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Pre-existing heart condition cause of death?

An underlying heart condition coupled with low grade fever could have led to cardiac arrest, say doctors

Gulf News

Dubai: A reduced level of oxygen at high altitude coupled with high temperature could have exacerbated a heart condition, causing arrhythmia (irregular heart beat) in the 11-month-old baby Rishi Priya who died on board a flight to Bahrain, say doctors.

A relative of the family revealed that the infant had pneumonia when she was four or five months old and was diagnosed with a heart condition for which she had been operated five months ago.

Rishi Priya was aboard a Gulf Air flight from Kochi to Manama when her shivering and breathlessness caused the aircraft to make an emergency landing at Abu Dhabi International Airport on Monday. She was rushed to Mafraq Hospital but was declared dead on arrival. The baby was accompanied by her mother, Aswani, and was on her way to join her father, Binoy Mundakkal.

Dr Vidya Narayanan, Specialist Paediatrician at Prime Hospital, said that although she does not have knowledge of the baby’s heart condition, she could say that it was likely that the infant was in stages of heart repair. “It is likely the heart condition may have led to reduced oxygen saturation. Usually, when infants are born, their oxygen saturation is low, but reaches 98 per cent soon. Even a 95 per cent saturation is fine. It is likely the baby had a synotic heart condition where the pure and impure blood was mixing. Heart surgeons usually do stage repairs in infants and it is likely a heart surgeon might have done only first stage intervention.”

Dr Narayanan attributed the death to a possible imbalance in heart rhythms: “On a flight, oxygen levels are comparatively lower and if the baby suffered an imbalance in heartbeats triggered by her temperature, it is likely the low oxygen outside and the low oxygen saturation in her blood may have caused difficulty in breathing and triggered a sudden cardiac arrest.”

The post mortem report of the baby stated the cause of death as Sudden Infant death Syndrome (SIDS) and Dr Narayanan said it would be very difficult to ascertain the true cause given her condition.

Dr Vivek Mehta, Senior Specialist Paediatrician at RAK Hospital, told Gulf News: “SIDS happens in the case of infants as young as one or two months and is unusual in the case of an infant older than a year. If an infant had a heart condition for which she required a surgery, then it is likely she suffered from congenital heart disease. Low-grade fevers cannot really cause death and it is likely the baby had some lower respiratory conditions that were compounded with her heart condition. I am surprised that a baby with a history of heart condition was allowed to fly.”

Dr Mehta added that many infants were turning up with undiagnosed heart conditions and the Abu Dhabi government has made it mandatory to screen all infants for heart conditions. “We check the oxygen saturation in the hands and legs of babies and I hope this screening is made mandatory in all emirates.”

Dr Mehta also felt that it is was important to standardise the ‘fit to fly’ certification which should be made mandatory in cases of infants and very old people. “All airlines need to train their staff in administering cardio pulmonary resuscitation (CPR) to passengers of all ages and also have oxygen masks small enough to fit a one-year-old.”