Mending broken hearts: how SA-UK collaboration is helping to save young lives

Some children in the Western Cape with congenital heart defects, including rheumatic heart disease, which damages heart valves, have received a second lease on life thanks to a screening programme that examines healthy youngsters who often go undiagnosed for years.

Cardiologists from Tygerberg Hospital, in collaboration with the British Society of Echocardiography, screened 7,000 schoolgoing children for rheumatic heart disease and other congenital heart conditions using echo (ultrasound) scans.

They diagnosed almost 200 cases of the former and 60 heart defects that otherwise would not have been detected.

As the world commemorates Congenital Heart Defect Awareness Week from February 7 to 14, local doctors celebrated the successes they’ve made in treating heart conditions in children.

One of the youngsters who received life-saving treatment during the Echo in Africa study project is a patient diagnosed with a hole in the heart between the left and right atria (thin-walled chambers that receive blood from the veins).

Dr Hellmuth Weich, acting head of cardiology at Tygerberg Hospital, said if left untreated the condition, which results in an increased volume of blood going through the heart, may be fatal.

After the diagnosis, doctors at the hospital closed the hole . “A tube was inserted into her leg vein and advanced up to the right heart, where the hole was identified, with an ultrasound probe placed in her gullet,” said Weich.

The tube was passed through the hole into the left atrium and a metal “double umbrella” was deployed to close the hole. “The device is then detached from its delivery cable and the tube removed. The patient can go home the same day and usually does not suffer discomfort from the procedure,” he said.

This was just one of many success stories from the project, Weich added. After screening some of the children were monitored, others required open heart surgery and some were treated with keyhole procedures.

According to the Africa Centres for Disease Control (CDC), congenital heart defects affect almost 1% of children born in the US annually. Only 25% require early surgery during the first year of life and the rest are treated later or remain without symptoms for decades.

“It is therefore very possible to have a congenital heart defect without knowing it. In some cases this may put strain on the heart over years and when it is finally diagnosed, may already have caused significant damage to the heart.”

Accurate data on the prevalence of congenital heart defects in SA is lacking. Research shows that rheumatic heart disease remains a major heart condition, affecting about 3-million people worldwide. It is caused by a bacterial throat infection that cross-reacts with the tissue of heart valves, damaging them.

Researchers say because it affects mostly younger people in lower-income countries, there is less funding for high-quality research into its prevalence. Lack thereof has been a major stumbling block in the management of rheumatic heart disease.