What Steps Should be Taken for Detection of Occult / Hidden Cases of Congenital Heart Disease CHD? Since there are still a large number of occult/hidden/ asymptomatic cases of CHD, especially of the late cyanotic or acyanotic (in which cyanosis does not occur) group, urgent steps are required to be taken for their early detection. Such cases can be detected in various camps, especially in schools/ colonies, etc. However, in many of the late diagnosed cases, as described earlier, treatment/surgery may not be possible.

It will be appropriate if at the time of birth, a pediatrician examines all the babies for any congenital lesion of the heart, and if suspected, an echocardiography should be carried out so that the disease can be diagnosed right at birth, and necessary steps of treatment can be planned well in time.

It is not difficult diagnosing/ suspecting/ detecting various congenital lesions in the heart, say, in the general population. The physician, besides a detailed clinical examination, is mainly required to auscultate the heart of each child or adult, as the case may be, for heart sounds and murmurs. It gives a fair clue of various congenital lesions of the heart, although all the murmurs of the heart may not be pathological. There are also so-called innocent murmurs. However, once the disease is suspected, the diagnosis can be confirmed by various tests, especially echocardiography.

Even a rare/uncommon heart disease can be diagnosed with fair accuracy on clinical examination of the heart. Hence in various camps that may be proposed to be organized by various voluntary organizations, not much expenditure is likely to be incurred. Routine tests, like ECG and X-rays etc., are required when’ there is at least some clue on auscultation/ Clinical examination about the presence of CHD.

The case of a Chinese woman suffering from a congenital heart disease, rupture of sinus of valsalva, which is not very common, was reported in the British Medical Journal in its issue of 16th March, 1968. The same year, a similar case of an Indian patient was suspected clinically by the author. Advanced tests like echocardiography etc. were not available at that time. The patient was operated at Mumbai by Dr. K.N. Dastur, Honorary Cardiac Surgeon and Honorary Professor of Surgery, Topiwala National Medical College and B.Y.L. Nair Charitable Hospital. Dr. Dastur, confirming the author’s diagnosis, wrote, “The rupture of sinus of valsalva was into the right ventricle as postulated by you.

Hence, a clinical examination/ auscultation of heart will go a long way in detecting the subclinical cases of congenital lesions of the heart. And, therefore, a general realization of this fact is all that is required so that people themselves corne forward for such routine check-ups of their children by their physician, or report in the various camps that may be held from time to time. Unless this is achieved, the desired goal can not be reached. And the people, especially the late cases who are not fit for operation, may go on suffering from the morbidity of the disease, which is chronic in many of the cases.

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Congenital heart disease is a kind of malformation or heart defect that exists somewhere in the heart. In some cases it is a defect that can be found in one of the blood vessels of the heart. It is defined as congenital because the defect is present when a baby is born. It is strongly believed that these types of heart defects take place while the fetus is developing but it is not clear at what stage throughout the nine months that it takes hold. Out of every 1,000 children born, 8 to 10 have this condition.

Some babies show symptoms of congenital heart defects from the very beginning of their lives while other people will not show symptoms until later in their childhoods. In other cases, such a defect is not discovered until a person has become an adult. It is estimated that 500,000 American adults suffer from congenital heart disease.

Trying to discover the cause of congenital heart disease is not easy. Most of the time the cause of it is not known. Doctors and medical researchers have discovered factors that do seem to suggest an increased risk of developing this disease however. One of these risk factors is a chromosomal abnormality or a genetic abnormality such as Down syndrome. Women who drink alcohol, use drugs or take specific types of medication during the period of their pregnancy are more likely to give birth to children with congenital heart defects. When a woman contracts a maternal viral infection such as German measles (also known as rubella) during the first trimester of her pregnancy she is more likely to give birth to a child with this disease.

If someone in the family such as a parent, grandparent or brother or sister was born with a congenital heart defect then the risk of a child in the family being born with it is even higher. For example, the risk for the general population is eight in 1000 but it becomes 16 in 1000 for those who have a family member with it.

There is more than one type of congenital heart disease. Heart valve defects are very common and these are stenosis or narrowing of the heart valves or in severe cases, valves that are narrowed to the point that they do not allow blood through at all. Leaky valves also fall under the category of heart valve defects. Atrial and ventricular septal defects which are defects in the walls between the atria and ventricles of the heart cause some blood which is oxygenated and some blood which is not, to mix which can cause problems in both the right and left areas of the heart. Another type of congenital heart disease is abnormalities in the heart muscle, which can then cause heart failure.

Congenital heart disease can cause symptoms but often times there are no symptoms at all. Sometimes it is necessary to undergo medical tests to determine whether or not a person is afflicted with this disease. If symptoms do show themselves the two most common are shortness of breath and a decreased ability for exercise.

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