What Happens If Hole in Heart Treatment is Delayed in Children?

A hole in heart by birth or septal defects are the most common type of congenital heart disease (CHD) which are defects in the heart present at birth. A staggering 200,000 cases of congenital heart defects (CHDs) are reported each year and a large chunk of them are septal defects. Heart, a versatile organ with sophisticated physiology starts its rhythmic beat long before being born and it continues to do so until death. Any alteration to this physiology, including a hole in heart by birth, can lead to serious complications if not treated promptly and definitively. What can happen if treatment is delayed for this condition? Is the timing of the hole in the heart treatment and type of treatment same for everyone? Let’s find out below.

What is Hole in the Heart by Birth?

Hole in heart or septal defects refer to an opening in the wall separating various chambers of the heart. Based on the location of the opening, it can be an Atrial septal defect (ASD) or a ventricular septal defect (VSD). These usually arise due to defective formation of the walls during development of the embryo. Most often, these are diagnosed at birth or during childhood but rarely present for the first time during adulthood. Hole in heart treatment and the outcomes depends on the type and severity. A larger and complex defect usually requires open heart surgeries while a smaller defect can be managed with minimally invasive procedures like device closures. Severity ultimately depends on how significantly normal physiology is altered.

What Happens if Treatment of Hole in Heart in Newborn is Delayed?

For most congenital heart defects (CHDs), including holes in heart, the timing of the hole in heart treatment is of paramount importance. Some of the smaller defects can close without any intervention, a wait and watch strategy is usually adopted. For larger and hemodynamically significant lesions (i.e. lesions where blood flow is considerably altered), there can be a multitude of complications including:

Heart Failure: Heart failure is NOT heart attack, but it is a condition where heart is not able to pump enough blood to meet the body’s demand. The left side of the heart normally contracts with higher pressure compared to right side. When a hole exists in the wall that separates both sides, a left to right shunt can develop due to this pressure difference and it can result in larger blood flow to the lungs which will eventually flow back to the heart, overloading the chambers. This can weaken their muscles over time and can result in heart failure.

Pulmonary Artery Hypertension: One of the serious complications of untimely treatment. As said above, the increased blood flow to the lungs will result in changes in the pulmonary vessels which will eventually lead to abnormally high pressure in the pulmonary arteries. If persisted long enough, it could be permanent and corrective treatment will no longer be possible.

Eisenmenger Syndrome: The most dreaded outcome of these defects if left alone is the development of Eisenmenger syndrome where there is reversal of the shunt due to pulmonary hypertension. This can result in bluish discoloration of the child. Once Eisenmenger sets in, the condition is irreversible. Although it can be managed by medications to an extent, the child is at a serious disadvantage in life and may even require a heart-lung transplant.

Infective Endocarditis: It is a serious and potentially life-threatening infection of the inner lining of the heart, the chances of which are more in children with CHD.

Poor Growth and Development: As the heart is burdened with extra volume and is not pumping efficiently, the child may tire easily leading to poor feeding and poor weight gain. This can impact on the normal growth of the child. There are many other complications including recurrent chest infections, rhythm abnormalities, increased risk of clot formation and stroke among others. Parents should look out for any danger signs in their children like breathlessness, high grade fever, poor feeding and bluish discoloration of lips to name a few.

Conclusion

Timely hole in heart treatment does matter for holes in the heart, as it can restore the heart’s function to near normal and the child can lead a perfectly normal life. The treatment option is chosen based on the type of defect, size and its severity. It can be anything from a minimally invasive device closure to corrective repair by open heart surgeries. The takeaway is that treatment of holes in heart in newborn should never be delayed if the lesion is significant. After all, our aim is the child living a happy, normal life with their little hearts beating stronger every day.

Genesis Foundation is an NGO in Haryana that facilitates hole in heart treatment at 25+ partner hospitals for children aged between 0 to 18 years and who come from families whose monthly income is Rs. 20,000 or less. If you want to know more about them or know someone who is struggling with getting the treatment of hole in heart in newborn, you can call them +91 96506 03438 at or drop an e-mail at contactus@genesis-foundation.net. Our team will assist you with further steps.