Heart disease not just an adult problem — early checks could save Ghanaian babies, says Teddy Totimeh

Heart disease in children is far more common than many Ghanaians realise, and delayed diagnosis is quietly costing lives, Teddy Totimeh, a consultant neurosurgeon, has warned.

Speaking on the Asaase Breakfast Show on Thursday (19 February), Dr Totimeh said congenital heart defects affect roughly one in every 100 babies globally and account for about one-third of all birth abnormalities — making them the most common congenital condition.

“When we talk about congenital heart disease, it simply means the baby is born with the problem,” he explained. “It’s not rare. One in a hundred is quite a number.”

Recent surveys, he noted, suggest Ghana’s rate is also just under one percent, but poor data collection and late detection obscure the true scale of the problem.

Critical cases often missed

Dr Totimeh distinguished between two main groups: congenital heart disease that can be monitored over time, and critical congenital heart disease that requires surgery within infancy.

In Ghana, he said, babies in the latter category face grim odds.

“For babies who need surgery within the first month, mortality is almost 100%,” he said. “The biggest problem is delayed diagnosis.”

In many advanced health systems, newborns undergo routine oxygen saturation checks 24 hours after birth. If oxygen levels fall below 95%, further tests are conducted to detect hidden heart defects.

But in Ghana, many mothers and babies are discharged before 24 hours, especially after normal deliveries, meaning the crucial screening window is missed.

“We lose the opportunity to check,” he said. “Yet with that simple test, we could detect more than 90% of heart disease cases early.”

‘Hole in the heart’ most common

Using a house analogy, Dr Totimeh described the heart as a four-room structure with valves acting like doors and walls separating blood flow to the lungs and the rest of the body.

Problems arise when:

• valves fail to open or close properly, or

• walls develop holes, allowing blood to flow the wrong way.

“The most common one is what people call a hole in the heart,” he said.

These include atrial septal defects and ventricular septal defects. The latter is often more serious, sending too much blood to the lungs while starving the rest of the body of oxygen.

Untreated children may develop breathing difficulties, repeated infections and what doctors call “failure to thrive,” where growth is stunted.

“The baby just doesn’t grow well,” he said.

Watch for warning signs

Dr Totimeh urged parents to look out for early red flags, particularly in newborns and infants.

These include fast or laboured breathing, repeated chest infections, poor feeding, slow weight gain compared to siblings and bluish skin or lips.

“If a baby looks like they’re struggling to breathe, that is a red flag,” he stressed. “They must be checked.”

He also encouraged consistent attendance at child welfare clinics, noting that many families stop visits after the first year, missing opportunities for early detection.

Diagnosis available, specialists scarce

While diagnostic tools such as echocardiography and ECG tests are available at Ghana’s major hospitals, access to specialist care remains limited.

He said facilities like Korle Bu Teaching Hospital and Komfo Anokye Teaching Hospital have cardiothoracic teams capable of operating on children, but young patients must compete with adults for theatre space.

“What we really need are dedicated children’s cardiac services and hospitals,” he said. “These children shouldn’t have to compete with adult cases.”

A call for routine screening

Dr Totimeh emphasised that most congenital heart defects form within the first eight weeks of pregnancy and are present at birth — even if symptoms appear later.

The key, he said, is systematic screening rather than waiting for complications.

“Heart disease in children is not rare — it’s just less talked about,” he said. “If we check oxygen levels routinely after birth, we can save many lives.”

He urged health authorities to prioritise newborn screening and specialised paediatric cardiac care to prevent avoidable deaths.

“This is something we can detect early and treat,” he added. “We just have to look.”