By Dr. Pradeep Suryawanshi
Did you know that every year, 2.4 lakh newborns succumb to congenital disorders globally within the first 28 days of birth? Among them, one of the most common are heart defects. Congenital heart disease (CHD) involves structural abnormalities of the heart which occur during foetal development, usually within the first eight weeks of pregnancy. In 2019, 3.12 million babies were born with CHD.
These defects can involve the walls, valves, arteries, or veins of the heart and may disrupt normal blood flow through the heart and to the rest of the body. CHD varies widely in its severity, from minor defects that may not cause symptoms to complex abnormalities that require surgical intervention shortly after birth. While the exact causes of CHD are often unknown, they can result from genetic or environmental factors or both. Some known risk factors for CHD include maternal diabetes, maternal use of certain medications, maternal smoking, and genetic.
CHD and respiratory infections
CHD can compromise respiratory function through various mechanisms, primarily due to the impact these defects have on heart and lung function. They can cause reduced levels of oxygen in the blood, leading to inadequate supply to tissues such as the lungs, impacting their normal function.
On the other hand, certain types of CHD, such as left-to-right shunts, can cause an increase in blood flow to the lungs. This increased blood volume can lead to pulmonary congestion and fluid accumulation within them, impairing gas exchange and predisposing patients to respiratory infections. Moreover, long-term hypoxemia and compromised circulation can also weaken the immune system, increasing the risk of respiratory infections. Additionally, recurrent respiratory infections can exacerbate existing cardiac and pulmonary issues, creating a vicious cycle.
Among these, infection with respiratory syncytial virus (RSV) stands out as a significant health concern, particularly for young children, due to its pervasive prevalence and the severity of its impact. RSV infection can present with a range of symptoms, varying from mild to severe. Common symptoms in infants and young children include:
- Persistent or severe coughing
- Wheezing
- Breathing difficulties
- Nasal congestion or stuffiness
- Fever
- Sneezing
- Decreased appetite
- Irritability and lethargy
It’s important to note that symptoms of RSV infection can resemble those of other respiratory infections, such as the common cold or influenza. In severe cases, RSV infection can progress to lower respiratory tract infections like bronchiolitis or pneumonia, leading to more severe symptoms and potentially life-threatening complications.
RSV is the most common cause of hospitalization and the second leading cause of mortality in infants under one year of age. Compared to those without CHD, severe RSV infections in infants with CHD are more likely to cause hospitalizations and greater utilization of ICU care and mechanical ventilation. The mortality rate associated with the infection is also elevated among these infants.
Ongoing research and development efforts are focused on advancing the understanding of RSV and developing effective preventive and therapeutic strategies. Researchers are exploring antiviral drugs that target RSV replication to reduce viral load and mitigate disease severity. Recently, vaccination against RSV has also been approved and recommended for infants, children, pregnant women, and adults over the age of 60. However, there is a growing need for rapid and accurate diagnostic tests for RSV to facilitate early detection and appropriate management.
Additionally, by promoting good hygiene practices, avoiding contact with patients, and seeking timely medical attention when symptoms arise, individuals can play a proactive role in preventing the spread of RSV and protecting themselves and others from respiratory infections. These simple yet effective measures are key components of comprehensive infection prevention strategies and are essential for maintaining public health and well-being. By understanding the link between CHD and RSV and staying informed about the latest advances, we can protect our children and mitigate the potential risks associated with this virus.
(The author is a Professor & Head, Department of Neonatalogy, BVU Medical college, Pune. Views expressed are personal and do not reflect the official position or policy of the FinancialExpress.com.)
