Heart disease in children
Heart disease is difficult enough when it strikes adults, but it can be especially tragic in children.
Many different types of heart problems can affect children. They include congenital heart defects, viral infections that affect the heart, and even 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 (CHD) is a type of heart disease that children are born with, usually caused by heart defects that are present at birth. In the U.S., an estimated
CHDs that affect children include:
- heart valve disorders like a narrowing of the aortic valve, which restricts blood flow
- hypoplastic left heart syndrome, where the left side of the heart is underdeveloped
- disorders involving holes in the heart, typically in the walls between the chambers and between major blood vessels leaving the heart, including:
- tetralogy of Fallot, which 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
- 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 buildup of fat and cholesterol-filled plaques inside arteries. As the buildup increases, arteries become stiffened and narrowed, which increases the risk of blood clots and heart attacks. It typically takes many years for atherosclerosis to develop. It’s unusual for children or teenagers to suffer from it.
However, obesity, diabetes, hypertension, and other health issues put children at higher risk. Doctors 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. This can cause the heart to pump less efficiently.
Many different types of arrhythmias may occur in children, including:
- a fast heart rate (tachycardia), the most common type found in children being supraventricular 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.
Kawasaki disease is a rare disease that primarily affects children and can cause inflammation in the blood vessels in their hands, feet, mouth, lips, and throat. It also produces a fever and swelling in the lymph nodes. Researchers aren’t sure yet what causes it.
According to the American Heart Association (AHA), the illness is a major cause of heart conditions in as many as 1 in 4 children. Most are under the age of 5.
Treatment depends on the extent of the disease, but often involves prompt treatment with intravenous gamma globulin or aspirin (Bufferin). Corticosteroids can sometimes reduce future complications. Children who suffer from this 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. Often it’s harmless. Other times it may signal an underlying cardiovascular problem.
Heart murmurs may be caused by CHDs, fever, or anemia. If a doctor hears an abnormal heart murmur in a child, they’ll perform additional tests to be sure the heart is healthy. “Innocent” heart murmurs usually resolve by themselves, but if the heart murmur is caused by a problem with the heart, it may require additional treatment.
This condition occurs when the thin sac or membrane that surrounds the heart (pericardium) 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 CHD, or it may be caused by bacterial 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.
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 valves and the heart muscle (by causing heart muscle inflammation, known as myocarditis). According to Seattle Children’s Hospital, rheumatic fever typically 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. Rheumatic fever and subsequent rheumatic heart disease are now uncommon in the U.S.
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 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.