Kamal Rampersad, managing director of Caribbean Heart Care
Medcorp, Cardiac Surgery Department, Adult and Paediatric
at Eric Williams Medical
Sciences Complex, Mt Hope.
Congenital heart disease is responsible for more deaths
in the first year of life than any other birth defect in
This was confirmed in an interview last week with Dr Kamal
Rampersad, an anaesthetist and head of the Caribbean Heart
Care Medcorp, Cardiac Surgery Department, Adult and Paediatric
at Eric Williams Medical Sciences Complex, Mt Hope.
Congenital heart disease (CHD) is a type of heart disease
in newborns. The defect may be so slight that the baby appears
healthy for many years after birth, or so severe that its
life is in immediate danger.
Stages of the disease
Symptoms of congenital heart disease can range from simple
to complex heart disease with the least complex presenting
itself in adulthood, such as in the case of Guardian journalist
Zen Dionne Jarrette, who passed away on January 11.
The middle to complex stages of the disease affects 80 per
cent of children born with this condition and the majority
of them require surgery in childhood.
The complex stage of this disease is present from six months
to one year and the middle stage presents itself from three
to six years of age.
What is congenital
Congenital heart disease exists primarily at birth and can
describe a wide variety of congenital heart defects. It
occurs when the heart or blood vessels next to the heart
are not generated properly before birth. Therefore, the
heart does not function properly because it is not completely
Heart defects originate in the early part of pregnancy when
the heart is forming, usually in the first eight to nine
weeks during pregnancy.
Multiple genetic and environmental factors interact to alter
the development of the heart during the early stages of
a foetus development. Certain environmental exposures
during the first trimester of pregnancy may cause structural
abnormalities. However, they can also be a part of various
genetic and chromosomal syndromes such as Down syndrome.
Environmental factors include exposure to anticonvulsant
medications, lithium, dermatologic medications, alcohol
and drugs during pregnancy. Exposure to industrial chemicals
during pregnancy can also increase the risk of congenital
Women who contract rubella (German measles) during the first
three months of pregnancy also have a high risk of having
a baby with a heart defect.
But most of the time, the specific cause of congenital heart
disease is not known.
half the cases in this country are related to Down Syndrome,
Teratogenic drugs, which are agents that can disturb the
development of the embryo or foetus, may be responsible
for most of the non-genetic cases, he said.
disease in adults
Although the majority of congenital heart disease diagnoses
are made in childhood, there are significant congenital
heart defects which may go undetected until adulthood.
Some congenital heart diseases can be treated with medication
alone, while others require one or more surgeries.
you have a congenital heart defect, it will present itself
sometime in your life, said Rampersad.
Defects include certain kinds of valve problems, transposition
disorders, holes in the heart, and abnormalities of the
hearts major veins and arteries. The most common congenital
heart disorder diagnosed in T&T is holes in the heart,
which may or may not require surgery, according to Rampersad.
children born with complex heart defects grow to adulthood
and lead productive lives. Very rarely in about two to three
per cent of cases this condition can heal with time.
those that dont heal with time will become symptomatic
in adult years. It usually does not affect life span but
patients are required to make changes in their lifestyle,
Congenital heart defects are most commonly diagnosed through
an echocardiograman ultrasound of the heart which
shows the hearts structure.
echocardiogram will determine if surgery is required,
Statistics of cases
Statistics compiled by Caribbean Heart Care Medcorp in 2001
showed that 61 children in T&T had open heart surgery
that year. Further data showed that 36 of them had holes
in their heart or congenital heart disease.
means 60 per cent of children who had open heart surgery
in 2001 had holes in their hearts. Our statistics also show
that two per cent of adults who had open heart surgery in
2001 had holes in the heart. That two per cent represented
three cases of adults with congenital heart disease,
He also stressed that T&T has one of the best success
rates for heart surgery in the world with a fatality rate
of just 1.5 per cent in adults.