AML: Some people are born with heart diseases while others acquire it in later stages of life. When a person is born with a heart defect it is called congenital heart disease (CHD) and on contrary when a person develops a heart disease after his/her birth and it grows during his life time it is called acquired heart disease (AHD)
Pediatric AHD affect the functioning of a heart and its associated blood vessels and are more common in adults than children. They can be caused due to some bacterial or viral infections. Chronic diseases and medications can also cause acquired heart diseases. Two most common acquired heart conditions in children are Rheumatic Heart Disease and Kawasaki disease.
Q: What are the most common Congenital Heart Diseases and how do they develop?
Dr.AML: CHDs are the most common type of birth defects and affect how blood flows through the heart to the rest of the body. Sometimes there is a defect in the walls of heart like a hole in the heart or a problem with the heart valves where in they get narrowed or blocked. This leads to mixing of red and blue blood. Some CHDs can affect blood flow, make its flow slow down or go in the wrong direction which in turn affects the oxygen supply throughout the body thus making it hard for the baby to breathe. They range from simple to normal to complex and can be managed by medicines or may need surgeries.
These defects occur during fetal development, and can be diagnosed during pregnancy using fetal echocardiogram. Other defects are detected after birth of the baby by observing symptoms like blue coloring or by simple screening, while some are not detected for many years until childhood or adulthood.
Congenital heart defects can be mild or critical but with the advancements in medical technology children with CHDs have a better chance of living a healthy life. There are many such obstructive and septal CHDs like Ventricular septal defect (VSD), atrial septal defect (ASD), Pulmonary Stenosis (PS), Aortic Stenosis (AS) etc but the most common among these is VSD.
In VSD a hole is present between two lower chambers of the heart which causes the blood to flow into the lungs thus congesting the lungs.
Q: Do you think there should be more awareness regarding pediatric cardiology and its advancements in Kashmir?
Dr.AML: Reaching out to masses and creating awareness about pediatric heart diseases, its early diagnosis and the available advanced treatments is very important. CHDs can be treated effectively if diagnosed early thus enabling a patient to live a healthy disease free life. Media both print and electronic has a great role to play in this regard. Well researched articles, patient testimonials, awareness campaigns can help a great deal.
Q: Your opinion on the preventive measures to deal with heart problems and advice for the parents and expecting mothers?
Dr AML: Prevention part comes into play right from the time a lady conceives because a fetal heart starts developing at the time of conception and is fully formed by eight weeks into pregnancy and it is during these eight weeks that CHDs can occur.
§ Know about the harmful impacts of the medicines that you are consuming
§ Avoid unnecessary medication
§ Know about the safety spectrum of the products that you consume
§ Keep a track of your babies heart health and the associated red flags
§ Proper parent counseling and awareness generation.
