WITH congenital heart defect being one of the leading causes of death in newborns, states such as New Jersey, Indiana, Maryland, and Virginia in the United States have made it mandatory for every baby to receive cardiac screening at birth.
While she does not advocate mandatory cardiac screening of babies, local paediatric cardiologist Dr Sandra Williams-Phillips believes parents must get their children screened once they start taking part in any competitive sporting activities.
"I would recommend it for any child who is going to do any form of sustained sporting activity like basketball and track and field — something that is going to push their limit," she said.
The cardiologist explained that cardiac screening is important, given the increasing number of student athletes dying from congenital cardiac sudden death.
Cardiac screening would involve a number of investigations geared towards finding clues that would indicate that the individual has or is prone to having a cardiac problem.
"You are going to be looking for specific problems. You are going to be looking for chest pains; you are going to be looking for palpitations or what people call 'heart racing'. The family history is extremely important, because in congenital cardiac problems, many times there is a member of the family who has the problems," Williams-Phillips explained.
"So you will look for sudden infant death syndrome, meaning that if there was anybody in the family who died the first year of life suddenly without anybody knowing the cause, or if there was a sudden death of an adult less than 50 years of age, that is an indication of the possibility of a congenital cardiac problem," she added.
Some of the examinations done during a cardiac screening includes an electrocardiogram (ECG), a stress test and an echocardiogram, which works similar to an ultra-sound.
"This is the instrument or investigation that can pick up structural cardiac lesions. The most common cause for sudden deaths in athletes is something called hypertrophic cardiomyopathy," Williams-Phillips disclosed.
The tests can be done at major hospitals or at facilities such as the Heart Foundation of Jamaica and the Heart Institute of the Caribbean. An ECG, for example, could cost between $2,000 and $2,500, whereas an echocardiogram could be done for about $2,000 — depending on the institution. A treadmill stress test at the University Hospital of the West Indies could amount to about $4,000.
Williams-Phillips said it is not necessary for children to undergo mandatory cardiac screening at birth because babies would need to be examined by their paediatricians, who would be able to detect any abnormalities in them.
"If the paediatrician picks up an abnormal sound in the heart or an abnormal rhythm in the heart, then they would obviously send for the evaluation to be done to find out what is really wrong," she said.
Not every cardiac issue is manifested during childhood. In cases where they do, not all of them will require surgery.
"The most common cardiac lesion is a hole in the heart, and if it is small and tiny, you would need to fix it and sometimes they close spontaneously. Sometimes you have the severe form of cardiac disease where the baby comes out blue and they can have imminent death if not treated and managed very quickly," she said.