What is a congenital heart defect?
A congenital heart defect is a condition that develops early in pregnancy. It may involve one abnormality or a combination
of abnormalities in the structure of a child’s heart. Some of the more common defects are:
Holes in the walls between the heart chambers
Abnormal valves
Abnormalities in the blood vessels entering or leaving the heart
In most cases, the cause of a congenital heart defect cannot be determined. In some, certain medications or infections, such
as rubella, contracted during pregnancy have been known to cause heart abnormalities.
Congenital heart defects are usually diagnosed before a child is enrolled at school.
Students with a congenital heart condition
Most children with simple heart defects do not require any special care when they attend school. Those with more complicated
heart defects, however, may show signs that occasionally require attention. These signs include:
Cyanosis. This is a blueness of the lips and nailbeds that may increase with exercise but will not bother the student. It
is caused by reduced oxygen in the blood flow to the lips and skin.
Increased fatigue. Children may tire more easily or may be short of breath after exercise.
Increased susceptibility to chest infections. Students may be more likely to get common respiratory infections such as bronchitis
and pneumonia. In some types of heart disease, too much blood reaches the lungs, making them more susceptible to infection.
Small size – Students with heart defects may be shorter or lighter than their classmates. Many children with congenital heart
defects have difficulty gaining weight.
What teachers need to know
It is important that teachers know the nature of a student’s heart condition and the implications it has for school activities.
Parents, cardiology clinic nurses, and physicians can provide you with information about the student’s health, permitted activity
level, medications, and future treatment.
For example, if there are only five minutes between classes but a child with a heart condition needs ten minutes to travel
from one class to another, arrangements should be made to give the child the extra time to get to class and not be penalized
for taking a few extra minutes.
Your student’s permitted activity level
Permitted activity levels are determined by your student’s physicians. Ask the parents if the student has any activity restrictions.
In general, activity restrictions are graded in the following manner:
Full – The student is allowed to exercise at will and participate fully in all sports.
No competitive sports – The student is allowed to exercise but is not allowed to participate in races, organized games or
team sports
Restricted – Please obtain specific guide-lines from your student’s parents.
If you have any questions about any activity restrictions, please contact the child’s parents or speak to the staff at the
child’s cardiology clinic.
Your student’s medications
Medication is usually taken at home. In cases where children need to take some medication while at school, arrangements should
be made between school board officials, your student’s physician and the parents. As the teacher, you should be kept informed
of the medications your student is taking and of their specific purpose.
Your student’s future treatment
Continuing contact with your student’s parents will keep you informed about plans, if any, for a student’s future hospitalization.
This information can help you identify and respond to the child’s needs and concerns. The prospect of hospitalization and/or
surgery may create anxiety, which sometimes results in changes in behaviour and performance at school.
What to do if your student is going for surgery
To help your student before surgery, you may want to discuss with the child’s parents the date of surgery, the reason for
it, the proposed length of hospitalization, and the time needed to recover before the student returns to school. You should
know what specific information your student about the coming surgery, and whether it is all right for you to discuss the surgery
with the student or classmates.
If you have any questions about preparation for surgery for your student or about what to say to classmates, you should speak
with staff at the student’s cardiac clinic. Many cardiac clinics have a teacher on staff to help child patients keep up with
their schoolwork. If your student is going to be in hospital longer than two weeks, continuation of schoolwork can be arranged.
A student in hospital can benefit from contact with his or her classmates. It can take the form of get-well cards or audio
cassettes sent to the hospital, or visits once the patient has returned home. Students over the age of twelve may be able
to visit a classmate in hospital. Please check with the parents of the hospitalized child before visiting or suggesting visits.
What you should know after your student’s surgery
Generally, children recover at home for about two weeks following heart surgery. A gradual return to school and other normal
activities is usually the recommendation. For example, a student may initially attend classes for half days for the first
few days back at school.
Possible behavioural changes
You may see an improvement in the colour and/or activity level of your student after surgery. It is important for you to discuss
with parents and the cardiology clinic nurse any changes in the limitations placed on the student’s activities. You may encounter
some behaviour changes when your student returns to school. These changes may occur in response to hospitalization and surgery
and are usually temporary. Some children will require more of your time and attention than before surgery. Others experience
nightmares and disrupted sleep patterns, and tire more quickly than usual – all of which may affect their school behaviour.
Possible physical and mental effects due to surgery
Depending on the type and difficulty of the surgery, some students may experience special-visual deficits, neurological impairments
or gross and fine motor delays. This may be more common following open-heart surgery. These deficits can affect a child’s
everyday functioning, and social and emotional well-being. Prompt identification of deficits in any of these areas can lead
to early interventions and improved outcomes.
Support from teachers and the school board
Students with congenital heart disease need your support to develop their full academic potential, since physical limitations
may exclude them from certain types of employment. Your help is essential. If a student has any special needs arising from
a cardiac problem, he or she should be referred for review by the appropriate school or board committee. Please discuss your
student’s needs with the parents and the cardiac clinic nurse as well.
Review
A heart condition will often have some impact on a student’s performance at school, both in and out of the classroom.
Teachers should be aware of any restrictions on physical activity a student has because of a heart condition.
Teachers should understand that heart surgery will be disruptive to the students school work and may also have other physical
and behavioural effects.
By co-ordinating with other such as the students parents and staff at the child’s cardiac clinic, teachers can help children
with heart conditions succeed.
