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Mother’s nutrition and the baby’s exposure to infection after birth may determine heart ailments

Mother’s nutrition and the baby’s exposure to infection after birth may determine heart ailments

Fetal programming hypothesis by Dr. Barker, which proposed that the environment of the foetus and neonate  – determined by the mother’s nutrition and the baby’s exposure to infection after birth – is responsible for the pathologies in later life. He also suggested that our heart can be compared to the fuel pump and arteries as fuel pipes. The two lungs are the carburetors and the various functioning parts of the body are the engine. In order to keeps this engine running, oxygenated blood needs to be circulated to the various body parts. This is the primary role of the heart.

 

The supply of the heart and its muscles is maintained through two coronary arteries – Right Coronary Artery (RCA) and Left Coronary Artery. The Left Coronary Artery further divides into two branches – Left Anterior Descending Artery (LAD) and Left Circumflex Artery (LCx).  Narrowing of the arteries is comparable to  clogging of the fuel pipes in motor car,  which leads to an imbalance between supply and demand of blood to the heart, thereby causing starvation of the heart which leads to heart attack. The first manifestation of heart attack is pain in the centre of the front of the chest and/or a constricted feeling in the throat. This pain may be accompanied with shortness of breath and sweating. The pain may move towards the shoulder, the upper part of the abdomen or the arms. This is known as Angina.   The pain may subside on its own after few minutes of rest or can persist longer, for 30 minutes or so. Under such circumstances it may lead to permanent damage to the heart. This is called Myocardial Infarction (Heart Attack).

CONGENITAL HEART DEFECTS (HOLES IN HEART)

Congenital heart defects (CHDs) are problems with the heart’s structure that are present at birth.

Common examples include holes in the inside walls of the heart and narrowed or leaky valves. In more severe forms of CHDs, blood vessels or heart chambers may be missing, poorly formed, and/or in the wrong place. CHDs are the most common birth defects. CHDs occur in almost 1% of births.

 

What is the health impact of congenital heart defects?

 

  • CHDs are the most common cause of infant death due to birth defects.

 

  • Approximately 25% of children born with a CHD will need heart surgery or other interventions to survive.

 

  • Over 85% of babies born with a CHD now live to at least age 18. However, children born with more severe forms of CHDs are less likely to reach adulthood.

 

  • Surgery is often not a cure for CHDs. Many individuals with CHDs require additional operation(s) and/or medications as adults.

 

  • People with CHDs face a life-long risk of health problems such as issues with growth and eating, developmental delays, difficulty with exercise, heart rhythm problems, heart failure, sudden cardiac arrest or stroke.

  • People with CHDs are now living long enough to develop illnesses like the rest of the adult population, such as high blood pressure, obesity and acquired heart disease.

 

  • CHDs are now the most common heart problem in pregnant women.

 

  • Most CHDs are thought to be caused by a combination of genes and other risk factors, such as environmental exposures and maternal conditions. Because the heart is formed early in pregnancy, the damage may occur before most women know they are pregnant.

 

  • Environmental exposures that may be related to risk of having a CHD include the mother’s diet and certain chemicals and medications. Maternal diabetes is a recognized cause of CHDs. Maternal obesity, smoking, and some infections also may raise the risk of having a baby with a CHD. Preventing these risk factors before a pregnancy is crucial.

 

  • A baby’s risk of having a CHD is increased by 3 times if the mother, father, or sibling has a CHD

 

Some congenital heart defects can be found before birth. Knowing if a baby has a heart defect before birth can help families plan for the future. Some heart defects can be found at birth, because they can cause a baby to have bluish tinted nails or lips or troubled breathing. Also, some heart defects potentially can be detected in babies soon after birth using pulse oximetry screening, which is a test to determine the amount of oxygen in the blood and pulse rate. Certain hospitals screen all babies soon after birth using pulse oximetry screening. However, pulse oximetry screening is not required in most states. Other heart defects might have no signs at birth and are not found until later in life, during childhood or even adulthood. If a health care provider (a doctor or nurse) thinks a congenital heart defect is present, the baby can have several tests to diagnose the defect. As medical care and treatments have advanced, infants with heart defects are living longer and healthier lives. Many now are living into adulthood. About one million adults in the United States are living with a congenital heart defect. It is important for children and adults living with a congenital heart defect to see a heart doctor regularly throughout their lives.

The cause of most congenital heart defects is unknown. Some babies have heart defects because of changes in their genes or chromosomes. They also might be caused by a mix of genes and other risk factors. The Centers for Disease Control and Prevention’s National Birth Defects Prevention Study has found that women who are obese, have diabetes, or smoke during pregnancy increase their chances of having a baby born with a heart defect. A woman can take some important steps before and during pregnancy to help prevent congenital heart defects. She can work to get to and stay at a healthy weight, control diagnosed diabetes, quit smoking, and take folic acid daily. These actions can reduce the risk of having a baby with a congenital heart defect.

 

Signs and Symptoms of Heart Defects

 

Parents should be alert to the following symptoms in infancy:

·         Tires easily during feeding (i.e. falls asleep before feeding finishes

·         Sweating around the head, especially during feeding

·         Fast breathing when at rest or sleeping

·         Pale or bluish skin colour

·         Poor weight gain

·         Sleeps a lot – not playful or curious for any length of time

·         Puffy face, hands, and/or feet

·         Often irritable, difficult to console

 

Some children with CHDs may not have any symptoms until later in childhood. Things to look for include:

·         Gets out of breath during play

·         Difficulty “keeping up” with playmates

·         Tires easily/sleeps a lot

·         Change in colour during active play or sports (looks pale or has a bluish tint around mouth and nose)

·         Frequent colds and respiratory illnesses

·         Slow growth and weight gain/poor appetite

·         Complains of chest pain and/or heart poundin

 

 

Diagnosis

Some congenital heart defects may be diagnosed during pregnancy using a special type of ultrasound called a foetal echocardiogram, which creates pictures of the heart of the fetus. However, some congenital heart defects are not detected until later in life, during childhood or adulthood. Usually, though, congenital heart defects are diagnosed at birth or shortly afterward. If a health care provider suspects a congenital heart defect is present, the baby can get several tests (such as blood tests, an X-ray, and an echocardiogram) to confirm the diagnosis.

Treatment

Treatment for congenital heart defects depends on the type and severity of the defect present. Some might get better by themselves; however, others might need one or more surgeries to repair the heart or blood vessels. Some also can be treated without surgery with a procedure called cardiac catheterization. A long tube, called a catheter, is threaded through the blood vessels into the heart where a doctor can take measurements, do tests, or repair the problem.

 

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