GENERAL MANAGEMENT OF CONGENITAL HEART DISEASE

The following general principles should guide the management of congenital heart disease:

  • Parents should be counselled on what can and what cannot be done depending on the heart lesion.
  • Evaluation and close follow up of affected children are vital for appropriate and effective management.
  • The majority of patients having mild CHD require no treatment. Such patients are expected to live normal lives and should not have any exercise restriction. The parents of the child should be made aware of this.
  • Good nutrition should be maintained with adequate immunization and prevention of anaemia.
  • Children with severe disease will tend to limit their own exercise, but if dyspnoea, headache, and fatigability in cyanotic patients occur, their exercise and other activities should be limited.
  • Bacterial infections should be treated vigorously.
  • Prophylaxis against bacterial endocarditis should be given before dental procedures, urinary tract instrumentation, and lower GIT manipulation.
  • Cyanotic patients should be observed for polycythaemia in and dehydration avoided.
  • Venesection with volume replacement should be carried out for polycythaemic when haematocrit goes above >65% and maintain it between 55–65%.