Understanding Congenital Heart Disease: Causes, Symptoms, and Treatments

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Congenital heart defects refer to defects in the heart that children are born with. These are one of the most common congenital defects globally. In India too, 200,000+ children are born with a congenital heart defect (CHD). These are the numbers of the cases that are recorded – there maybe many more which go undiagnosed and hence untreated. Only 25 per cent of the children diagnosed with a congenital heart defect are able to get the required treatment. A lack of awareness and access to resources are the biggest challenges in children getting timely treatment. Organisations like Genesis Foundation, a congenital heart foundation India has been taking steps to both build awareness and provide financial treatment to those who cannot afford the cost of treatment. The treatment for CHD is expensive and families that do not earn enough to meet their daily needs have to depend on funds they receive as a congenital heart disease donation to support the treatment. Symptoms of Congenital Heart
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Does Covid-19 affect children with heart disease?

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In December 2019, the SARS-CoV-2 infection (COVID-19) was initially discovered in China as a new emerging disease. Subsequently, it has spread rapidly among other countries including Iran, and eventually, it was declared by the World Health Organization as a “pandemic” on 11th March 2020. The Health Ministry said that the common symptoms among children might include fever, cough, breathlessness or shortness of breath, fatigue, sore throat, myalgia (muscle pains, aches, pain in ligaments), rhinorrhea (excess drainage, ranging from a clear fluid to thick mucus from the nose), diarrhoea, loss of smell, loss of taste. Meanwhile, few children might also show symptoms of gastrointestinal issues.


But having said that, it is also reported that the prevalence of symptoms is lower in children compared to adults. Coronary artery diseases, heart failure, and cardiac arrhythmia have been associated with increased mortality among adults with COVID-19.



There is still a lack of knowledge and studies regarding children and adolescents suffering from congenital heart diseases (CHD) and COVID-19. SARS-CoV-2 infection may have direct cardiac involvement or indirect effects on the heart through respiratory and other organ involvements. As a Foundation working for children, Genesis Foundation has also struggled finding information. Theoretically, the effects of this infection on a pressure- or volume-overload heart in the setting of CHD may be more serious. In addition, risk factors for the severity of COVID-19 in patients with CHD are unknown. Genetic syndromes are usually seen in patients with CHD, but their effects in this situation are unknown. Discovering the impacts of CHD on the course and outcome of COVID-19 enables physicians to set priorities for emergency interventions. 

Although children with COVID-19 are often asymptomatic, special underlying congenital heart defects can predispose to serious and rarely fatal outcomes. Of particular importance is the burden of disease in patients with severe untreated obstructive lesions (Right ventricular outflow tract obstruction (RVOT) or left ventricular outflow tract obstruction (LVOT) and patients with significant Pulmonary artery hypertension (PAH). The RVOT is generally associated with Tetralogy of Fallot, Pulmonary Atresia. 

The clinical symptoms, CT scan findings, and laboratory parameters of COVID-19 are similar among children with normal heart or those having Congenital Herat Defects. Heart failure can be seen due to myocarditis or as a manifestation of Multisystem Inflammatory Syndrome in children presented with mild transient ventricular dysfunction without any rise in cardiac enzymes. 

As a children’s heart Foundation, we are closely watching the long-term effects of children with CHD and COVID, which is still an area of ongoing research. Genesis Foundation (www.genesis-foundation.net) is a Foundation working for children with Congenital Heart Defects. As a Children Heart Foundation, some of the children supported by the Foundation were infected with COVID before undergoing treatment for Congenital Heart Defects. But surgery was postponed until their Covid results turned negative, and currently they all are doing well.


References: 

M. R. Mehra, S. S. Desai, S. Kuy, T. D. Henry, and A. M. Patel, “Cardiovascular disease, drug therapy, and mortality in COVID-19,” New England Journal of Medicine.
Location: India

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