As people around the world will on Sunday mark World Heart Day, a Gqeberha paediatric cardiologist wants to spread the message that children, too, can experience heart conditions.
Dr Samkelo Jiyana, who practises at the Netcare Greenacres Hospital, said many are unaware that approximately one in a hundred children are affected by heart conditions or heart disease.
Raising awareness of paediatric heart conditions can lead to earlier diagnoses and more effective treatments using modern medical techniques. With timely intervention, children diagnosed with heart conditions often have the potential to live long, healthy lives.
His patient, Kheera Mcetywa, is a bubbly 13-year-old who enjoys drawing and writing her own songs. Although spirited and lively now, Jiyana recalls that when he first met her, Kheera was a frail child.
She presented with recurrent chest infections and had been unwell since infancy. She was eventually diagnosed with a congenital ventricular septal defect (VSD), a condition characterised by a hole in the wall separating the two lower chambers of the heart.
While there is always hope that a VSD will close on its own, Kheera’s did not, leading to recurrent chest infections.
Additionally, her growth was stunted, and she was smaller than her peers. She had needed the procedure for quite some time.
Jiyana explained that a VSD is typically present at birth and results from improper heart development during foetal growth.
Kheera’s family was initially shocked and afraid when they were told she needed treatment to close the hole in her heart.
“But when I explained that we would repair the defect using a minimally invasive procedure through a small hole in her groin, they were more comfortable. It’s so much safer than open heart surgery. The patient can generally go home the next day, whereas with open heart surgery, patients remain in hospital for two weeks, Jiyana explained.
He added that the procedure was not without risks. “There’s still anxiety because complications can occur. There’s also the sense that you’re working on a child, and this can present its own challenges.”
In explaining the procedure, he said that when a VSD is closed percutaneously (through the skin) in a cath lab, the heart is accessed through the skin, typically via a small incision in the groin area where a catheter (a thin, flexible tube) is inserted into a blood vessel.
“We insert a device to close the hole, with the pressure inside the heart keeping the device in place. In time, a membrane will develop over the device, which helps keep the hole closed.”
There’s also a lower risk of complications than with open-heart surgery.
Kheera’s mother, Micaela Mcetywa, described her daughter as a brave, intelligent child.
“She’s not scared to take chances. She constantly seeks to improve herself and improve her knowledge.”
She said initially, they didn’t know there was a problem with Kheera’s heart, but they’d noticed she’d been a sickly child from birth. “She had no appetite and was always getting a cold. At two years old, she contracted TB.”
When she was four, she was sick with tonsillitis. The doctor detected that her heart was making an unusual sound, so he referred her for tests, which revealed she had a VSD.
Mcetywa said Kheera remained “very cool and calm” throughout her experience in the hospital. “I talked to her, and she told me she realised there was no other option; she knew it had to be done, and she was optimistic.”
Kheera was so impressed by the treatment she received, that she now wants to become a paediatric cardiologist one day.