Dr. Yuttapon Tiaram
Dr. Yuttapon Tiaram earned his Doctor of Medicine degree from the Faculty of Medicine, Siriraj Hospital, Mahidol University. He subsequently pursued advanced training in Pediatrics and Pediatric Cardiology at the same institution. Reflecting on his education and professional journey, Dr. Yuttapon shared
Choosing Pediatrics and Pediatric Cardiology
“As a physician, I had the opportunity to care for patients in many different wards. When I began working in the pediatric ward, I found children truly endearing. Examining young patients brought me genuine joy, and interacting with them—especially when they were unwell—naturally evoked a deep sense of compassion.
Seeing children recover and return to their cheerful selves was heartwarming in a way that is uniquely special. These experiences ultimately inspired me to choose pediatrics as my specialty.”
During his training, Dr. Yuttapon encountered a large number of pediatric patients with heart disease. Congenital heart disease is relatively common, occurring in approximately 8 out of every 1,000 births. While many children have a good prognosis, some present with severe symptoms such as difficulty breathing, extreme fatigue, and pallor, which can be challenging to manage.
“What makes this field especially rewarding is seeing how dramatically children can improve. Once they recover—whether through surgery or medication—they often return to being active, healthy children. Witnessing that transformation brings me immense happiness and pride as a doctor.”
Treatment of Pediatric Heart Diseases
Pediatric heart conditions can generally be divided into two groups: congenital heart diseases, which are present from birth, and acquired heart diseases, which develop later in life. Some conditions can be cured, while others can be well controlled, allowing children to live near-normal lives with ongoing monitoring.
Dr. Yuttapon explained:
“All pediatricians can manage general pediatric conditions. However, at Phyathai Sriracha Hospital, we have a dedicated Pediatric Cardiology Clinic that focuses specifically on heart-related conditions. In addition to cardiology care, I also provide general pediatric services, such as routine check-ups and vaccinations.”
Warning Signs of Heart Disease in Children
After birth, pediatricians routinely assess infants’ health. If warning signs suggest a possible heart condition—such as abnormal heart sounds, fatigue, low oxygen levels, or bluish or greenish skin discoloration—the child is referred for further evaluation.
Some heart conditions may not be evident at birth but become noticeable after routine vaccinations at 1, 2, or 4 months of age. In these cases, pediatricians refer patients to Dr. Yuttapon for detailed cardiac evaluation and diagnosis of potential congenital heart disease.
Acquired Heart Diseases in Children
Not all pediatric heart diseases are present from birth. Some develop later in childhood, including:
Kawasaki disease, an inflammatory condition affecting the heart and blood vessels, characterized by prolonged fever, red eyes, red lips, skin peeling on the hands, and rash.
Rheumatic heart disease, caused by bacterial infection and often associated with family history. Symptoms may include fever, joint pain and swelling, subcutaneous nodules, skin rash, fatigue, and shortness of breath.
“If any of these symptoms are observed, parents should seek medical attention promptly.”
Two Memorable Pediatric Cardiology Cases
Case 1: A Newborn with Severe Cyanotic Heart Disease
One infant appeared healthy at birth but, around ten days later, developed continuous crying, pallor, and critically low oxygen levels of only 60%. Initial emergency treatment included fluids, oxygen, and medication, but the baby’s condition remained unstable, with low blood pressure and suspected infection.
Further treatment included medication to keep the patent ductus arteriosus (PDA) open to improve blood flow to the lungs, as well as drugs to support heart function. An echocardiogram later confirmed cyanotic congenital heart disease.
Given the infant’s very young age (10 days) and low body weight (2.7 kg), Dr. Yuttapon coordinated care with a specialized surgical team at Chulalongkorn Hospital. The baby underwent surgery to create an artificial blood vessel to improve pulmonary blood flow.“Today, the child is safe, with stable oxygen levels. I feel proud to have been involved in the initial diagnosis, emergency care, and referral that ultimately saved this child’s life.”
Case 2: Acute Myopericarditis in an Older Child
Another notable case involved an older child who presented with chest pain, palpitations, near-fainting, and fatigue. Further evaluation revealed acute myopericarditis, resulting in reduced heart function. Although the child had been previously healthy, the diagnosis was understandably distressing for the family.
After careful explanation, treatment with intravenous immunoglobulin (IVIG) was initiated, and the child was admitted to the ICU for close monitoring overnight. The condition improved steadily, and the child has since made a full recovery, returning to normal daily activities without residual heart inflammation.
Comprehensive Care and Advanced Diagnostic Technology
In addition to clinical expertise, the Pediatric Cardiology Clinic utilizes advanced diagnostic tools, including echocardiography, exercise stress testing (treadmill or bicycle), and 24-hour Holter monitoring, which allows continuous heart rhythm assessment at home before data interpretation by the physician.
Beyond technology, Dr. Yuttapon emphasizes that careful examination and attentive care remain essential.
“To be a pediatrician, one must have true passion, compassion, patience, and precision. Young children—especially infants—cannot describe their symptoms. Doctors must rely on observation, physical examination, and information from caregivers. Psychological skills are equally important to gain a child’s trust and cooperation, as hospitals can naturally make children anxious.”
Long-Term Care for Children with Heart Disease
In general hospitals, pediatricians care for children from birth until around 15 years of age. However, children with heart disease—particularly congenital conditions—often require long-term follow-up into adulthood.
“Heart disease in children differs significantly from adult heart disease. While adults commonly develop problems related to coronary arteries or heart muscle function, children usually have structural heart abnormalities. For this reason, pediatric cardiologists continue to provide ongoing care as these patients grow, ensuring continuity and the best possible outcomes.”
