Kuala lumpur: The birth of a child is one of life's purest joys. However, that joy can turn to fear when a heart defect is discovered.
According to BERNAMA News Agency, in Malaysia today, the rapid advancements in paediatric cardiology can bring a ray of hope to parents facing a diagnosis of congenital heart disease (CHD), which Sunway Medical Centre (SMC) Consultant Paediatrician and Paediatric Cardiologist Dr Lim Wooi Kok states affects about 1 in 100 babies in the country. "With today's imaging and interventional techniques, many children can now live to see adulthood compared to decades ago," Dr Lim mentioned in a statement.
He explained that heart problems in children fall into two categories: congenital, meaning present at birth, and acquired, which develop after birth. Congenital heart disease includes congenital acyanotic or 'pink' heart defects, and cyanotic defects known as 'blue baby' conditions that are often detected soon after birth, especially where newborn pulse-oximetry screening is done correctly, when a baby's oxygen levels are lower than 95 percent.
A cardiac ultrasound (echocardiography) is performed to confirm the diagnosis. For cyanotic defects such as Tetralogy of Fallot, Transposition of the Great Arteries, and Pulmonary Atresia, these are more serious and require early attention when the baby's lips and extremities turn blue. Acquired heart disease includes conditions like Kawasaki disease, rheumatic valve disease, or arrhythmias, which usually present with prolonged fever, chest pain, or fainting spells.
Dr Lim, a cardiologist with extensive expertise in cardiac multimodality imaging, uses advanced tools like echocardiography, CT, and MRI to visualize the heart in 2D, 3D, and even cardiac-strain images crucial for assessing how well each heart muscle segment contracts. "Not all cardiologists are trained to do cross-sectional imaging to reconstruct or read these complex images, but having this skill allows us to understand a child's heart with far greater precision."
He further explains that with the latest addition of advanced computed tomography (CT) imaging technologies, the photo-counting CT provides detailed 3D images of the heart while considering radiation exposure, which is particularly important in paediatric imaging. Congenital heart conditions such as Atrial Septal Defect (ASD), Patent Ductus Arteriosus (PDA), and Ventricular Septal Defect (VSD) can now be treated through minimally invasive percutaneous interventions.
The process takes only a few hours, and the child can usually go home within days, compared to weeks of recovery from open-heart surgery. Caring for a child with CHD requires patience and resilience. Dr Lim highlighted that most cases of CHD are purely genetic or occur by chance, with a slightly increased risk if a parent or sibling is affected.
"We always remind families they are not alone. With proper care, most children go on to lead full, active lives. I still see some of my patients 20 years later, now adults, some even married," he said. With today's technology and expertise, many heart defects can be effectively treated with early diagnosis and proper care.
Malaysia's healthcare system has made impressive strides in paediatric cardiology, including advanced foetal echocardiography, allowing heart defects to be detected even before birth. Dr Lim is optimistic about the future of paediatric cardiology in Malaysia as more specialists are trained in advanced imaging and interventions, providing even more hope to children facing CHD.