Bipasha Basu’s baby had a hole in the heart: What causes congenital heart defects? Do parents need to worry?

Congenital heart disease in kids (Designed by Abhishek Mitra)

WHAT IS VENTRICULAR SEPTAL DEFECT (VSD)?

During embryonic development in the uterus, the wall between the left and right ventricles is delicate and tears. “Now the right ventricle contains impure blood or deoxygenated blood and the left ventricle contains pure or oxygenated blood. These two kinds of blood mix inside the heart. These changes may increase blood pressure in the lungs, keep some of the impure blood in circulation, thereby exhausting the child, and requiring the heart to work harder to pump blood. A small VSD may cause no problems and closes on its own. Babies with medium or large VSDs may need surgery early in life to prevent complications,” adds he.

WHAT CAUSES CONGENITAL HEART DEFECTS?

Congenital heart defects can sometimes have a genetic component but they are often caused by a combination of genetic and environmental factors. “The foremost reason is less genetic dispersion or intrabreeding, which is common among the lower socio-economic strata where intracaste marriages are rampant. That’s why the number of children born with congenital heart defects is the highest among people in Bihar and Uttar Pradesh. Among the urban populace, the risk of congenital heart disease is higher because people are choosing to have their babies in the late 30s or early 40s through assisted reproductive technologies. Environmental factors mean the mother’s eating or drinking patterns may cause aberrations in the development stage of the foetus. Sometimes, it could be the medications the mother uses,” says Dr Chandra.

SIGNS AND SYMPTOMS

Sometimes, the child exhibits the signs rather early. For others, it takes a while for symptoms to show. Basu’s child was diagnosed on the third day. “There’s a shortness of breath and the baby gets tired or exhausted while feeding. Also, there is no weight gain. During a physical examination the doctor might hear a whooshing sound and then go ahead for confirmatory tests like an echocardiogram, which is an ultrasound of the heart and can show how big the hole in the heart is,” explains Dr Chandra. That’s why cardiologists request early interventions. “Many parents decide to wait because the cost of the procedure is between Rs 3 and Rs 4 lakhs but if left unattended, it can lead to an inoperable condition. Over time Eisenmenger syndrome can develop, when long-term damage to blood vessels and a reverse flow of oxygen-poor blood from the right ventricle to the left ventricle causes oxygen shortage in the body. In later years, you will then have to do a heart and lung transplant surgery,” says the cardiologist.

DO EXPECTANT PARENTS NEED TO WORRY?

While genetic testing can provide insights, it may not identify all potential issues. “That’s why gene testing is not recommended unless there is a family history of many children having been born with congenital defects. Instead, parents considering having a baby should focus on factors like prenatal care, a healthy lifestyle, and regular medical check-ups to ensure the best possible outcomes for their child’s heart health. Consulting a medical professional can provide personalised guidance based on their specific situation,” says Dr Chandra.

WHAT ARE OTHER KINDS OF CONGENITAL HEART DISEASE?

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There is a whole spectrum and let’s say VSD is in the most manageable spectrum. “We have cyanotic congenital heart disease, where heart defects reduce the amount of oxygen delivered to the rest of your body significantly. The baby’s skin has a bluish tint and is called a blue baby. Acyanotic congenital heart disease — VSD is one — involves defects that don’t reduce oxygen as much in the initial stages,” says Dr Chandra.