Nutritional Assessment

in

Congenital Heart Disease

Nutritional Assessment in Congenital Heart
Disease
By .Mrs Lally Hanna Luke
Sr.Lecturer
Department of Clinical Nutrition
Madras Medical Mission
Guided by
• Dr.D.Anandhi,
Asst Professor/
Research Scientist,
Dept of Biochemistry, CRL,
Meenakshi Ammal Dental College,
 Introduction
• CHD is defined as gross structural abnormality of the heart and great
vessels
• Most of the heart defects obstruct the blood flow in the heart and
vessels or causes blood to flow through the heart in abnormal pattern
• CHD are structural problems that arise from abnormal formations of
the heart or major blood vessels .
• Defects range from in severity from tiny pinholes between chambers
that may resolve spontaneously to major malformations that require
multiple surgical procedures
• The foetal heart begins to develop shortly after conception. During
development ,structural defects can occur .These defects can involve
the walls of heart ,the valves of heart and arteries and veins near the
heart .
• Congenital heart defects disrupt the normal flow of blood through the
heart
• The blood flow can
• Slow down
• Go in wrong direction or to the wrong place
• Can be blocked completely
 Review of literature
• Congenital heart disease is the most frequent occurring congenital disorder responsible
for 28percent of congenital birth defects .The birth prevalence of CHD is reported to be
8-12/1000 live births .
• Congenital heart disease (CHD) is the most frequently occurring congenital disorder,
responsible for 28% of all congenital birth defects. The birth prevalence of CHD is
reported to be 8-12/1000 live births . Considering a rate of 9/1000, about 1.35 million
babies are born with CHD each year globally .
• With rapid advances in diagnosis and treatment of CHD, vast majority of children born
with CHD in high-income countries reach adulthood. However, this is not the case for
children born in low- and middle-income countries (LMIC) as such advanced care is not
available for all children.
• Considering a birth prevalence as 9/1000, the estimated number of children born with
CHD every year in India approximates 240,000, posing a tremendous challenge for the
families, society and health care system. (Anita Saxena,2019)

•
 Need of the study
• The prevalence of congenital heart disease is 8-12 % per 1000 births in India
Though there are several advances in medical and surgical management, the pre-
existing state of nutrition, is one aspect of congenital disease that has received
little attention.(Valithyan etal.,2019)

• Literature review also states that children with congenital heart disease are often
small and undernourished .It may be due to low calorie intake, type of cardiac
lesions, chronic hypoxmia, hyper metabolism and malabsorption . (Rabab
etal.,2008)
• The nutritional assessment is one of the major tool in assessing the nutritional
status over a period of time
 AIM
• To assess the nutritional status in patients with congenital heart
disease
 Objectives
1. To assess the anthropometrical parameters in patients with congenital
heart disease

2. To evaluate the biochemical parameters in patients with congenital

heart disease

3. To assess the nutrient intake in patients with congenital heart disease

4. To evaluate the role of nutritional counseling in patients congenital

heart disease
 Materials and methods
Patients to be selected on the basis of clinical and laboratory examinations
including
 electrocardiography
• echocardiography
Exclusion Criteria
• Patients with a history of prematurity ,intrauterine growth retardation
,known genetic malformation ,Dysmorphic features and neurologic
disability were excluded
• Sample size -100 patients with congenital heart disease
• Age group -1month to 10 years of age both male and female
• Place of Study – The Madras medical Mission, Mogappair, and Chennai 37
 1.SELECTION OF CONGENITAL HEART DISEASE PATIENTS

2.EVALUATION OF ANTHROPOMETRIC PARAMETERS

3.BIOCHEMICAL ASSESSMENT
BBBBBIOFVCHB3UUU

4.DIETARY GDGD
ASSSESSMENT
 2.EVALUATION OF ANTHROPOMETRIC PARAMETERS

HEIGHT WEIGHT MIDARM CIRCUMFERENCE HEAD CIRCUMFERENCE SKINFOLD THICKNESS

 BIOCHEMICAL ASSESSMENT

BIOCHEMISTRY HEMATOLOGY ELECTROLYTES INFAMATORY MARK THYROID FUNCTION

C-Reactive protein T-3

Serum creatnine haemoglobin calcium
magnesium T-4
urea platelets
Total protein sodium TSH

albumin potassium
Vitamin D
Vitamin B12
Folic acid
 Dietary Assessment
• The dietary history of the patients has to be taken by interviewing the
child’s mother using 24 hour recall method
• The nutrient content of carbohydrate ,proteins and fats are calculated

• Nutritional Counseling has to be given to the patient’s parents giving the

importance of balanced diet and inclusion of all the basic 5 foods groups.

• Parents were provided with individualized diet chart.

 Reference
• 1.M Mitchell, R.W Logan ,J.C S Pollock ,M PG .Jamieson .Nutritional Status of
Children with Congenital Disease .Journal of Pediatrics 17 October 1994 ,Vol 2
• 2.Rabab Hasan Baaker*,Areege Abdul –Abass **,Ashraf Ahmad
Kamel***.Malnutrition Growth Status in Patients with Congenital Heart Disease
.The Iraoqi Post Graduate Medical Journal ,Vol .7,2, 2008.
• 3.Birguli Varan, Kursad Tokei ,Gonca Yilmax .Malnutrition and growth Failure in
cyanotic and acyanotic congenital heart disease with and without pulmonary
hypertension .Arch Dis 1999,81:49-52
• 4.Balu Vaidyanathan,Sreeparvathy .B.Nair ,K.R Sundaram * Uma .K.Babu ,K
Shivaprakash .Malnutrition in Children with Congenital Heart Disease (CHD) :
Determinants and short term Impact of Corrective Intervention .J.Indian Pediatrics
,Vol 45 ,July -17,2008
• 5.Vinod .K.Paul,Arvind Bagga , Text Book of Essential Pediatrics ,Eight Edition
,CBS Publishers &Distributors ,2013
• 6.Anitha Saxena “Congenital Heart Disease in India: A Status Report”I ndian
Pediatrics 2019;55:1075-1082