Wrong for adult cardiologists to treat pediatric patients, say doctors

In the absence of awareness on the existence of the super-specialised doctors, hundreds of children across the country are wrongly taken to adult cardiologists, say experts.

Kolkata: When 11-year-old Joydeb Rishi was diagnosed of a heart ailment, he was referred to an adult cardiologist by doctors. It was only a year after that his parents realised that what their son required was a pediatric cardiologist.

In the absence of awareness on the existence of the super-specialised doctors, hundreds of children across the country are wrongly taken to adult cardiologists, say experts. Finding a pediatric cardiologist isn't easy either, especially in smaller cities and towns.

Dr Subhendu Mandal, head of the department of pediatric cardiology at BM Birla Heart Research Centre in Kolkata, says there are only around a hundred such pediatric cardiologists like him all over India where 600 children are born each day with a heart disease.

"Adult cardiologists are just not trained nor equipped to handle children. They don't know the subject. I feel like a rare species myself as there are so little trained pediatric cardiologists," says Dr Mandal who did a two-year fellowship in pediatric cardiology from UK.

India's top cardiac surgeon Dr Devi Shetty agrees with him saying the difference between adult cardiology and pediatric cardiology is that of repairing a wall clock and a wrist watch.

"Pediatric cardiology requires a greater set of skills. This is what differentiates the men from the boys. But it's unfortunate that there are so little number of pediatric cardiologists in India," says Dr Shetty who runs the multi-specialty Narayana Health hospital chain.

According to statistics, every hundredth child born in India suffers from a congenital heart disease but not all require immediate medical intervention as complications may surface later on in life.

Dr Sreesha Maiya from Narayana Health City Bangalore says a major problem is also with the doctors who don't refer such cardiac cases to pediatric cardiologists.

"There is no law in the country which stops adult cardiologists from treating or even operating upon a pediatric patient," he laments.

What makes pediatric cardiology more complicated is the number of variations.

"There can be around 15,000 different types of cases as the arteries and the valve of the heart can come up in different and complicated ways. So we keep seeing something new and unusual most of the times," says the doctor.

Even when it comes to diagnosis, special equipment is needed for doing eco-cardiography of children.

"The equipments need specialisation for correct diagnosis in case of kids," says Dr Mandal adding that he sees many patients who miss the boat because of a late diagnosis as over 90 per cent of the problems are curable.

Symptoms may include a blue-ish colouration on the lips, tongue and fingernails, inadequate weight gain, problem in sucking and very rapid breathing.

To handle the large number of child cardiac cases, India needs an army of specially trained doctors.

"We need policy changes to increase the number of medical seats in the country. At present there are 50,000 undergraduate seats but only 14,000 post-graduate level seats. This is the biggest impediment in the growth of India's healthcare system. If this goes on like this then India would soon become a classic example of healthcare deterioration," says Dr Shetty.


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