Half of Babies Who Need Corrective Heart Disease Go Unattended | F5 News

Half of newborns who would need surgery to correct congenital heart disease are left without care in Brazil, according to data from the São Paulo State Cardiology Society (Socesp). The entity, however, estimates that the percentage may have increased to 70% during the covid-19 pandemic.

According to the World Health Organization (WHO), approximately 130 million children worldwide suffer from congenital heart disease.

According to the Ministry of Health, in Brazil there are ten cases out of a thousand live births, or one child out of 100 births has a cardiovascular malformation. according to place of the Fundação Oswaldo Cruz (Fiocruz), is equivalent to approximately 30,000 children with congenital heart disease per year, of which 6% die before completing 1 year. After birth, severe forms of the disease can be responsible for 30% of deaths in the neonatal period. Last Sunday (12), Congenital Heart Disease Day was celebrated.

The medical director of the non-governmental organization (NGO) Pro Criança Cardíaco, Isabela Rangel, explained that congenital heart diseases are malformations or abnormalities in the structure or cardiorespiratory function of the heart. “It happens during fetal life. [da criança].”

Isabela said there is no definite cause for congenital heart disease, which occurs due to the interaction of genetic and environmental factors. “Genetics, we speak when these are patients with other syndromes, which may be associated with heart defects. Environmental, when the mothers used some type of drug or medicine, had diseases such as lupus, diabetes or certain viruses that the pregnant woman contracted and can cause intracardiac malformation”. The doctor emphasizes that it is also necessary to be aware of the history of heart disease in previous pregnancies and genetic inheritance.

Genetic syndromes are also factors associated with intracardiac malformations, such as Down syndrome, in which a percentage of patients may have AVSD, among other heart conditions. Advanced maternal age is also considered a risk factor for congenital heart disease.

Prevention

Isabela Rangel stressed that there is no prevention, but said that every woman who wants to get pregnant must know her state of health, so that her doctor can monitor and advise on medicines and drugs that should not be be used during pregnancy. The woman should maintain a healthy diet and habits, avoiding alcoholic beverages and smoking, which can lead to changes in the development of the fetus.

It is also important to check the vaccination schedule and see if any vaccinations are needed before getting pregnant.

Isabela stressed the importance of healthy eating habits, citing recent studies that found fortifying certain foods with folic acid was associated with reductions in the rate of congenital heart disease.

Diagnostic

The diagnosis of congenital heart disease is made while the child is still in the womb. Isabela said that the NGO she leads strives to raise awareness among all professionals who care for pregnant women of the importance of doing the morphological examination and the fetal echocardiogram (ecofoetal), capable of detecting heart disease congenital.

Fetal echocardiography is a method capable of identifying structural lesions before birth and, in general, should be performed between the 24th and 28th week of gestation. “And if you have a heart condition that requires intervention in the first days of life, that’s critical for the baby’s prognosis. All the more so when we know that this pregnant woman has a fetus with heart disease and, since it is a critical and complex heart disease, we ensure that she gives birth in a health unit that has an intensive care unit. [unidade de terapia intensiva]in which the child has an echo after birth, where there are resources, so that the baby is treated with all the attention.

Not all babies with congenital heart disease need surgery at birth. It depends on the intracardiac pathology. Interventions will vary depending on the pathology and severity. Isabela pointed out that some babies will not be operated on until much later, while others with more serious heart conditions must undergo the procedure in the middle of the neonatal period.

Some heart diseases can be treated with hemodynamics. Instead of having open chest surgery, the child can have a less invasive procedure called therapeutic cardiac catheterization. “This is an example. Some heart diseases can be treated by therapeutic catheterization. It is invasive, but much less than cardiac surgery. Early diagnosis is essential, especially in the most serious heart diseases, reinforced Isabela.

The doctor pointed out that one of the obstacles that delays the diagnosis is the lack of information from families about the existence of heart disease in children. “The pediatric follow-up of babies is essential because, during the routine consultation, any alteration suggestive of heart disease can be identified; thus, the pediatrician directs them towards the specialized center.

To concentrate

The objective of the Pro Criança Cardíaco project is to take care of needy children and adolescents suffering from heart disease. The project receives children on an outpatient basis and, depending on whether it is a surgical case, they can be referred to the Pro Criança Jutta Batista pediatric hospital, a partner of the NGO. The same applies when there is a diagnosis of therapeutic catheterization. “Any invasive procedure is performed at the hospital level.”

Pro Criança Cardíaco accompanies children from infancy to adulthood, 18 years old, and offers a multidisciplinary care team, which includes medications, cardiologists, nutritionists, social workers, psychologists and dentists, ” because the patients cannot have an infectious focus in the mouth”.

The Pró Criança Cardíaco project is not a hospital; is a non-profit medical institution, founded in 1996 by cardiologist Rosa Celia, which provides free care to children and adolescents with congenital heart disease. In 25 years of existence, it has accompanied 15,100 children and adolescents with heart disease, carried out more than 33,000 cardiology consultations and performed 1,659,000 invasive procedures, cardiac surgeries and catheterizations at the partner hospital.

At its headquarters in Rio de Janeiro, the NGO assists around 160 children per month in the clinic, who undergo a clinical evaluation, an electrocardiogram, an echocardiogram and a holter monitor 24 hours a day. Other outpatient examinations, such as hematological evaluation and tomography, and invasive procedures, including cardiac surgeries and catheterizations, are performed at the Pro Criança Jutta Batista Pediatric Hospital.

After leaving the hospital, an outpatient return is planned for the child to continue his treatment. Throughout the process, the team that accompanies the patient is the same and offers all the support.

To register for the first service, the person must call the number (21) 3239-4500, Monday to Friday, from 8 a.m. to 6 p.m. Pro Criança Cardíaco currently has 16 first aid vacancies. Vacancies are filled based on availability or urgency previously assessed by the medical team.

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