Little heart feats
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By MEGAN MIERS World Staff Writer
2/28/2002
Correction
This story on congenital heart defects confused the nature of some diagnostic
heart tests. An echocardiogram is a test that bounces sound waves off the heart
to produce a picture. An electrocardiograph, or EKG, is a test that measures
the heart's electrical activity. Both tests are used in the diagnosis of
congenital heart defects.
Ashley Cornett shares a moment with Daxon, her 2-year-old
son who was born with a heart defect that is expected to heal.
Below: Daxon Cornett, one of an estimated 35,000 children born each year with a
congenital heart defect, loves to run around, play ball and try out the rides
at his favorite restaurant.
Photos by JAMES GIBBARD /
Prognosis of congenital
defects encourages parents
Like many other toddlers his age, Daxon
Cornett is active, rambunctious and into everything.
The sandy-haired 2-year-old with a cute, dimpled grin loves to run around, play
ball and try out the rides at his favorite restaurant, Chuck E Cheese's.
By
all outward appearances, the son Ashley Cornett describes as "100 percent
little boy" is a normal, healthy toddler. But shortly after Daxon was
born, Cornett received the kind of news no parent wants to hear: their child
has a serious medical problem.
When Daxon was 3 months old, Cornett and her husband, Dustin, noticed something
unusual in their son's breathing pattern -- his stomach was retracting as he
breathed. After consulting with their family pediatrician, the couple took
Daxon to a pediatric cardiologist for further examination.
An X-ray and echocardiogram (EKG) revealed a hole in Daxon's pulmonary artery,
a condition that he was born with.
Daxon is one of an estimated 35,000 children born each year with a congenital
(present at birth) heart defect. Approximately eight babies out of every 1,000
born will have some form of congenital heart disorder, according to the
American Heart Association.
Finding out that her son had a problem with his heart was frightening, Cornett
said.
"If you're a parent, you want your child to be perfect," she said.
"When you hear that something's wrong with the heart, you automatically
think they're not going to make it."
In most cases, there are no known causes for congenital heart defects, which
are usually diagnosed when a child is a newborn or infant.
"Usually, the child will have (symptoms) that tip off the
pediatrician," said Dr. William Jackson, a pediatric cardiologist with
Pediatric Cardiology of Tulsa.
A heart murmur (an extra sound made by the heart) is often a clue that
something is amiss. Though many murmurs are harmless, they are more likely to
be indicative of a problem if the child is a newborn or infant,
Other symptoms such as rapid breathing, low blood pressure, shock and cyanosis
(bluing of the skin due to low levels of oxygen in the blood) can also indicate
problems with the heart.
Tests used to diagnose congenital heart defects include EKGs, X-rays and
catheterization, which provide a variety of ways for the physician to view the
patient's heart.
The EKG bounces sound waves off the heart to produce exact pictures of the
moving muscle, thus enabling the physician to see how blood is flowing through
the heart. It is an especially useful diagnostic tool because it can sometimes
eliminate the need for more invasive procedures, said Dr. Richard Ranne, a
pediatric heart surgeon in
"The EKG has had a tremendous impact for diagnosing kids with heart
disease," he said, adding that the hourlong procedure is painless and is
usually not a problem for kids.
"Catheterization can possibly be eliminated if the EKG gives good
pictures."
The most frequently occurring forms of congenital heart disorder are septal
defects, commonly known as holes in the heart, according to
Ventricular septal defect (VSD) is the term used to describe a hole located
between the two lower chambers (ventricles) of the heart. Atrial septal defect
(ASD) is the term for holes located between the heart's two upper chambers
(atria).
If severe, the holes can cause problems with blood flow and make the heart work
harder than it should. Damage to the heart muscle and lungs can result from the
poor circulation.
Depending on the size and location of the hole, medical treatment may or may
not be necessary. About two-thirds of the holes will eventually close up
without any intervention, according to Ranne. Monitoring the child's health for
any changes and maintaining a regular medical follow-up schedule may be all
that's needed in milder cases.
For the remaining one-third of cases, surgical correction is required, Ranne
said. Again, the location and size of the holes are a determining factor in
when and what kind of treatment is performed.
Earlier treatment when the child is still an infant is necessary in some cases,
such as in severe forms of VSD. In other cases, treatment can be postponed
until the child is several years old. Most procedures are usually done before
the child reaches school age.
"Closure of the hole in the right time should allow the child to have a
normal life expectancy," Ranne said.
"If it isn't done in time, permanent damage to the lungs and heart muscle
can occur, and that shortens the child's lifespan."
Surgeons can close holes by sewing them or or patching them. The average
hospital stay after surgery is about four days, according to Ranne. Thanks to
medical advancements in pain management, anesthesia, and blood and fluid
management, recovery for most little patients will be brief.
Once the hole has been closed, the child will more than likely be cured for
life, Ranne said. In general, children with congenital heart defects can live a
normal life without any major problems. Most are encouraged to participate in
regular physical activity to keep their hearts healthy and strong.
"Maintaining that sense of normalcy was really important to us," said
Cornett, adding that surgery is unlikely in Daxon's condition, which is expected
to heal on its own.
"We're an athletic family and we want Daxon to be able to play sports like
everyone else does."
One exception to that sense of normalcy is that congenital heart patients must
maintain a lifelong awareness about bacterial infections. Before undergoing any
dental or surgical procedures -- even a regular tooth-cleaning -- they must
take antibitiotics to ward off illness-causing bacteria.
"The biggest risk in congenital heart patients is for the development of
endocarditis (bacterial infection-caused inflammation of the heart's inner
lining),"
In patients with congenital defects, rough spots inside the heart can be havens
for bacteria. If infection does occur, the child may be required to spend
several weeks in the hospital and receive heavy doses of intravenous
antibiotics to kill the infection.
Other than that, parents of congenital heart patients should have few concerns.
Cornett says talking with others about your child's health can help allay any
fears.
"Being able to talk with other parents was a big help," she said.
"Just having someone to relate to made it easier to go through something
like this."