The term “heart disease” describes a wide range of conditions affecting the cardiovascular system of both adults and children. Even if we limit our attention to children, it still covers a broad spectrum of conditions, from those with no symptoms or diagnosis to immediately visible and possibly fatal.

This article provides a useful starting point if you want to learn more about a specific condition and its symptoms, progression, and treatment options. We also extensively cover congenital (existing at birth) and acquired (obtained later in life) disorders. Read for more details!

Understanding Heart Disease in Children

Children are vulnerable to a wide range of heart conditions. The following are among them:

  • Congenital defects or disease of the heart present at birth
  • Infections of the heart caused by viruses
  • Cardiovascular disease develops later in life due to an external factor, such as an infection or a hereditary condition.

Fortunately, contemporary medical treatments have enabled many youngsters diagnosed with heart illness to lead productive everyday lives.

Simply put, heart disease in children can be categorized into two; congenital defects and those acquired diseases.

Congenital Heart Disease in Children (CHD)

The term “congenital heart defect” refers to an issue in the heart’s structure that is present at birth. They are prevalent; in fact, about 1% of newborns in the United States are diagnosed with congenital heart disease each year.

There are cases of congenital cardiac disease in children that are so minor that they don’t require any treatment. However, more severe forms of congenital cardiac disease in children may necessitate a series of operations spread over several years.

To better comprehend your kid’s congenital heart problem and prepare for the future, educating yourself about the issue is essential.

Image alt text: pediatric heart disease. A flow chart for stroke response time.

Author credit: By No machine-readable author provided. Webber assumed (based on copyright claims). – No machine-readable source provided. Own work assumed (based on copyright claims)., Public Domain, https://commons.wikimedia.org/w/index.php?curid=1571159

How do you know when your kid has congenital heart disease?

Signs and symptoms of congenital defects in children

Watch out on these signs and symptoms:

  • Short, shallow breaths
  • Swelling of the feet, hands, face, or hands
  • Lips, tongue, and fingernails that are bluish-gray or gray (cyanosis)
  • Difficulty breathing during feedings, resulting in insufficient growth

There is a possibility that less severe congenital cardiac abnormalities won’t be identified until much later in infancy. Some of the symptoms and signs of congenital cardiac abnormalities in older children are:

  • Edema of the extremities
  • Palpitations during Physical Activity
  • Quick to fatigue through physical activities
  • Experiencing difficulty in breathing during physical exertion

What causes congenital heart illnesses?

Knowing how the heart usually functions can help understand the factors that lead to the development of congenital cardiac abnormalities.

Here’s how CHD develops:

A baby’s developing and beating heart can be seen as early as the sixth week of pregnancy. This is also a crucial period for developing the main blood arteries that supply and drain the heart.

There is an increased risk of congenital heart abnormalities beginning at this stage of fetal development. Most of these problems have an unknown etiology. Still, scientists suspect that heredity, illness, medication, and even things like smoking all play a part.

Types of Congenital Heart Diseases

Congenital cardiac abnormalities come in a wide variety of forms. They can be grouped into the broad classes shown below.

  • Altered connection
  • Valve problems
  • Combination of defects

Abnormalities of the heart’s valves at birth

The heart’s valves function as passageways between the heart’s chambers and the arteries and veins. And they are responsible for controlling blood flow. Blood flow is disrupted when the valves don’t open and close properly.

These are some common types of congenital cardiac valve defects:

  • Ebstein anomaly: tricuspid valve, which connects your right atrium to the ventricle, is typically faulty and causes leakage between the two chambers of the heart on the right side of the body.
  • Stenosis of the pulmonary artery: When blood flow is slowed by a defect on or close to the pulmonary valve, the condition is known as pulmonary stenosis.
  • Aortic stenosis: Birth defects include aortic valves having less than the typical three cusps. Because of this, the blood passageway becomes narrower and smaller. The heart has to work harder to push blood through the obstructed valve. The heart eventually swells, and the cardiac muscle thickens due to this.

Altered connection in the blood vessels

Physiologically impossible blood flow has been made possible by rerouting the vessels. One form of this congenital heart disease manifests as a wall opening separating two heart chambers.

Blood low on oxygen might mix with blood high on oxygen if the link is disrupted. It decreases the quantity of oxygen that the body receives. Lungs and the heart have to work harder to compensate for the shift in blood flow.

Heart and blood vessel abnormalities can take the form of:

  • Atrial septal defect
  • Ventricular septal defect
  • Partial or total anomalous PV connection

Combination of defects

Many congenital cardiac abnormalities can significantly impact the development and health of the heart, and some newborns are born with more than one. Significant alterations to blood flow or underdeveloped heart chambers may result from highly complex heart issues.

In the case of tetralogy of Fallot, for instance, four separate cardiac abnormalities are present at birth:

  • Thickening of the Right ventricular muscle
  • Constriction of the tube connecting the right ventricle to the pulmonary artery
  • Disruption of the aortic arch’s original link to the pumping chamber of the heart
  • Separation of the lower chambers of the heart via a hole in the heart’s wall (ventricles)

Here are some of the combined consequences of congenital defects:

Pulmonary atresia: Pulmonary valve malformation refers to the abnormal valve development that controls blood flow from the heart to the lungs. Normal circulation of blood to the lungs to pick up oxygen is compromised.

Tricuspid atresia: Lack of development of the tricuspid valve. This is because no blood flows freely between the ventricle-right atrium and the right ventricle. Therefore, the baby’s right ventricle is underdeveloped, and blood flow is restricted due to this congenital heart abnormality.

Image alt text: pediatric heart disease. An illustration of atrial fib stroke in young children.

Author credit: By National Heart Lung and Blood Institute (NIH) – National Heart Lung and Blood Institute (NIH), Public Domain, https://commons.wikimedia.org/w/index.php?curid=29590099

Syndrome of the underdeveloped left ventricle (hypoplastic left heart syndrome). The development of a significant portion of the heart is disrupted. When a person has hypoplastic left heart syndrome, the heart’s left ventricle doesn’t fully form, preventing it from delivering the necessary blood volume and pressure to the rest of the body.

What Are The Risk Factors Of Congenital Heart Defects?

Prenatal abnormalities in heart development account for most congenital heart problems. Although most cases of congenital cardiac abnormalities have an unknown etiology, researchers have found certain potential risk factors. Other possible causes of congenital heart abnormalities are:

Diabetes; Congenital cardiac abnormalities are less likely to occur when a woman’s blood sugar is carefully monitored before and throughout pregnancy. Infants with gestational diabetes are not at higher risk for congenital cardiac disease than those without the condition.

Pregnancy-related alcohol consumption. Studies have shown that if a mother drinks alcohol while pregnant, her unborn child is likelier to be born with a heart abnormality. Medications.

Medications; Statins, several anti-anxiety medications, thalidomide, and the acne medication isotretinoin have all been linked to birth malformations, including congenital heart problems, when taken during pregnancy.

When attempting to conceive, you must inform your doctor of all the medications you’re currently taking.

Genetics or family history; A genetic syndrome may cause congenital cardiac abnormalities when they repeatedly occur in a family. Congenital defects are common among children with Down syndrome, which results from an additional 21st chromosome.

You must also quit smoking as it increases your child’s likelihood of having congenital defects.

What Constitutes a Need for Medical Attention?

Most children with serious congenital cardiac abnormalities are identified before or shortly after birth. Your baby must see a doctor if you observe any of the aforementioned symptoms.

If you see any of the symptoms associated with less severe heart problems during your child’s development, don’t hesitate to contact your child’s doctor. Your child’s doctor can tell you if their symptoms are related to a heart abnormality or something else.

How can you prevent congenital defects?

Now that you know the root causes and potential dangers, you can take the necessary precautions. The incidence of birth abnormalities can be reduced by taking the following precautions.

  • Seek out appropriate prenatal care: Seeing a doctor regularly throughout pregnancy is essential for the health of both the mother and the child.
  • Manage your glucose levels: Careful management of blood sugar levels can lessen the likelihood of developing congenital cardiac abnormalities in those with diabetes.
  • Take care of persistent illnesses: It’s important to discuss treatment and management options with your doctor if you have multiple chronic health issues.
  • Consult with your doctor before taking any medication: There is evidence that some drugs can affect fetal development. Discuss your drugs, even those you’ve purchased legally over the counter, with your doctor.
  • Don’t light up or drink. A baby’s health can be negatively affected by these types of choices in parenting. Avoid exposure to secondhand smoke as much as possible.

Acquired Heart Disease in Children

Apart from congenital disabilities, your child may also have several acquired pediatric heart diseases.

Acquired heart defects in children are cardiac conditions that appear later in childhood. An infection, an immunological reaction, or other factors can bring them on. The most frequently seen congenital cardiac abnormalities in children are:

Kawasaki Disease

This is a highly unusual syndrome in which the immune system mistakenly destroys healthy tissue. As a consequence, the coronary arteries and heart muscles become inflamed.

Heart problems caused by Kawasaki illness are potentially fatal because coronary artery dilatation cuts off blood flow to the heart. Short-term or long-term involvement of the coronary arteries increases the risk of thrombosis, angina, and myocardial infarction.

How do you know if your child has Kawasaki disease?

Signs and symptoms of Kawasaki:

Kawasaki illness can cause a variety of symptoms;

  • Finger and toe swelling and redness
  • Rashes on the skin that are not irritating, accompanied by skin and fingers peeling
  • Eyes that are red and swollen due to inflammation are sometimes known as “bloodshot eyes.”

The severity of the disease determines the course of treatment, which may include intravenous gamma globulin. Subsequent problems may be lessened with corticosteroids in some cases. Children with this condition often need regular checkups for the rest of their lives to monitor their heart health.

Myocarditis

These conditions encompass a spectrum in which the heart’s structure is unaltered. Still, the muscle’s ability to contract and operate abnormally causes symptoms. With myocarditis comes inflammation or swelling of your heart muscle, which can cause a temporary loss of cardiac function and heart failure and is often the result of a viral infection.

If left untreated, myocarditis can lead to dilated cardiomyopathy, characterized by a dramatic reduction in cardiac pumping capacity and a dramatic enlargement of the heart. Temporarily, medicines can help with dilated cardiomyopathy. Still, ventricular assist systems or heart transplants may be necessary for difficult situations.

Myocarditis, and other cardiac virus infections, are uncommon and may present with a few apparent symptoms like; shortness of breath, fatigue, and chest pain.

An Abnormal Heartbeat, Or Murmur

One definition of a heart murmur is the “whooshing” sound produced by blood moving through the heart’s chambers or valves or the veins surrounding the heart. It’s usually not dangerous. Sometimes it’s a symptom of something more serious, like heart disease.

Congenital heart defects (CHDs), fever, and anemia are all potential causes of a heart murmur. A child’s heart will undergo additional testing to ensure its health if a doctor detects an abnormal cardiac murmur. In most cases, heart murmurs clear up without any therapy. Still, medical intervention may be necessary if the condition is due to cardiac disease.

Atherosclerosis

This is the development of cholesterol and fat-filled plaques within the arteries. This raises your risk of heart attacks as plaque accumulates in the arteries, making them rigid and narrow. Atherosclerosis is a disease that takes time to develop, and it rarely affects those of young age.

However, children are more vulnerable to the effects of health problems, including diabetes, hypertension, and obesity. Therefore, parents must strive for healthy obesity and ensure they take their children for regular screening for high blood pressure and cholesterol levels, especially those with a family history of cardiac defects.

<h3>Pericarditis<h3>

Pericarditis is caused by infection or inflammation of the membrane or thin sac surrounding the heart. The heart’s capacity to pump blood effectively is hindered due to an increase in the fluid content between its two layers.

This condition may happen after surgery or when your kid has a viral infection and chest injuries. The patient’s age, the ailment’s intensity, and general health all play a role in determining the best course of treatment.

Heart Failure

Also known as congestive heart failure, heart failure occurs once your heart cannot pump enough blood to supply the body’s organs with the oxygen and nutrients they require. The heart continues to beat but with less efficiency than a normal heart. Heart failure is typically a symptom of a more serious, chronic cardiac problem.

What are the causes of pediatric heart failure?

Those born with a cardiac defect are at a higher risk of developing heart failure. Heart failure can be caused by a wide variety of other conditions, including;

  • Heart valve problems
  • Viral infection
  • Irregular heartbeats
  • High blood pressure
  • Overactive thyroid
  • Chronic lung illness

Pediatric heart failure symptoms

Some children may show early symptoms, while others may not. However, here are some of the common heart failure symptoms in children:

  • Fatigue
  • Nausea
  • Excessive sweating
  • Less muscle mass
  • Lung congestion
  • Lack of appetite
  • Shortness of breath

When your heart’s pumping capacity is severely impaired, the illness’s severity and associated symptoms increase. There may be a misdiagnosis since heart failure symptoms are similar to other diseases. Get professional medical advice before making assumptions about your child’s heart health.

Identifying pediatric heart failure

As part of the physical examination, your child’s healthcare provider would comprehensively analyze the child’s medical history. They may also perform additional tests, including:

  • Urine and blood tests
  • Chest X-rays
  • Echocardiogram
  • Cardiac catheterization

Pediatric heart failure treatment

Your child’s doctor will make treatment decisions for heart failure based on the following:

  • The extent or scope of the illness
  • How well does your kid handle various therapy, procedures, and medications
  • Details about your child’s age, current health, and past medical history

Heart surgery may be required if heart failure results from a congenital (existing at birth) heart abnormality or an acquired heart condition, like rheumatic valve disease.

Treating heart failure early with medication or a pacemaker is often effective. Many children are born with cardiac problems. While drugs can help for a while, they eventually lose efficacy, and surgery becomes necessary. After surgery, medication may be taken to aid heart function while the patient recovers.

Conclusion

Over 600,000 children in the United States have either acquired or congenital heart defects, and the risk of developing atherosclerotic and other heart-related diseases increases as they grow into adulthood. This is due to high blood pressure, obesity, certain drugs, and excessive cholesterol levels in their bodies. You should see a doctor if you have any concerns that your child may have a cardiovascular issue.