Congenital Heart Defects are those defects that are present at the time of birth of a child. World over the incidence of Congenital Heart Defects (CHD) is same, 9 per 1000 live births. These defects lead to abnormal functioning of the heart. Some of the defects are simple in nature like holes (between the different chambers of the heart) while other defects can be complex like abnormal formation of the heart valves, wrong origins of the blood vessels. The treatment modalities of the defects are different and also depend on the severity of the defect, age of the child etc. Some of the defects require open heart surgery, some of them are treated by Cath Lab based procedures. Some of the defects classified as heart failures require medications and in some cases, children may require heart transplant as and when they grow older.
Congestive Heart failure (CHF)
Congestive Heart failure (CHF) defined as an abnormality of cardiac structure leading to impairment of oxygen delivery to tissues in the heart.
Heart failure in adults been well researched and lay protocols for the management and treatment of adults with heart failure. However, heart failure in children has not received much attention because of several difficulties. The causes of HF in children are significantly different from those usually responsible for the condition in adults. In children, cardiac failure most often caused by congenital heart disease (CHD) and cardiomyopathy. Cardiomyopathy is one of the leading causes of Congestive heart failure in infants and children. Moreover, In post Covid 19 era, multisystem inflammatory disorder in children (MISC) also shown to cause heart failure and shock in an uncertain percentage of children with the disease. Broadly speaking the causes of heart failures infants and children can divided into 2 groups:
- Excess circulation of blood
- Pump failure (capacity of the heart to pump blood)
Common types of congenital heart defects associated with excess Pulmonary blood flow are :
Ventricular Septal Defects, Patent Ductus Arteriosus, Aorta Pulmonary Window etc
Common types of congenital heart defects associated with Pump failure are :
Aortic Stenosis, Coarctation of Aorta etc.
The heart treatment for children with congestive heart failure is primarily medical management. Most of the children given Digoxin and Beta blockers are on continuous follow up. However, Some children may end up having heart transplants as and when they grow older as the heart muscles die and the capacity of the heart to pump blood significantly reduces. In some cases, the cause of heart failure in children can be an underlying chd like a ventricular Septal Defect. In addition, If the underlying cause treated, then the children recover from heart failure. Genesis Foundation is a child heart foundation supporting children with Congenital Heart Defects. Some of the children supported by the Foundation for heart treatment have had heart failure. Therefore, Once the underlying cause identified and treated, they had recovered from heart failure.
References : Dickstein K, Cohen-Solal A, Filippatos G, McMurray JJ, Ponikowski P, Poole-Wilson PA, et al. ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2008