Department of Pediatric Cardiology

Pediatric Cardiology Department in Turkish Hospitals

The field of pediatric cardiology is concerned with diagnosing and treating heart diseases that originate from the fetal heart in the womb and persist until the age of 18. The development of the heart, assuming its distinctive shape through cell differentiation and growth, is completed within approximately two months after fertilization. The heart transforms from a tubular structure into an organ with four valves and four chambers within 60 days, remaining functional throughout a person's life. In some cases, disruptions in the formation of the fetal heart in the womb lead to abnormalities, known as congenital heart defects, constituting approximately 10% to 30% of all diseases observed at birth. It is noteworthy that around 9 out of every 1000 births exhibit congenital heart disease.

Among the congenital heart defects that may appear, some may be clinically insignificant and can improve spontaneously, while others require surgical intervention. Emphasis is placed on the importance of early diagnosis and detection in cases of heart diseases, as many of these conditions may result from genetic and environmental factors, even though the exact cause of most remains entirely unknown.

Congenital Heart Diseases:

Most congenital heart diseases, those apparent from birth, are identified in the period following birth up to one year. In some cases, they can be discovered during fetal examinations using fetal echocardiography. Typically, pediatricians detect heart diseases during routine examinations conducted within the first year of life. Families are referred to pediatric cardiologists due to signs and symptoms that may not be very apparent to parents, often because these signs may not be alarming enough for parents. However, congenital heart diseases may manifest with some of the following signs:

• Cyanosis, a change in skin color to blue or ashen.

• Difficulty breathing.

• Frequent or abnormal respiration.

• Recurrent respiratory infections.

• Audible murmurs in the heart.

• Palpitations or rhythm disturbances.

• Rapid fatigue or easy tiredness.

• Dizziness or fainting.

• Chest pain.

• High blood pressure.

• Difficulty gaining weight.

• Growth delays.

Causes of Congenital Heart Diseases:

Congenital heart diseases result from a diverse range of factors, including:

1. Genetic Factors: Studies indicate that around 9% of cases of congenital heart diseases in newborns are associated with chromosomal abnormalities. For example, heart defects are observed in approximately 40% of children with Down syndrome.

2. Metabolic Diseases: Metabolic conditions in pregnant mothers, such as diabetes, suggest that approximately 1% to 2% of cases of infant heart diseases may be attributed to them. The risk of heart diseases in children of diabetic mothers increases to a range of 2% to 6%.

3. Teratogenic Factors: Fetal exposure to smoking, alcohol, drugs, X-rays, chemicals, and certain medications during pregnancy can lead to heart deformities in the fetus.

Diagnostic Tests and Examinations:

Diagnosing pediatric heart diseases involves a variety of tests and examinations:

1. Cardiac Catheterization and Angiography: These procedures are conducted to measure heart pressures in different areas and monitor anatomical problems.

2. Electrocardiography (ECG): Used to monitor the heart's electrical activity and determine whether it is functioning properly.

3. 24-Hour Holter Monitoring (ECG): Monitors heart activity throughout the day to record any changes in pulse or rhythm during daily activities.

4. Telecardiography: Analyzes heart size, appearance, and dilations of certain openings.

5. Echocardiography: Uses ultrasound to monitor valves, chamber sizes, wall motion, and measure heart pressure.

6. Color Doppler Echocardiography: Determines locations and sizes of cardiac abnormalities.

7. Electrophysiology: Used to assess conduction abnormalities in patients with unexplained symptoms like fainting.

8. Stress Test: Evaluates heart performance during physical activity, assessing the presence of congenital heart disease, measuring heart capacity, and observing the heart's condition under stress.