What are congenital heart defects?

The birth of a child is a momentous occasion filled with joy and anticipation. However, parents and caregivers need to be vigilant about their infant’s health, as some babies may be born with a congenital heart disease (CHD) that has structural or functional abnormalities present at birth that affect the heart’s ability to pump blood effectively. Early detection is crucial for prompt intervention and improved outcomes. So what are the abnormal signs that may indicate CHDs in infants?

Cyanosis: One of the most noticeable signs of CHD is cyanosis, a bluish or greyish discolouration of the skin, particularly around the lips, tongue, or nail beds. This occurs when there is a lack of oxygenated blood circulating in the body. Cyanosis may become more pronounced during feeding or when the infant is active.

Rapid breathing: Infants with CHDs may breathe faster than usual, especially during rest or sleep. Rapid breathing is the body’s attempt to compensate for decreased oxygen levels in the bloodstream.

Difficulty feeding: Babies with CHD often experience difficulty while feeding. They may sweat profusely, become fatigued quickly, or exhibit signs of shortness of breath during feeds. This can lead to inadequate feeding and poor weight gain.

Poor growth: Inadequate weight gain or failure to thrive despite adequate feeding is another concerning sign. Infants with CHDs may struggle to gain weight and exhibit slower growth compared to their peers.

Abnormal heartbeat: An abnormal heartbeat can be a tell-tale sign of congenital heart disease. It may manifest as an irregular rhythm, an unusually fast or slow heartbeat, or the presence of a heart murmur — a distinct sound heard when a healthcare provider listens to the heart. These abnormalities may be detected during routine check-ups or screenings.

Swelling: Fluid retention leading to swelling is a common symptom of CHDs in infants. Swelling may occur in the abdomen, legs, or around the eyes, indicating that the heart is struggling to pump blood efficiently.

Respiratory infections: Infants with CHD are more susceptible to frequent lung or respiratory infections. This vulnerability results from fluid buildup in the lungs, making them prone to infections that can further compromise their respiratory health.

Excessive sweating: Excessive sweating, particularly during feeds or physical activity, can be a sign of CHD. The effort required by the heart to pump blood effectively may lead to increased sweating.

Lethargy: Unusual tiredness or lethargy, which is not typical for an infant, can be an alarming sign. It may indicate that the baby’s heart is struggling to provide sufficient oxygen to the body. 

Irritability: Babies with congenital heart diseases may exhibit unexplained fussiness or irritability, especially during feeds or when they are active. Discomfort caused by reduced oxygen levels can lead to increased irritability.

Vigilance and awareness are key when it comes to detecting congenital heart diseases in infants. These abnormalities can manifest in various ways, and recognising the signs early is crucial for timely intervention.

If you notice any of these abnormal signs or have concerns about your infant’s health, it is imperative to seek prompt medical attention.

Paediatricians and paediatric cardiologists can perform the necessary tests and provide appropriate care to improve outcomes for infants with congenital heart diseases.

Remember that early detection and intervention can make a significant difference in the life of a child with CHD.

(The author is a Hyderabad-based paediatric cardiothoracic surgeon.)