- If the child develops respiratory distress or bluish spell, report to nearest hospital/clinic immediately.
- Always take care of dental caries.
- Stop diuretics during episodes of Diarrhea.
- Stop B-blocker if a child has Bronchial Asthma.
- Stop Enalapril/ Captopril if the baby has less urine output.
- Don’t give vaccine within 3 months of open heart surgery.
- If the child has Down syndrome or any chromosomal or genetic disorder, please take special counseling.
- Report to the pediatrician immediately if the baby has fever, diarrhea, cough, lethargy, breathing difficulty, convulsion, less urine output etc
- Education is not a problem for children with heart disease.
- Exercise: sudden death may occur in some serious lesions after exercise like Aortic stenosis, Eisenmenger syndrome, Cyanotic heart disease, Hypertrophic obstructive cardiomyopathy. Guideline for exercise. Trivial heart disease – No restriction B. Mild heart disease- No restriction in recreational exercise but the restriction of strenuous sports. C. Moderate heart disease – Moderate exercise but no competitive sports D.Severe heart disease- No sport or exercise
- Management of noncardiac surgery. The two main problems for patients with heart disease undergoing non-cardiac operations are the anesthesia and the necessity for prophylaxis against infective endocarditis. There is no worry about surgery for the patients who are asymptomatic and cyanotic. On the other hand, if there is pulmonary hypertension, cyanosis, congestive heart failure or the risk of arrhythmias, then there is a great risk. As long as all the information about the patient is available the anesthetist is aware of the hemodynamic situation, then most surgery has a satisfactory outcome. The anesthetist can discuss the management of possible complications in advance and the patients’ ECG and blood pressure should be monitored during the operation. Patients who are polycythemic should be given intravenous maintenance fluids to avoid thrombotic complications. The arterial Po2 should be monitored as well as PH. any acidosis which develops must be corrected. If the patient has heart failure the fluid balance must be carefully assessed and electrolytes measured and corrected. Alterations in the electrolyte and an increased digoxin concentration can precipitate arrhythmias. Patient with a pacemaker should not have diathermy during surgery. If there is a risk of serious arrhythmias, or severe hypoxemia or severe outflow tract obstruction, then it is wise to arrange surgery at a center with the appropriate cardiological services. All patients should have prophylaxis against endocarditis as outlined in chapter infective endocarditis.
Majority of employer and carrier office deny them from employment while they noticed scar mark in their chest. But carrier offices or doctors should contact the concern pediatric cardiologist so that every possible help is given and the information is sent to the appropriate person.
Patients are anxious to know whether they will be able to take out life insurance. Untreated cyanosed patients will not be given insurance. When the operation has been carried out the insurers tend to wait for a year before giving an opinion. They also appreciate surgery in early life. The patient must be assessed individually as there is a great variation in the severity in each lesion and in the surgical results.