The birth of a child is one of life’s purest joys, yet that joy can quickly turn into fear when a heart defect is discovered. Today, however, rapid advancements in paediatric cardiology in Malaysia have transformed such diagnoses from a sentence of despair into a journey of hope.
“Congenital heart disease (CHD) affects about one in every 100 babies,” says Dr Lim Wooi Kok, Consultant Paediatrician and Paediatric Cardiologist at Sunway Medical Centre, Sunway City (SMC). “But with today’s imaging and interventional techniques, many children can now live to see adulthood compared to decades ago.”
Heart problems in children generally fall into two categories: congenital and acquired. Congenital conditions are present at birth and include acyanotic or “pink” heart defects as well as cyanotic “blue baby” conditions. These are often detected soon after birth, particularly when newborn pulse oximetry screening shows oxygen levels below 95 percent. Diagnosis is typically confirmed through cardiac ultrasound, or echocardiography. More serious cyanotic conditions, such as Tetralogy of Fallot, Transposition of the Great Arteries, and Pulmonary Atresia, require early medical attention, especially when a baby’s lips and extremities turn blue.
Acquired heart conditions develop later in life and include Kawasaki disease, rheumatic valve disease, and arrhythmias. These conditions often present with prolonged fever, chest pain, or fainting spells. Heart murmurs may be detected during examination, with an echocardiogram usually required to confirm the diagnosis.
With advancements in cardiac imaging, specialists are now able to visualise the heart with greater clarity and precision. Dr Lim, who has extensive expertise in cardiac multimodality imaging, uses advanced tools such as echocardiography, CT scans, and MRI to produce two-dimensional, three-dimensional, and cardiac strain images. These are essential for assessing how well each segment of the heart muscle contracts, particularly in newborns, infants, children, teenagers, and even adults with congenital heart disease. He notes that not all cardiologists are trained to perform cross-sectional imaging or interpret these complex images, but such expertise allows for a far more precise understanding of a child’s heart.
The ability to visualise the heart in three dimensions also enables safer and more personalised treatment planning. Dr Lim explains that newer technologies, such as photo-counting CT imaging, provide detailed 3D images while carefully managing radiation exposure, which is especially important in paediatric cases. These developments help clinicians visualise small structures more clearly and support safe, accurate treatment planning for children with heart conditions.
Many congenital heart conditions, including Atrial Septal Defect (ASD), Patent Ductus Arteriosus (PDA), and Ventricular Septal Defect (VSD), can now be treated through percutaneous interventions. This minimally invasive procedure is performed using a small catheter inserted through the groin, typically takes only a few hours, and allows the child to return home within a couple of days, compared to the longer recovery associated with open-heart surgery. After treatment, maintaining good oral hygiene and following endocarditis prevention advice are essential for long-term heart health.
Caring for a child with CHD requires patience and resilience. Many children experience feeding difficulties, slower growth, and frequent hospital visits. Dr Lim explains that even simple activities such as drinking milk can be physically demanding, as these children use significant energy just to breathe. Parents must manage medications, attend regular follow-ups, and balance work and financial responsibilities, making it a lifelong journey.
Despite technological progress, the emotional burden on families remains significant. “Parents often blame themselves. They wonder if it was something they ate or did during pregnancy. But most cases are genetic or occur by chance. The risk rises slightly to about two to three percent if a parent or sibling is affected,” says Dr Lim. He adds that emotional support from both healthcare providers and other parents is crucial, noting that families are continually reminded that they are not alone and that, with proper care, most children can go on to lead full and active lives.
This long-term care fosters a lasting bond between patients and their cardiologists, ensuring continuous support into adulthood. “Children with congenital heart conditions need lifelong care. I still see some of my patients 20 years later, now adults, some even married. It’s a bond that lasts a lifetime,” he says. Dr Lim reassures parents not to panic, emphasising that with early diagnosis and proper care, many heart defects can be effectively treated. He also highlights the importance of prevention and follow-up, including regular screenings and vaccinations to protect children from infections.
Malaysia’s healthcare system has made significant progress in paediatric cardiology, including advancements in fetal echocardiography that allow heart defects to be detected even before birth. This enables parents to prepare and doctors to plan for safe delivery and immediate intervention if needed. “Expectant mothers can now have their baby’s heart examined in the womb as early as 18 to 22 weeks, allowing proper care to be coordinated with the obstetrician if a defect is found. This can make the difference between life and death,” Dr Lim explains.
Looking ahead, Dr Lim remains optimistic about the future of paediatric cardiology in Malaysia. With more specialists being trained in advanced imaging and interventional techniques, the outlook continues to improve. “The future is bright. Each advancement brings even more hope,” he says. Ultimately, he adds, at the heart of every breakthrough is a parent’s wish to see their child grow, laugh, and live fully. Thanks to continuous advancements, that wish is increasingly becoming a reality for children across Malaysia.
