A 2-month-old boy who was slow to gain weight, had rapid breathing, wheezing, and excessive sweating was diagnosed with congenital heart disease after a respiratory examination.
Ms. Chanh Soc Thia (of Khmer ethnicity, residing in An Giang province) said that more than a month after birth, her baby, Chanh San Vi Sal, did not gain weight, often breathed rapidly, had prolonged wheezing, sweated excessively from the head, and fed slowly. She took the baby for a respiratory examination, where the doctor informed her that the baby had congenital heart disease. The young mother found it hard to believe because the baby was born healthy, weighing 3.4 kg, and there was no family history of this condition.
After five years of longing for a child, Thia's joy was short-lived when she discovered her child was ill. She and her husband temporarily put their work aside to take their child to Ho Chi Minh City for treatment. Each time they went for a check-up, the whole family would travel by motorbike, leaving at 3 am and arriving in Ho Chi Minh City by 9-10 am to ensure they could be examined and return the same day. But after more than two months of traveling back and forth, the child still hadn't had surgery.
Seeing that her baby was feeding poorly and losing weight significantly, Ms. Thia took her child to Tam Anh General Hospital in Ho Chi Minh City for examination. There, Dr. Pham Thuc Minh Thuy, a specialist in Congenital Heart Disease at the Cardiovascular Center, stated that baby Vi Sal presented with symptoms of rapid breathing, sweating, rapid heart rate, poor feeding, and malnutrition, weighing only 5.7 kg at nearly 4.5 months old.
Echocardiogram results showed the baby had a large ventricular septal defect (8.5 x 10 mm) with dilated left chamber, increased pulmonary blood flow, and a mean pulmonary artery pressure of up to 41 mmHg (2-3 times higher than normal). Simultaneously, the baby also exhibited right ventricular outflow tract hyperplasia (the blood pathway from the right ventricle to the pulmonary artery) along with thickened pulmonary valve leaflets causing lung damage. Furthermore, the baby had a rare congenital anomaly of the mitral valve (hammock valve) leading to restricted valve function. The mitral valve annulus was also dilated due to the dilated left ventricular chamber (because of the large ventricular septal defect), further exacerbating the mitral regurgitation.
"The baby needs surgery before 6 months of age. If we wait past the 'golden time,' the chances of recovery will be lower, and intervention may even be impossible due to irreversible damage to the pulmonary blood vessels," said Dr. Thuy.
Dr. Pham Thuc Minh Thuy, a specialist in internal medicine, examined baby Vi Sal to assess her health condition before surgery.
Shortly afterward, Vi Sal was admitted to the hospital and quickly underwent surgery. Dr. Nguyen Minh Tri Vien, Consultant in Cardiac Surgery at the Cardiovascular Center, and his team repaired the ventricular septal defect using a piece of the patient's own pericardium, restoring the blood flow to the lungs and repairing the mitral valve. After more than two hours, the surgery was successfully completed. A transesophageal echocardiogram performed before suturing showed that the ventricular septal defect was closed, the right ventricular outflow tract was no longer narrowed, pulmonary artery pressure had decreased, and the mitral valve regurgitation had improved.
Dr. Vien stated that Vi Sal suffered from severe malnutrition and multiple cardiac abnormalities, most seriously pulmonary hypertension and heart failure. Therefore, the surgical team prepared all necessary equipment for the operation, including an extracorporeal membrane oxygenation (ECMO) system and a team of experienced pediatric cardiac surgeons and anesthesiologists. The child received general anesthesia combined with erector spinae plane (ESP) block for post-operative pain relief. The surgery was shortened, reducing the time spent on the extracorporeal circulation system, and the patient was weaned off the ventilator early.
Vi Sal left the intensive care unit after 3 days, was pain-free, and was discharged from the hospital after a week, continuing with regular health check-ups.
Baby Vi Sal, 4.5 months old, is healthy and pain-free three days after open-heart surgery.
Signs of congenital heart disease in newborns can manifest as recurrent respiratory infections, wheezing, or poor feeding and slow weight gain, which can easily be mistaken for other respiratory or digestive illnesses. Therefore, heart disease is sometimes discovered during pre-vaccination checkups or examinations for other conditions. Dr. Thuy recommends that parents take their child to a cardiologist if they exhibit symptoms such as rapid breathing, wheezing, infrequent or interrupted feeding, prolonged feeding sessions, excessive sweating, cold hands and feet, slow weight gain, paleness, cyanosis of the lips and fingertips/toes, or worsening cyanosis when crying.
"Symptoms of congenital heart disease can range from subtle to overt, such as heart failure and severe cyanosis. Proactive screening helps in early treatment and avoids dangerous complications," Dr. Thuy emphasized.
Thu Ha
Photo: Tam Anh Hospital
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