Zakia, a 12-year-old chirpy girl from Afghanistan had a difficult childhood. For her parents, Zakia was a blessing to them and they were very happy at her birth. Like any other child, it was expected that Zakia will also grow the same way. She has two siblings and she loves to play with them. But she couldn’t keep up her energy and would get tired soon. She would feel breathless, had excessive sweating, and her face would have blue discoloration or cyanosis when she used to cry.
Her parents were worried and they took her to the local hospital for a check-up. Local doctors did a few tests on her and advised her to take bed rest. Test results showed that Zakia had a hole in her heart and that she urgently needed heart surgery. Her parents were devastated knowing about this. Also, they were concerned that already their daughter is so weak how will she cope up with heart surgery at such a tender age. They consulted other cardiologists in Afghanistan and every time they felt more disappointed and helpless.
Zakia’s mother said, “we were not fully convinced about the heart surgery which local doctors advised for our daughter. We were in a dilemma and due to the lack of proper healthcare facilities in Afghanistan our concerns were increasing. We were losing hope and were sad to know that the age when other kids go to school and play, why our daughter is not so fortunate to have a normal childhood!”
Support by MedX
Zakia’s condition was deteriorating, she used to breathe rapidly and was unable to eat properly. She would vomit often and also had irregular heartbeats. Her parents were losing hope but they continued their research to find a proper treatment option for Zakia. One of the local doctors recommended them to opt for medical tourism and visit a super specialty medical facility in some other country. To their luck, they came across MedX health assistance. They were surprised to know that such a facility is available and that they can consult with a specialist online from Afghanistan itself. MedX team helped Zakia and her parents. They arranged for a teleconsultation with a renowned pediatric cardiologist Dr. Manvinder Singh Sachdev from India. Zakia’s preliminary reports were also shared and after the consultation and reports study, Dr. Manvinder advised that Zaika should visit India for specialized care and course of treatment. They were assured by the MedX team of the world-class treatment for Zakia. Zakia’s parents were convinced and they agreed to visit India.
MedX team helped Zakia and her parents with the medical Visa and other requirements to make their stay in India comfortable.
The Treatment Plan in India
On their arrival, Zakia and her parents’ travel from the airport to the hospital was arranged by MedX and also their accommodation was booked in the vicinity of the hospital. Zakia was admitted under pediatric cardiologist Dr. Manvinder Singh Sachdev and renowned cardiac surgeon Dr. Sandeep Attawar at Fortis Research Memorial Institute, Gurgaon. Zakia’s main symptoms at the time of admission were breathlessness and cyanosis (bluish discoloration) on crying. She was admitted and evaluated in detail. She underwent a series of high-end investigations such as an electrocardiogram (ECG), chest x-ray to check for possible enlargement of the heart, and a 2-D echocardiogram to assess various aspects of heart function. Her investigation results showed her diagnosis as Truncus Arteriosus, Large Truncal VSD, And Moderate Truncal Valve Regurgitation. It means although she had a hole in her heart as per the doctors in Afghanistan, her condition was rare. Normally, two separate vessels are coming out of the heart. But in this rare defect, only one large blood vessel leads out of the heart. Also, there is a hole — known as a ventricular septal defect (VSD) — between the two lower chambers of the heart. As a result of Truncus Arteriosus, oxygen-poor blood that should go to the lungs and oxygen-rich blood that should go to the rest of the body are mixed. This creates severe circulatory problems.
If left untreated, Truncus Arteriosus can be fatal. Usually, surgery needs to be performed to repair such heart defects. But Zakia’s case was not easy, her heart was not strong enough to undergo such a complex surgery as she had pulmonary arterial hypertension (PAH). Because of the PAH, the blood vessels in her lungs were narrowed which interrupted the normal blood flow. Her heart had to work harder to pump blood. The extra effort eventually caused her heart muscle to become weak and frail.
Seeing her condition, the expert team of Dr. Sandeep Attawar decided that Zakia is not a suitable candidate for the truncus repair surgery. It was planned to manage Zakia’s defects through medical management. She was given diuretics, a type of medicine that increases the urine output to stop the collection of extra fluid in the body. She was also given ionotropic agents which helped to strengthen the heart’s contraction.
Zakia was constantly monitored and observed. The medications were strong and that is why Zakia was on a liquid and soft diet to overcome the weakness.
Life After The Treatment
After five days of continuous medication and observation, Zakia’s condition was reevaluated, and her heart function was monitored. She was showing improvement, there was no complaint of breathlessness. She was hemodynamically stable and symptomatically better. Hence, it was decided that she will be discharged with proper instructions on medication and diet control. She was also advised about the exercises which would help her in getting back her pace. It was recommended for her to do a regular check-up from a local cardiologist and exercise testing to be done to monitor the safe levels of physical exertion.
Zakia’s parents are happy with the care and treatment she received in India, expressing their feeling they said, “As parents, we want nothing more than to see our child fulfill her dreams, and enjoy her childhood. We are thankful to the MedX team and expert team of medical professionals at Fortis hospital. We feel overwhelmed to realize the importance of second opinions, had we not come across MedX we don’t know what would have happened to Zakia. Today, we are happy and look forward to seeing Zakia grow up as a normal child.”