Expanded Hearts in Infants: Origin, Identification, and Management Strategies

In the world of paediatric health, regular check-ups are of utmost importance for children with Autism Spectrum Disorder (ASD), as they also serve to monitor normal growth and development. However, this article focuses on a different aspect of child health - congenital heart defects, specifically Atrial Septal Defect (ASD) and Ventricular Septal Defect (VSD).

An Atrial Septal Defect (ASD) is a hole or an opening in the septum that separates the left and right atrium in infants. On the other hand, a Ventricular Septal Defect (VSD) is a hole or opening in the septum that separates the left ventricle from the right ventricle. Both defects disrupt normal blood flow and increase the heart's workload.

Common causes of these congenital heart defects include genetic factors, prenatal influences such as family history, maternal infections like rubella, maternal age over 35, maternal alcohol or cigarette use during pregnancy, prematurity, and high maternal blood glucose levels.

For babies diagnosed with a small VSD and showing no symptoms, regular check-ups with a cardiologist are recommended. However, if a VSD does not heal naturally by the age of one, heart surgery may be recommended.

Babies with VSD may show signs such as a heart murmur, fast breathing, signs of exhaustion while feeding, sweating or crying while being fed, and slow weight gain. Proper oral hygiene is important for a baby with VSD, as bacteria from the mouth may enter the bloodstream and cause an infection in the inner linings of the heart.

ASD is a hole in the wall between the heart's two upper chambers (atria), while VSD is a hole in the septum between the two lower chambers (ventricles). Small ASDs may not require treatment and can close on their own. Larger or persistent ASDs usually require closure to prevent complications like heart rhythm problems or heart failure.

The treatment for ASD can be done by cardiac catheterization (transcatheter closure), a minimally invasive procedure where a device is inserted through a blood vessel to seal the hole, or open-heart surgery, depending on the size, location, or specific patient factors such as associated syndromes. Follow-up care is important post-treatment to monitor for complications.

Treatment for VSD depends on defect size and symptoms. Small VSDs may close spontaneously without intervention. Larger VSDs or those causing symptoms (such as breathlessness, poor growth) generally require surgical repair to prevent heart failure or lung damage. Surgery involves patching the hole in the ventricular septum. Medical management with medications may be used to manage symptoms like heart failure until surgery.

Early diagnosis and appropriate management can significantly improve outcomes and reduce risks of complications such as arrhythmia and heart failure. A paediatric cardiologist may conduct a chest X-ray, electrocardiogram, echocardiogram, and in some cases, cardiac catheterization to diagnose ASD. Diagnosis of a ventricular septal defect may involve a consultation with a pediatric cardiologist, a chest X-ray, electrocardiogram, echocardiogram, and in some cases, cardiac catheterization.

In conclusion, congenital heart defects like ASD and VSD arise from complex prenatal and genetic factors. Treatment ranges from observation to minimally invasive device closure or open-heart surgery based on defect size and patient condition. With early diagnosis and appropriate management, the risks of complications can be minimised, and the quality of life for affected children can be significantly improved.