दिल में छेद जन्मजात हृदय दोष के एक प्रकार के लिए एक चिकित्सा शब्द है। ये हल्के दोष या गंभीर दोष हो सकते हैं। जन्मजात दिल के छेद का इलाज दोष के प्रकार पर निर्भर करता है। गंभीर दोषों के मामले में, बच्चे को जीवित रहने में सक्षम होने के लिए पहले वर्ष के भीतर इलाज की आवश्यकता होती है। दिल में छेद जन्म से मौजूद होते हैं और बच्चे पर उनके प्रभाव के आधार पर बच्चे की यात्रा के विभिन्न चरणों में लक्षण के रूप में सामने आ सकते हैं।
हल्के दोष जो बच्चे को कोई परेशानी नहीं देते हैं, लक्षण दिखाई नहीं दे सकते हैं या जीवन में बाद के चरणों में दिखाई दे सकते हैं। गंभीर दोषों में, लक्षण जन्म के समय ही दिखाई दे सकते हैं। 20 सप्ताह में किए गए भ्रूण विसंगति स्कैन के दौरान बड़े छेद दिखाई दे सकते हैं। यदि ऐसा होता है तो यह मेडिकल टीम को बच्चे के जन्म के साथ ही आवश्यक दिल के छेद का इलाज के कदम उठाने के लिए तैयार करने में सक्षम बनाता है।
चूंकि जन्म के समय दिल में छेद होता है, इसके सटीक कारण अभी तक स्थापित नहीं किए जा सके हैं। कुछ ऐसे कारक हैं जो बच्चे को हृदय दोष विकसित कर सकते हैं :
1) जेनेटिक्स: कई मामलों में जेनेटिक्स हृदय दोष के साथ पैदा होने वाले बच्चों में प्रमुख भूमिका निभाते हैं। डाउन सिंड्रोम, टर्नर सिंड्रोम जैसी कुछ अनुवांशिक स्थितियां जन्मजात हृदय दोषों से निकटता से जुड़ी हुई हैं।
2) कुछ संक्रमणों का जोखिम: रूबेला और खसरा जैसे संक्रमणों के लिए गर्भवती माँ के संपर्क में आने से भ्रूण को जन्मजात हृदय दोष के साथ पैदा होने की संभावना होती है। इसलिए सभी गर्भवती महिलाओं को दोनों बीमारियों का टीका लगवाने की सलाह दी जाती है।
3) धूम्रपान और शराब पीने के संपर्क में आना: गर्भावस्था के दौरान धूम्रपान या शराब पीने वाली माँ से भ्रूण में जन्मजात हृदय दोष विकसित होने का खतरा बढ़ सकता है।
4) मधुमेह: जो महिलाएं टाइप 1 या टाइप II मधुमेह से पीड़ित हैं, उनमें जन्मजात हृदय दोष वाले बच्चे को जन्म देने का जोखिम उन महिलाओं की तुलना में अधिक होता है जिनके पास नहीं है।
5) दवाइयां: गर्भावस्था के दौरान मां द्वारा कुछ दवाओं का सेवन करने से भ्रूण में जन्मजात हृदय दोष विकसित होने का खतरा बढ़ सकता है। इन दवाओं में इबुप्रोफेन, कुछ मुँहासे दवाएं जैसे आइसोट्रेटिनॉइन और एंटी-जब्त दवाएं शामिल हैं।
6) विषाक्त पदार्थों के संपर्क में आना: मां को नेल पॉलिश, गोंद और पेंट जैसे विषाक्त पदार्थों के संपर्क में आने से भी उसके जन्मजात हृदय दोष वाले बच्चे को जन्म देने का खतरा बढ़ जाता है।कई मामलों में गंभीर जन्मजात हृदय दोषों का गर्भावस्था के दौरान या जन्म के ठीक बाद निदान किया जा सकता है क्योंकि गंभीरता के कारण लक्षण पहले दिखाई देते हैं।
दुग्ध दोषों के मामले में, लक्षण बाद में स्वयं प्रकट हो सकते हैं। पहले निदान और दिल के छेद का इलाज, बच्चे के लिए सामान्य जीवन जीने में सक्षम होने का मौका उतना ही अधिक होगा।
इलेक्ट्रोकार्डियोग्राम, पल्स ऑक्सीमेट्री, एक्स रे और कार्डियक कैथीटेराइजेशन जैसे परीक्षणों का उपयोग करके जन्मजात हृदय दोषों का निदान किया जा सकता है। एक बार निदान हो जाने के बाद यह सुनिश्चित करने के लिए एक अच्छे बाल रोग विशेषज्ञ से जुड़ना महत्वपूर्ण है कि बच्चे को वह उपचार मिले जिसकी उसे आवश्यकता है।
जन्मजात हृदय दोष का उपचार दोष के प्रकार और गंभीरता पर निर्भर करता है। व्यापक रूप से बोलते हुए, जन्मजात हृदय दोष के इलाज के मुख्य तरीके हैं:
1) दवाइयां: जन्मजात हृदय दोष के लक्षणों के उपचार के लिए रक्तचाप की दवाएं, मूत्रवर्धक और अतालता रोधी दवाओं का उपयोग किया जाता है। ये शायद अलगाव में या एक प्रक्रिया के साथ उपयोग किए जाते हैं।
2) कार्डिएक कैथीटेराइजेशन : यह एक गैर-सर्जिकल हस्तक्षेप है जहां पतली, लचीली ट्यूबों (कैथेटर) का उपयोग आमतौर पर कमर के माध्यम से डाला जाता है और हृदय में ले जाया जाता है। दोष को ठीक करने के लिए छोटे उपकरणों को कैथेटर के माध्यम से हृदय तक पहुँचाया जाता है। उदाहरण के लिए, कार्डियक कैथीटेराइजेशन का उपयोग दिल में छेद या संकुचन के क्षेत्रों को ठीक करने के लिए किया जा सकता है
3) हार्ट सर्जरी: कुछ दोषों के लिए बच्चे को उसी के इलाज के लिए ओपन हार्ट सर्जरी की आवश्यकता होगी।
हल्के हृदय दोषों के मामले में, दोष का बच्चे के विकास पर कोई दीर्घकालिक प्रभाव नहीं हो सकता है और ऐसे मामलों में बच्चे को किसी उपचार की आवश्यकता नहीं हो सकती है। हालांकि, दोष हल्का होने पर भी बाल रोग विशेषज्ञ के संपर्क में रहना महत्वपूर्ण है। समय पर निदान और दिल के छेद का इलाज के साथ, हृदय दोष के साथ पैदा हुए अधिकांश बच्चे अपने वयस्कता में अच्छी तरह से जी सकते हैं।
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