IN PREGNANCY, by the end of the first trimester, a foetus will already have a beating heart, functioning kidneys, and the beginnings of a nervous system.
By term, a single cell would have transformed into a fully formed baby – that’s the miracle of life.
However, this delicate process can be disrupted, and one of the possible consequences is congenital disease, anomalies that are either structural or functional that develop in the womb.
One such anomaly affects the heart, and this group of conditions is collectively called congenital heart disease (CHD).
Sunway Medical Centre Penang consultant cardiologist Dr Ng Rui Lun, who specialises in diagnosing and treating congenital diseases, explains that CHD refers to a range of structural defects in the heart that are present at birth.
“These abnormalities can involve the walls of the heart, the valves, and the arteries or veins near the heart, disrupting the normal flow of blood.”
Dr Ng notes that CHD is one of the most common birth defects in Malaysia.
While some forms of CHD are relatively minor and may not require intervention, Dr Ng stresses that others can be life-threatening and necessitate urgent medical treatment.
Children with untreated severe CHD may experience difficulty breathing, poor weight gain, fatigue, frequent lung infections, or swelling in the legs or abdomen, he explains.
“They also have a higher risk of developing endocarditis, an infection of the inner lining of the heart. Over time, untreated CHD can lead to heart failure, and its consequences.”
Why, who, how
Dr Ng adds that CHD is a complex condition with a variety of causes. While the exact reason for many cases of CHD remains unknown, genetic and environmental factors play key roles.
“Certain families are at higher risk of having babies with CHD, such as those with a family history of congenital heart defects or chromosomal abnormalities.
“If a parent or sibling has CHD, there is a 3%-6% chance that a newborn will also be affected by a heart defect.”
According to him, mothers exposed to factors like rubella, flu, lupus, poorly controlled diabetes, substance abuse (alcohol, drugs), or radiation during pregnancy significantly increase the likelihood of their babies being born with CHD.
Diagnosis, early intervention
Early screening and diagnosis, particularly foetal diagnosis during pregnancy, is critical, Dr Ng says, as it allows cardiologists to monitor the condition and make timely decisions, preventing irreversible complications.
It also helps doctors prepare for the birth, ensuring the required specialised care immediately after birth.
However, not all defects are detected before birth, and some are diagnosed only after birth through physical examination or specialised tests like echocardiograms, electrocardiograms, and chest X-rays.
Paediatric cardiologists can detect heart defects soon after birth or during infancy by listening to the baby’s heart sounds, shares Dr Ng, adding that further tests will then be carried out to confirm the diagnosis.
“In fact, from the 18th week onwards, obstetricians or cardiologists can detect potential CHDs in high-risk pregnancies.”
Early detection allows the medical team to plan for the necessary treatment and monitoring.
Although about one-third of CHD cases are mild and may resolve without intervention, over half of the cases will require medical treatment or surgery to correct the defect.
Treating CHD
In the past, the primary method of treating many types of CHD was through open-heart surgery. Now, Dr Ng points out that advances in medical technology allow many heart defects to be treated using minimally invasive catheterisation techniques, which do not require open-heart surgery.
“Cardiac catheterisation can help repair holes in the heart, such as atrial or ventricular septal defects, using special devices.
“It can also widen narrowed heart valves or blood vessels through balloon angioplasty or place stents to keep them open. These techniques are less painful and offer quicker recovery.”
These methods are continually improving as new instruments and technologies are developed every few years.
What the future holds
“The timing of treatment for CHD depends on the type and severity of the heart defect. Minor defects may heal on their own as the child grows,” says Dr Ng.
Most children with mild or well-managed CHD can live normal, active lives and attend school like their peers, while more complex conditions often require multiple stages of surgery.
However, he adds, the main concern is the highly specialised requirements for treating CHD. “The challenge lies in ensuring we have enough specialised cardiologists and medical teams trained in these complex procedures.”
Dr Ng emphasises that hospitals must also be equipped with the latest technology to perform advanced CHD treatments. Sunway Medical Centre Penang is one such hospital leading the way, offering comprehensive care for children with congenital heart disease.
Dr Ng notes that due to the growing number of CHD cases nationwide, there is still a gap in the overall healthcare system.
This sometimes leads to longer waiting times for treatment, particularly in areas with fewer resources.
He calls for greater collaboration among stakeholders to ensure that families across the country have timely access to the specialised care their children need, regardless of location.
KKLIU 2837 / Expiry Dec 31, 2026
