Q: - What is a pediatric cardiologist? What is a difference between pediatric & adult cardiologist?
A: - A pediatric cardiologist is a physician who has received extensive training in diagnosis and treating children’s cardiac problem. Evaluation and treatment may begin with the fetus since heart problem can now be detected before the birth. He/she is also trained to look after adults who were born with heart problems. When a pediatrician suspects a heart problem, he or she may ask a pediatric cardiologist to investigate further. Common causes for a referral to the pediatric cardiologist includes heart murmurs, chest pain, dizzy spells or palpitation. Initial evaluation may result in-patient and his/her parents being reassured that there is nothing to worry about. A pediatric cardiologist is trained to perform and interpret procedures such as echocardiograms and exercise test. In case of more significant heart disease, a pediatric cardiologist may perform a cardiac catheterization in order to diagnose or treat child’s heart problem. If the child needs to be hospitalized, the pediatric cardiologist & pediatric cardiac surgeon work together in planning cardiac surgery, when needs. However, in all cases the pediatric cardiologist is there every step of the way.
Q: - When will I receive results?
A:- On most occasions you will get results from the physician immediately.
Q: - How long the visit takes?
A:- Typically new patients visit last approximately 40-60 minutes.
Q: - Do I need prior appointments?
A:- It is always advisable to take prior appointment to save your waiting time. However in case of other emergency or operation being performed, you may have to wait longer.
Q: - Are all heart problems in children congenital?
A:- No, but most are. There are generally three categories of possible childhood heart problems: structural defects, acquired damage and heart rhythm disturbances. These defects are usually - but not always - diagnosed early in life. Rarely, childhood heart problems are not congenital, but heart damage may occur during childhood due to infection. This type of heart disease is called acquired; examples include Kawasaki disease and rheumatic fever. Children also can be born with or develop heart rate problems such as slow, fast, or irregular heartbeats, known as "arrhythmias".
Q: - Who is at risk to have a child with a congenital heart defect?
A:- Anyone can have a child with a congenital heart defect. Out of 1,000 births, nine babies will have some form of congenital heart disorder, most of which are mild. If you or other family members have already had a baby with a heart defect, your risk of having a baby with heart disease may be higher.
Q: - What causes congenital heart defects?
A:- Most of the time we do not know. Although the reason defects occur is presumed to be genetic, only a few genes have been discovered that have been linked to the presence of heart defects. Rarely the ingestion of some drugs and the occurrence of some infections during pregnancy can cause defects.
Q: - How well can people with congenital heart defects function?
A:- Virtually all children with simple defects survive into adulthood. Although exercise capacity may be limited, most people lead normal or nearly normal lives. For more complex lesions, limitations are common. Some children with congenital heart disease have developmental delay or other learning difficulties.
Q: - What is the social/financial impact of congenital heart defects?
A:- Successful treatment requires highly specialized care. Severe congenital heart disease requires extensive financial resources both in and out of the hospital. Children with developmental delay also require community and school-based resources to achieve optimum functioning.
Q: - What is the impact of congenital heart disease on families?
A:- The presence of a serious congenital heart defect often results in an enormous emotional and financial strain on young families at a very vulnerable time. Patient/family education is an important part of successful coping.
Q: - What treatment is available?
A:- Treatment depends on the type and severity of the condition. Some children won't require any treatment, while others may need medication or heart surgery. There are also other new techniques and procedures that, in some cases, can be done instead of surgery.
Fetal Cardiology: Ultrasound scanning of pregnant women with suspicion of, or known congenital heart disease in the unborn child
Q: - Is fetal echo necessary in every pregnancy?
1. Why do it?
2. When to do it?
A: - 1. About 8-10 per 1000 live births are complicated by heart disease in the babies. 50% of still births are caused by heart disease in babies. 50000 babies die every year in our country before their first birthday due to their untreated heart disease. Many of heart disease are completely curable and parents get the time to prepare for the problems
2. Tran abdominal or external fetal echo can be done any time, ideally between 16-18 weeks of pregnancy
Q: - Who should undergo fetal echo?
A: - 1. Elderly mothers >35 years. 2. Having previous child with heart disease. 3. Mothers getting viral fever, rash, joint pain in the first 3 months of pregnancy. 4. Routine ultrasound showing other malfunctions of fetus. 5. Routine ultrasound showing very high very slow heart rates in fetus. 6. Unexplained repeated abortions 7. Unexplained early child deaths 8. Family having history of heart disease.
Q: - Where and which doctors perform fetal echo?
A: - Usually pediatric cardiologists or fetal medicine specialist. A pediatric cardiologists not only does the echo but also explains you about the type of heart problems, the treatment for it, & treats the child after delivery.
Q: - Are there any side effects of fetal echo?
A: - no, it is painless without any no side effects on baby and mother.
Q: - Benefits of fetal echo?
A: - 1. It allows parents to understand the heart problems in unborn baby and prepares them psychologically at the time of delivery. 2. In extremely complicated cases termination of pregnancy is advised.
Dr Abhay Bhoyar is a Consultant Paediatric Interventional and Fetal Cardiologist. He belongs to Amravati in Vidarbha. After completing his MBBS and MD(paediatrics) from KEM Hospital and LTMMC, Mumbai University, he went to UK in 2000 to pursue higher studies. There he competed MRCPCH and then underwent 5 years of systematic training in paediatric cardiology which resulted in a certificate of completion of specialist training in paediatric cardiology (CCT). He has gained experience in paediatric cardiology at esteemed Birmingham children’s hospital, Birmingham and Glenfield hospital, Leicester, UK. In asia he spent one month in national heart institute(IJN), Malaysia and 2 weeks at Cochin.
His clinical expertise is the care of infants, children and teenagers with all forms of heart disease as well as in the unborn child.
Although serving population of nearly 15 million, the pediatric cardiology services in central India are largely far behind the rest of India, let alone the international standards. Parents are running from pillar to post to get the best care for their loved ones.
101, Niti Gaurav Complex, Wing - A, Near Center Point Hotel, Ramdaspeth., Nagpur, Maharashtra 440010, India