THE birth of a child is one of life’s purest joys. However, that joy can quickly turn to fear when a heart defect is discovered. Thanks to rapid advancements in paediatric cardiology, such a diagnosis in Malaysia today is no longer a sentence of despair, but a journey of hope.
“Congenital heart disease (CHD) affects about one in 100 babies,” said Dr Lim Wooi Kok, Consultant Paediatrician and Paediatric Cardiologist at Sunway Medical Centre, Sunway City (SMC).
“But with today’s imaging and interventional techniques, many children can now live well into adulthood compared to decades ago.”
Understanding childhood heart conditions
Heart problems in children generally fall into two categories: congenital and acquired
Congenital conditions are present at birth and include both acyanotic (“pink”) and cyanotic (“blue baby”) defects. Cyanotic conditions are often detected early, especially with proper newborn pulse oximetry screening, when oxygen levels fall below 95%.
Serious conditions such as Tetralogy of Fallot, Transposition of the Great Arteries, and Pulmonary Atresia require early medical attention, particularly when a baby’s lips or extremities appear bluish. Diagnosis is typically confirmed through echocardiography.
Acquired conditions develop later in life and include Kawasaki disease, rheumatic valve disease, and arrhythmias. These may present with prolonged fever, chest pain, fainting spells, or heart murmurs, and also require further imaging for confirmation.
Seeing the heart with greater precision
Advances in cardiac imaging have transformed how doctors diagnose and manage these conditions.
Dr Lim, who specialises in cardiac multimodality imaging, uses echocardiography, CT, and MRI to visualise the heart in two and three dimensions, including detailed strain imaging to assess how well the heart muscle functions.
“Not all cardiologists are trained in cross-sectional imaging to interpret these complex scans but having this expertise allows us to understand a child’s heart with far greater precision,” he explained.
Newer technologies, such as photon-counting CT, now enable highly detailed 3D imaging while minimising radiation exposure—an important consideration in paediatric care. These tools help clinicians visualise even the smallest structures more clearly, allowing for safer and more accurate treatment planning.
Less invasive treatment, faster recovery
Many congenital heart defects, including atrial septal defect (ASD), patent ductus arteriosus (PDA), and ventricular septal defect (VSD), can now be treated through minimally invasive procedures.
Using a small catheter inserted through the groin, doctors can repair defects without the need for open-heart surgery.
“These procedures typically take a few hours, and children can often return home within a couple of days. Recovery is much faster compared to traditional surgery,” Dr Lim said.
However, long-term care remains essential. Maintaining good oral hygiene and following medical advice to prevent infections, such as endocarditis, are crucial for protecting heart health.
The emotional and practical journey for families
Caring for a child with CHD requires patience and resilience. Many children face feeding difficulties, slower growth, and repeated hospital visits.
“Every ounce of milk they drink takes effort because they are using so much energy just to breathe,” Dr Lim elaborated.
For parents, the journey extends beyond medical care. They must manage medications, attend frequent follow-ups, and balance work and financial responsibilities. The emotional toll can also be significant.
“Parents often blame themselves, wondering if it was something they did during pregnancy,” he says. “But most cases are genetic or occur by chance. The risk rises slightly to about 2–3% if a parent or sibling is affected,” he remarked.
Support from healthcare providers and peer networks plays a vital role. “We always remind families they are not alone. With proper care, most children go on to lead full, active lives,” Dr Lim added.
A lifelong commitment to care
Children with congenital heart conditions often require lifelong monitoring. Over time, the relationship between patient and doctor becomes deeply personal.
“I still see some of my patients 20 years later. They are now adults, some even married. It’s a bond that lasts a lifetime,” Dr Lim said.
He reassures parents not to panic. “With today’s technology and expertise, many heart defects can be effectively treated with early diagnosis and proper care.”
Malaysia has also made significant progress in prenatal care. Fetal echocardiography now allows doctors to detect heart defects as early as 18 to 22 weeks of pregnancy.
“This gives parents time to prepare and doctors time to plan for a safe delivery and immediate intervention if needed. It can make the difference between life and death,” he noted.
A future filled with hope
Looking ahead, Dr Lim remains optimistic. “The future of paediatric cardiology in Malaysia is bright. We are seeing more specialists trained in advanced imaging and interventions, each bringing more hope,” he said.
“Ultimately, at the heart of every breakthrough is a parent’s wish to see their child grow, laugh, and live fully. And with these advancements, that wish is increasingly becoming a reality.” ‒ Focus Malaysia
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