Heart disease is difficult enough when it strikes adults, but it can be especially tragic in children. There are many different types of heart problems that can affect children, from congenital heart defects to viral infections and heart disease acquired later in childhood due to illnesses or genetic syndromes. The good news is that with advances in medicine and technology, many children with heart disease go on to live active, full lives.
Congenital Heart Disease
Congenital heart disease is a type of heart disease that children are born with, usually caused by heart defects that are present at birth. In fact, the most common heart conditions found in children are structural heart defects, which occur in roughly eight of 1,000 live births. These usually involve a problem with the heart muscle or the heart valves and include:
- heart valve conditions, such as a narrowing of the aortic valve, or a mitral valve prolapse, in which the mitral valve leaks
- defects in the septum, the wall that separates the left and right sides of the heart
Other congenital heart defects that affect children include:
- hypoplastic left heart syndrome (HLHS), where the left side of the heart is underdeveloped
- holes in the heart, typically in the walls between the chambers and between major blood vessels leaving the heart. Examples include ventricle heart defects, atrial septal defects, and patent ductus ateriosus
- a combination of defects. For example, tetralogyof Fallot is a combination of four defects, including a hole in the ventricular septum, a narrowed passage between the right ventricle and pulmonary artery, a thickened right side of the heart, and a displaced aorta.
Congenital heart defects may have long-term effects on a child’s health. They’re usually treated with surgery, catheter procedures, medications, and in severe cases, heart transplants. Some children will require lifelong monitoring and treatment.
Atherosclerosis is the term used to describe the build-up of fat and cholesterol-filled plaques inside the arteries. As the build-up increases, arteries become stiffened and narrowed, which increases the risk of blood clots and heart attacks. Typically, it takes many years for atherosclerosis to develop, so it’s unusual for children or teenagers to suffer from it.
However, obesity, diabetes, hypertension, and other health issues put children today at higher risk than they used to be. Doctors now recommend screening for high cholesterol and high blood pressure in children who have risk factors like family history of heart disease or diabetes and are overweight or obese. Treatment typically involves lifestyle changes like increased exercise and dietary modifications.
An arrhythmia is an abnormal rhythm of the heart, which can cause the heart to pump less efficiently.
Many different types of arrhythmias may occur in children, including:
- a fast heart rate (tachycardia)
- a slow heart rate (bradycardia)
- Long Q-T Syndrome (LQTS)
- Wolff-Parkinson-White syndrome (WPW syndrome)
Symptoms may include:
- difficulty feeding
Treatments depend on the type of arrhythmia and how it’s affecting the child’s health.
Though not a type of heart disease specifically, this syndrome typically indicates a problem with the heart. Eisenmenger’s is actually a collection of three symptoms, including:
- cyanosis: pale blue or grayish skin due to decreased oxygen in the blood
- pulmonary hypertension: high blood pressure in the blood vessels of the lungs
- polycythaemia: excess number of red blood cells
This syndrome may affect adolescents and adults with certain congenital heart defects that were repaired later in life or were never repaired. However, it can also occur in newborns born with pulmonary hypertension.
Basically, Eisenmenger syndrome is a sign that the blood isn’t flowing correctly from the left to the right side of the heart. Left untreated, it can cause blood clots, stroke, and kidney failure.
Treatment usually depends on the symptoms and involves: medications to decrease pulmonary hypertension, supplemental oxygen, and sometimes phlebotomy (removal of blood to reduce the excess number of circulating red blood cells).
This is a rare disease that primarily affects children and can cause inflammation in the blood vessels in the hands, feet, mouth, lips, and throat. It also produces a fever and swelling in the lymph nodes. Scientists aren’t sure yet what causes it. However, it can affect the heart and blood vessels in about one in five children who have it.
According to the American Heart Association (AHA), the illness is a major cause of heart disease in children, affecting about 4,000 each year. Most are under the age of five. Treatment depends on the extent of the disease, but prompt treatment with IV gamma globulin, aspirin, and sometimes corticosteroids can reduce future complications. Children who suffer from the disease often require lifelong follow-up appointments to keep an eye on heart health.
A heart murmur is a “whooshing” sound made by blood circulating through the heart’s chambers or valves, or through blood vessels near the heart. Sometimes it’s harmless, but other times it may signal an underlying cardiovascular problem.
Heart murmurs may be caused by congenital heart defects, fever, or anemia. If a doctor hears a heart murmur in a child, typically they’ll perform additional tests to be sure the heart is healthy. “Innocent” heart murmurs usually resolve by themselves, but others may require additional treatment.
This condition occurs when the pericardium (the thin sac or membrane that surrounds the heart) becomes inflamed or infected. The amount of fluid between its two layers increases, impairing the heart’s ability to pump blood like it should. Pericarditis may occur after surgery to repair a congenital heart defect, or may be caused by infections, chest traumas, or connective tissue disorders like lupus. Treatments depend on the severity of the disease, the child’s age, and their overall health.
Rheumatic Heart Disease
When left untreated, the streptococcus bacteria that cause strep throat and scarlet fever can also cause rheumatic heart disease. This disease can seriously and permanently damage the heart muscle (myocarditis) and the heart valves. Most of the time, rheumatic fever occurs in children ages 5 to 15, but usually the symptoms of rheumatic heart disease don’t show up for 10 to 20 years after the original illness. This disease can be prevented by promptly treating strep throat with antibiotics.
Viruses, in addition to causing respiratory illness or the flu, can also affect heart health. Viral infections can cause heart muscle inflammation (myocarditis), which may affect the heart’s ability to pump blood throughout the body. Viral infections of the heart are rare and may show few symptoms. When symptoms do appear, they’re similar to flu-like symptoms, including fatigue, shortness of breath, and chest discomfort. Treatment involves medications and treatments for the symptoms of myocarditis.