Pectus excavatum (or funnel chest) is a common chest wall deformity where the breastbone (sternum) and ribs grow inward, creating a sunken or caved-in appearance, often noticeable at birth or during teenage growth spurts. While mild cases are cosmetic, severe cases can cause shortness of breath, chest pain, fatigue, and reduced exercise tolerance by affecting heart and lung function, leading to treatments like physical therapy, vacuum devices, or surgery (Nuss or Ravitch procedures) to correct the shape.

Causes

• Congenital: Present at birth, often due to excess growth of connective tissue joining ribs to the sternum, causing it to push inward. 
• Growth Spurt: Can become more noticeable during teenage growth spurts.
• Genetics: May have a genetic link and can run in families.

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Congenital heart defects (CHDs) are the most common type of birth defects. As medical care and treatment have advanced, babies with a CHD are living longer and healthier lives. 

congenital heart disease (congenital heart defect) is one or more abnormalities in your heart’s structure that you’re born with. This most common of birth defects can alter the way blood flows through your heart. Defects range from simple, which might cause no problems, to complex, which can cause life-threatening complications.

Advances in diagnosis and treatment mean most babies who once died of congenital heart disease survive well into adulthood. However, signs and symptoms of the condition can occur in adults later in life, even those who had treatment as a child.Learn more facts about CHDs below.

Types

Listed below are  different types of CHDs. The types marked with a star (*) are considered critical CHDs & needs immediate medical attentionAtrial Septal Defect

• Atrioventricular Septal Defect
• Coarctation of the Aorta*
• Double-outlet Right Ventricle*
• d-Transposition of the Great Arteries*
• Ebstein Anomaly*
• Hypoplastic Left Heart Syndrome*
• Interrupted Aortic Arch*
• Pulmonary Atresia*
• Single Ventricle*
• Tetralogy of Fallot*
• Total Anomalous Pulmonary Venous Return*
• Tricuspid Atresia*
• Truncus Arteriosus*
• Ventricular Septal Defect (VSD)

Cyanotic and Acyanotic Congenital Heart Disease

Many doctors classify congenital heart disease as either cyanotic congenital heart disease or acyanotic congenital heart disease. In both types, the heart isn’t pumping blood as efficiently as it should. The main difference is that cyanotic congenital heart disease causes low levels of oxygen in the blood, and acyanotic congenital heart disease doesn’t. Babies with reduced oxygen levels may experience breathlessness and a bluish tint to their skin. Babies who have enough oxygen in their blood don’t display these symptoms, but they may still develop complications later in life, such as high blood pressure.

 Causes 

 The defect typically interferes with the normal flow of blood through the heart, which may affect breathing. Although researchers aren’t exactly sure why the heart fails to develop correctly, suspected causes include the following:

The heart defect may run in families.

Taking certain prescription drugs during pregnancy puts a child at a higher risk for a heart defect.

Using alcohol or illegal drugs during pregnancy can increase a child’s risk of having a heart defect.

Mothers who had a viral infection during the first trimester of pregnancy are more likely to give birth to a child with a heart defect.

Increased blood sugar levels, such as occurs with diabetes, may affect childhood development.

Signs and Symptoms

Signs and symptoms for CHDs depend on the type and severity of the particular defect. Some defects might have few or no signs or symptoms. Others might cause a baby to have the following symptoms:

• shortness of breath
• Problems with exercise
• Blue-tinted nails or lips
• Fast or troubled breathing
• Tiredness when feeding
• Sleepiness

Diagnosis

Some CHDs may be diagnosed during pregnancy using a special type of ultrasound called a fetal echocardiogram, which creates ultrasound pictures of the heart of the developing baby. However, some CHDs are not detected until after birth or later in life, during childhood or adulthood. If a healthcare provider suspects a CHD may be present, the baby can get several tests (such as an echocardiogram) to confirm the diagnosis.

Treatment

The treatment for a congenital heart defect depends on the type and severity of the defect. Some babies have mild heart defects that heal on their own with time. Others may have severe defects that require extensive treatment. In these cases, treatment may include the following:

Medications

There are various medications that can help the heart work more efficiently. Some can also be used to prevent blood clots from forming or to control an irregular heartbeat.

Implantable Heart Devices

Some of the complications associated with congenital heart defects can be prevented with the use of certain devices, including pacemakers and implantable cardioverter defibrillators (ICDs). A pacemaker can help regulate an abnormal heart rate, and an ICD may correct life-threatening irregular heartbeats.

Catheter Procedures

Catheterization techniques allow doctors to repair certain congenital heart defects without surgically opening the chest and heart. During these procedures, the doctor will insert a thin tube into a vein in the leg and guide it up to the heart. Once the catheter is in the correct position, the doctor will use small tools threaded through the catheter to correct the defect.

Open-Heart Surgery

This type of surgery may be needed if catheter procedures aren’t enough to repair a congenital heart defect. A surgeon may perform open-heart surgery to close holes in the heart, repair heart valves, or widen blood vessels.

Heart Transplant

In the rare cases in which a congenital heart defect is too complex to fix, a heart transplant may be needed. During this procedure, the child’s heart is replaced with a healthy heart from a donor.

Congenital Heart Disease in Adults

Depending on the defect, diagnosis and treatment may begin shortly after birth, during childhood, or in adulthood. Some defects don’t cause any symptoms until the child becomes an adult, so diagnosis and treatment may be delayed. In these cases, the symptoms of a newly discovered congenital heart defect may include:

• shortness of breath
• chest pain
• a reduced ability to exercise
• being easily fatigued

The treatment for congenital heart disease in adults can also vary depending on the severity of the heart defect. Some people may only need to monitor their condition closely, and others may require medications and surgeries.

In some cases, defects that may have been treated in childhood can present problems again in adulthood. The original repair may no longer be effective or the initial defect may have become worse over time. Scar tissue that developed around the original repair may also end up causing problems, such as heart arrhythmias.

it’s important to continue seeing your doctor for follow-up care. Treatment may not cure your condition, but it can help you maintain an active, productive life. It will also reduce your risk for serious complications, such as heart infections, heart failure, and stroke.

Living & Managing with CHD

With the improved Medical advances & treatments babies and children with congenital heart defects (CHDs) are living longer and healthier lives.Ongoing, appropriate medical care help children and adults with a CHD live a healthy life.

People with a CHD need routine checkups with a cardiologist (heart doctor) to stay as healthy as possible. They also might need further operations after initial childhood surgeries. It is important for people with a CHD to visit their doctor on a regular basis and discuss their health, including their specific heart condition, with their doctor.

For more information & support  you can share us the latest reports at query@gtsmeditour.com  and get second opinion with our best cardiologists available at Apollo Hospitals, Columbia Asia Hospitals, Narayana Health Centre,Manipal Hospitals Etc..

Suggested Reading : Coronary Heart Disease

Proton therapy or proton radiotherapy  is a kind of particle therapy which uses a beam of protons to irradiate diseased tissue in the treatment of cancer. it uses ionizing radiation. So that protons are positively charged subatomic particles which attack the DNA of the cancer cells and destroy them.Proton therapy is non-invasive and painless. The beam is delivered from a machine and the therapy is typically carried out on an outpatient basis.

 It is very precise in treating the tumor with minimal exposure to healthy tissues, where as other radiation therapy deliver radiation to the healthy tissues before & after the tumor. Therefore increasing the chances of healthy tissue damage.

What Experts say:

When the protons are deliver to the tissue, they go into a certain distance in the tissue depending upon the imaging imparted to it at the beginning and can make them stop right where the tumor is located. 

Proton radiation Therapy is found to be particularly  very useful in treatment of most of the cancers surrounded by a critical structure like the spinal cord, base of the skull or optic nerve. 

The above image depicts proton beam precisely targets the tumor and releases its energy inside it. So, the areas adjacent to the tumor, do not get affected.This enhances the quality of cure and reduces side effects, Proton therapy is non-invasive and painless. The beam is delivered from a machine and the therapy is typically carried out on an outpatient basis.

The therapy has undergone tremendous innovations in the last ten years. “Its newer forms like pencil beam scanning are very exciting Hence Proton therapy can be used for the treatment of most of the cancer,including the prostate cancer.

Candidates for Robot Surgery

The treatment type recommended for your condition will depend on several factors like  the type and severity of heart disease, age, medical history and lifestyle etc.Several diagnostic tests are carried out to determine if you are appropriate for robotic cardiac surgery.This include a cardiac catheterization and chest x-ray. An echocardiogram and/or a computed tomography scan also may be required to provide more details about the medical condition.After reviewing the results of all these tests,doctors conclude whether to take robotic cardiac surgery or not.

Types of robotic cardiac surgery

• Mitral valve repair and replacement
• Tricuspid valve repair and replacement
• Aortic valve replacement
• Ablation of atrial fibrillation or Maze procedure for atrial fibrillation
• Coronary artery bypass surgery
• Saphenous vein harvest for coronary artery bypass surgery
•  Atrial septal defect (ASD) repair
• Patent foramen ovale (PFO) repair
• Removal of cardiac tumors (Myxoma, Fibroelastoma)
• Combined coronary artery bypass and angioplasty

Advantages

With open heart surgery ,splitting the sternum and spreading the rib cage to gain access to the heart contribute to significant morbidity. Also,cardiac surgery is different than other surgical procedures because the heart-lung machine adds further morbidity which is avoided in closed chest heart surgery.In addition,other advantages are

• Less blood loss
• Lower risk of infection
• Reduced trauma and pain
• Shorter time in the hospital, faster recovery and quicker return to normal activities
• Smaller, less noticeable scars.Traditional surgery would leave a 20 cm scar for rest of the life.

Risks

As with any surgery,robotic assisted surgeries also pose some risks.Although the minimally invasive procedure removes many complications,some possible risks are

• Heart attack
• Stroke
• Infection

In some cases, doctor may not be able to complete the surgery with the robot. In that case, open-heart surgery may be needed.

Technological advances have facilitated totally endoscopic/key hole  robotic cardiac surgery.In India several hospitals provide minimally invasive endoscopic surgeries.The success rate is very high ,more than 92%.The potential in this technology is enormous and the path is minimal.
For any queries regarding the procedure and treatment facilities,email us at query@gtsmeditour.com.

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