Paediatric Cardiology In Malaysia: Restoring Hope, Saving Young Lives
KUALA LUMPUR, April 21 (Bernama) -- The birth of a child is one of life’s purest joys. However, that joy can turn to fear when a heart defect is discovered.
In Malaysia today, the rapid advancements in paediatric cardiology can bring a ray of hope to parents facing a diagnosis of congenital heart disease (CHD), which according to Sunway Medical Centre (SMC) Consultant Paediatrician & Paediatric Cardiologist Dr Lim Wooi Kok, affects about 1 in 100 babies in the country.
“With today’s imaging and interventional techniques, many children can now live to see adulthood compared to decades ago,” he said in a statement today.
He explained that heart problems in children fall into two categories, congenital, meaning present at birth, and acquired, problems which develop after birth.
Congential heart disease includes congenital acyanotic or “pink” heart defects, cyanotic defects known as “blue baby” conditions that are often detected soon after birth, especially where newborn pulse-oximetry screening is done correctly, when baby’s oxygen levels are lower than 95 per cent, Dr Lim said.
A cardiac ultrasound (echocardiography) is performed to confirm the diagnosis, while for cyanotic defects such as Tetralogy of Fallot, Transposition of the Great Arteries, and Pulmonary Atresia, they are more serious and require early attention when the baby’s lips and extremities turn blue, he added.
Acquired heart disease include Kawasaki disease, rheumatic valve disease, or arrhythmias, which are usually present with prolonged fever, chest pain or fainting spells, he said.
“Heart murmurs are usually heard during examination, and echocardiogram is usually needed to confirm the diagnosis,” he shared.
Dr Lim, a cardiologist with extensive expertise in cardiac multimodality imaging, uses advanced tools like echocardiography, CT and MRI to visualise the heart in 2D, 3D, and even cardiac-strain images crucial for assessing how well each heart muscle segment contracts, especially in newborns, infants, children, teenagers and even adults with congenital heart disease (ACHD).
“Not all cardiologists are trained to do cross sectional imaging to reconstruct or read these complex images, but having this skill allows us to understand a child’s heart with far greater precision.
“Being able to visualise a child’s heart in 3D helps us plan a safer, more personalised treatment. These developments may assist clinicians in visualising small structures more clearly, which can support safe and accurate treatment planning for children with heart conditions,” Dr Lim said.
He explains that with the latest addition of advanced computed tomography (CT) imaging technologies, the photo-counting CT is designed to provide detailed 3D images of the heart while considering radiation exposure, which is particularly important in paediatric imaging.
Congenital heart conditions such as Atrial Septal Defect (ASD), Patent Ductus Arteriosus (PDA), and Ventricular Septal Defect (VSD) can now be treated through percutaneous interventions, a minimally invasive procedure done via a small catheter in the groin.
The process takes only a few hours, and the child can usually go home within a couple of days compared to weeks of recovery from open-heart surgery, and is advised to maintain good oral hygiene and following endocarditis-prevention advice is vital for long-term heart protection.
Caring for a child with CHD requires patience and resilience. Children with CHD often face feeding difficulties, slower growth, or recurrent hospital visits, Dr Lim said, adding that parents must monitor medications, attend follow-ups, and manage works and finances.
He pointed out that most cases of CHD are purely genetic or occur by chance and CHD risk rises slightly to two to three per cent if a parent of sibling is affected.
. “We always remind families they are not alone. With proper care, most children go on to lead full, active lives. . I still see some of my patients 20 years later, now adults, some even married,” he said.
With today’s technology and expertise, many heart defects can be effectively treated with early diagnosis and proper care, he assured, and stressed that regular screenings and vaccinations can protect children from infections.
“Malaysia’s healthcare system has made impressive strides in paediatric cardiology including advanced foetal echocardiography which allows heart defects to be detected even before birth. This gives parents time to prepare and doctors time to plan for safe delivery and immediate intervention if needed.
“Expectant mothers can now have their baby’s heart examined in the womb as early as 18 to 22 weeks and proper care can be given together with the obstetrician if a detect is found. This can make the difference between life and death,” he said.
Dr Lim is optimistic about the future of paediatric cardiology in Malaysia as there more specialists trained in advanced imaging and interventions, each such step brings even more hope to children facing CHD.
-- BERNAMA
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