Timely diagnosis of congenital heart disease imperative for right treatment

Timely diagnosis of congenital heart disease imperative for right treatment About 1.8 lakh babies in India are born with congenital heart disease, which may occur due to genetic factors New Delhi, 24 June 2017: About 8 out of every 1000 children in India are born with a congenital heart disease (CHD) resulting in about 1.8 lakh babies born every year with a CHD. Of these, about 60,000 to 90,000 have critical CHD, which requires an immediate intervention. Children with high-risk CHD can die if not diagnosed in time and this makes early diagnosis extremely important. Some chhildren with uncorrected heart defect may survive into adulthood and require intervention later. Congenital heart disease is a result of a defect in the formation of the heart. Care should be taken to avoid medications or alcohol etc. that are likely to interfere with organ formation in the fetus to lower the risk of CHD. Newborns with critical CHD exhibit symptoms that can be identified soon after birth. However, in some cases diagnosis is not possible till a later time. Speaking about this, Padma Shri Awardee Dr K K Aggarwal, National President Indian Medical Association (IMA) and President Heart Care Foundation of India (HCFI) and Dr RN Tandon – Honorary Secretary General IMA in a joint statement, said "Certain medications such as retinoic acid for acne, alcohol or drug abuse during pregnancy, and poorly controlled blood sugar in women who have diabetes during pregnancy increase the risk of CHD in the baby. Although the exact cause is not known, CHD may be genetic and get passed down through families. Although not entirely preventable, it is possible for children with CHD to lead active and productive lives with timely diagnosis and the right treatment. Though there is a good success rate for treatments, it is important to diagnose this condition early enough and reach the hospital on time. However, most of the times babies are diagnosed much later and reach the hospital in a critical stage. This reduces the efficacy of treatments." It is possible to detect any structural abnormalities in the fetus, including in the heart, with the help of a level-II ultrasound in the second trimester. Adding further, Dr Aggarwal, said, "It is imperative to make testing for CHD a standard practice in hospitals before babies are discharged. As a part of the efforts to save lives of children with CHD, the HCFI under its flagship project, the Sameer Malik Heart Care Foundation Fund, has saved over 500 lives in the past two years. This fund was initiated towards ensuring that no one dies of a heart disease just because they cannot afford treatment." Though it is not possible to prevent the likelihood of CHD in babies, there are some precautions that mothers can take during pregnancy. • Get vaccinated against rubella and flu • Avoid drinking alcohol or taking drugs • Taking folic acid supplement during the first trimester relatively lowers the risk of giving birth to a baby with CHD or any other birth defects. • Do not take any over the counter (OTC) medication including herbal remedies without consulting your doctor. • Avoid contact with people who have any infection. • Women with diabetes should try and keep the condition under check. • Avoid exposure to organic solvents, such as those used in dry cleaning, paint thinners, and nail polish remover.

Timely diagnosis and treatment imperative during a heart attack

Timely diagnosis and treatment imperative during a heart attack ‘Heart attack guidance for physicians: When to suspect, how to diagnose, what to do?’ a comprehensive guidebook by Dr KK Aggarwal and Dr Sundeep Mishra published in the Indian Heart Journal New Delhi, April 23, 2017: Cerebrovascular diseases have become the number one cause of mortality and morbidity in India. Among these, heart attack is one of the most serious conditions associated with very high morbidity and death rate. General practitioners must recognize the signs early on in order to bring down the high complication rate and follow it up with proper treatment by certified cardiologists. An instructive document titled ‘Heart attack guidance for physicians: When to suspect, how to diagnose, what to do?’ has been published by Dr KK Aggarwal, National President of the Indian Medical Association and Prof. Sundeep Mishra, Professor of Cardiology at AIIMS in the special STEMI Supplement of the Indian Heart Journal. It provides simple guidance on how to suspect and diagnose a heart attack, early treatment, and when to refer a patient with this condition. This information is important not only clinically but from the medico-legal standpoint as well because any delay can worsen survival and even result in death. Speaking on the subject, Padma Shri Awardee Dr KK Aggarwal, National President Indian Medical Association (IMA) and President Heart Care Foundation of India (HCFI) said, "Heart attack, particularly STEMI, can be totally reversible if diagnosed and treated early. The adage 'Time is Muscle' is extremely relevant in the diagnosis and treatment of this disease. The door-to-balloon time when a heart attack patient arrives in the emergency room until percutaneous coronary intervention is performed to restore blood flow also needs to be considered by physicians. It is therefore important that physicians be trained to recognize any such symptoms right at the onset such that the appropriate guidance can be given without losing out on precious time." There is severe chest discomfort during a heart attack. Deaths occur due to abnormal heart rhythm (ventricular fibrillation) due to electrical instability of the heart or heart failure due to massive heart attack. Occasionally, a heart attack can cause a heart muscle to rupture and this can prove fatal. Adding to this, Prof. Sundeep Mishra, Professor of Cardiology at AIIMS and Editor, Indian Heart Journal said, " It is very important for the first-contact physicians to suspect a heart attack early on, confirm it through an ECG as soon as possible, and refer the patient for revascularization to a center that is better equipped. This is where clear cut guidance for physicians regarding when to suspect a heart attack, how to confirm it, and how to proceed when a diagnosis is made assumes utmost importance and the instructive document will be like a comprehensive guide to this and more." Following are the signs and symptoms of a heart attack. • Pain areas: in the area between shoulder blades, arm, chest, chest, jaw, left arm, or upper abdomen • Pain types: can be crushing, like a clenched fist in the chest, radiating from the chest, sudden in the chest, or mild • Pain circumstances: can occur during rest • Whole body: dizziness, fatigue, light-headedness, clammy skin, cold sweat, or sweating • Gastrointestinal: heartburn, indigestion, nausea, or vomiting • Chest: discomfort, fullness, or tightness • Neck: discomfort or tightness • Arm: discomfort or tightness • Also common are anxiety, feeling of impending doom, sensation of an abnormal heartbeat, shortness of breath, or shoulder discomfort. Physicians must also raise awareness about the preventable aspect of heart disease. Simple lifestyle modifications such as consuming a healthy diet, exercising regularly, cessation of alcohol consumption and smoking and effective stress management techniques can go a long way in helping reduce the risk of heart attacks.