Veins of salvation

 Siriraj Piyamaharajkarun Hospital recently organised the third in its “SiPH 2gether Caring & Sharing” events, calling on Bangkokians to take time out and donate their blood and also learn about a group of patients that desperately need that blood if they are to survive: children with congenital heart disease.

CDH, defined as a problem with the heart’s structure and function, is today the most common type of birth defect and affects more than 7 babies in 1,000. Unfortunately only half of them receive the critical care they need.

“Each year, we see 5,000-6,000 patients who require surgery but are only able to operate on 3,500. The rest have to wait. We simply don’t have the medical capacity to treat them all,” laments Professor Kritvikrom Durongpisitkul, the SiPH deputy director and head of the Paediatric Cardiology Unit. .

“There are only about 70 to 80 doctors with the expertise to undertake CDH surgery and we have very few specialised heart diseases centres that can receive patients,” Kritvikrom adds. 

CDH can describe a number of different problems affecting the heart. Although congenital heart disease is present at birth, the symptoms may not appear right away.

“Heart pain is often identified with the contraction of muscles around the chest but the sensation that comes with a heart attack is like having a refrigerator placed on top of your chest. It’s a heavy and constricted sort of feeling,” the doctor explains, adding that steps can be taken to prevent the disease and that patients, once cured, can lead a fairly normal life.

There are two types of CHD: Cyanotic and Non-cyanotic also called Acyanotic heart disease. These cardiac diseases alter a patient’s cardiovascular physiology and haemodynamic circulation, both of which cause critical complications. 

“A warning sign that a baby has CHD is if he or she breathes fast while sucking milk,” he continues. “Research has shown that one of the major causes of CHD today is the mother’s behaviour during pregnancy, for example if she uses drugs, drinks alcohol, or smokes. So this can be prevented. Heart defects can also be part of genetic and chromosome syndromes and often occur in Down Syndrome children. It can be diagnosed through ultrasound or testing the amniotic fluid during pregnancy. A third cause is an abnormal pattern in the heart.”

Congenital heart diseases continue to be investigated and researched but it is known that close monitoring from birth onwards plays a major role in both prevention and cure. Those with a family history of congenital heart disease should be tested for diabetes and rubella and pregnant women should have an amniotic fluid test and ultrasound. 

Which treatment is used, and how well the baby responds to it, depends on the condition. Having medical care ready during delivery can mean the difference between life and death for some babies. Many defects need to be followed carefully. Some will heal over time, while others will need to be treated. Some congenital heart diseases can be treated with medication alone. Others will require one or more surgical interventions.

“CDH patients should be careful of using medicine and in babies under 12 months old, feeding should be controlled with small amounts given at one time and more often. Salty and oily food must be avoided and in older individuals, exercising to keep fit is important,” Kritvikrom notes. 

“A heart defect is complicated and treatment is long and drawn out. I don’t going to tell my young patients not to run or play with their friends but to take a rest when feeling tired.”

Many defects do not need treatment, he stresses, but some complex congenital heart defects require medication or surgery. This is when the need for blood comes into play: every heart operation needs about 6-8 units of spare blood on hand to save a life. 

“There is never enough blood,” says SIPH’s Dr Kulvara Kihisares. “One person donates about 450 cc per unit. Men can donate every three months while for women the time gap is six months. The blood can be kept for 35 days and is separated into transfusable components – red cells, plasma, platelets. So a one-time donor can save three lives.” 

 

 

 

Give a little

 

To donate blood, visit Siriraj Piyamaharajkarun Hospital on Prannok Road. Call (02) 419 1000 or visit www.SIPHHospital.com.