Paediatric Cardiology Services

Cardiomyopathy, an acquired chronic congenital heart disease, is the leading cause of death in children under eighteen years of age and occurs when there's a strain on the myocardium. The heart muscle becomes enlarged and thickens, and as a result, the heart fails to pump rhythmically resulting in the lack of blood supply to the body and severe cases leads to sudden death or heart failure.

Viral myocarditis weakens the heart leading to irregular heartbeat and cardiac arrest. Inflammation begins when immune cells responsible for fighting infections penetrate heart tissue producing chemicals that damage the heart muscle cells. The heart muscle swells and all four affected chambers of the heart become enlarged, leading to cell death and scar formation hindering the heart's ability to pump blood. Primary organs and tissues in the body don’t receive oxygen and nutrients and fail to expel fluid, causing congestive cardiac failure. If left untreated, it could develop into kidney and liver failure. Dr Jiyana extensively evaluates cardiac problems when symptoms of chest pain, fainting and excessive fatigue after physical activity occurs.

What is an Atrial Septal Defect (ASD)?

An atrial septal defect is a heart defect characterised by a hole separating the heart’s first two upper chambers. This hole results in increased volume of blood getting into the right atrium, right ventricle and subsequently the lungs than they would usually handle. In the long run, this can result in irreversible high pressure in the child’s lung.

How is an atrial septal defect treated?

Dr Jiyana will either refer to a chest and heart surgeon for open-heart surgery or cardiac catheterisation to close a large hole depending on the severity of the defect. Open surgery becomes the only option for treating atrial septal defect when the fault is irregularly situated in the heart, or there are additional heart defects present.

Dr Jiyana performs cardiac catheterisation by inserting a catheter into an artery or vein in the neck, arm or groin and threads it through the heart’s blood vessels. Cardiac catheterisation is used in combination with angioplasty and balloon valvuloplasty to diagnose and treat heart disease. The paediatric cardiologist may place coils through the catheter to clog unnecessary blood vessels and holes in the wall between chambers.

What is hypoplastic left heart syndrome (HLHS)?

Hypoplastic left heart syndrome is a congenital heart disease that occurs from the malformation of the left side of the heart that includes the aorta, mitral and aortic valve, as well as the left ventricle. As a result of congenital malformation, the left side of the heart can't regularly pump blood to the rest of the body and instead, the right ventricle pumps blood into the pulmonary artery whereby blood travels through the ductus arteriosus to reach the aorta.

How is hypoplastic left heart syndrome treated?

Hypoplastic left heart syndrome is treated in stages. The Norwood technique enables the right ventricle to pump blood to the lungs and the rest of the body without the need of the open ductus. A Sano shunt or Blalock-Taussig assists by redirecting blood to the lungs. A Hemi-Fontan or bidirectional Glenn is a secondary procedure after the Norwood operation followed by a lateral tunnel Fontan between eighteen months and three years after birth.

Children with congenital heart defects, need to take antibiotics for tooth extractions and operations that involve intestinal organs, the nose and mouth, as well as urogenital systems. Taking antibiotics prevents bacteria from entering the bloodstream, causing infective endocarditis in the defect of the heart. The best way to prevent infection inside the heart in these kiddies is to ensure they brush their teeth regularly.

Lastly, your precious one may be referred to see Dr Jiyana, by their GP or paediatrician because of a heart murmur.

What is a Heart Murmur?

A heart murmur is a unique, irregular sound that the doctor may hear with their stethoscope. This sound may be purely typical, otherwise known as an innocent murmur. It may, however, indicate a congenital heart problem. A murmur if loud enough may be felt by the doctor, what is known as a thrill. The paediatric cardiologist is equipped to deal with this.