Heart Disease in Children and Teens
As adults, we often believe that cardiologists are only visited by grown-ups dealing with coronary artery disease, diabetes, or other such ailments. However, problems can occur in little hearts, too. According to the Royal Children’s Hospital in Melbourne, one in every hundred children experiences a heart problem. And while some of these problems are present at birth, others develop as a child matures into their teenage years. Here, we will talk about some of the diseases that affect the younger population, what risk factors there are, and some of the preventative measures we can take to protect our loved ones.
Congenital Heart Defects
Congenital heart defects are abnormalities in normal heart structure and function that change the way blood passes through the heart and to the rest of the body. There are many types of congenital heart defects, and while some are mild, such as a small hole in the heart, others are more severe and can be a threat to the baby’s survival. Oftentimes, such defects are discovered during pregnancy via ultrasound, but others are not detected until after birth, or even adulthood. Babies with excess sleepiness, bluish nails or lips, and fast or troubled breathing are suspected of having a congenital heart defect and go through several tests to confirm the diagnosis. Treatments for congenital heart defects vary and depend on the type and severity of the defect. Some involve surgery, while others involve a procedure called cardiac catheterization. With the advancement of medicine and technology, children with congenital heart defects live healthy lives, but some experience a degree of disability, especially for those whose defects have not been fully cured.
An arrhythmia occurs when there is a change in the regular beating of the heart. Forms of arrhythmia include beating too fast or too slow, skipping a beat, or skipping multiple beats. In children, arrhythmias can occur due to congenital heart defects, cardiomyopathy, or outside factors such as fever, allergies, or certain medications. While most cases are harmless, arrhythmia can be dangerous if it alters the ability of the heart to effectively transport blood to the rest of the body, which can result in damage to other organs. Symptoms of arrhythmia include weakness, dizziness, tiredness, palpitations, paleness, noticeable changes in heartbeat, and shortness of breath, and are usually diagnosed with an electrocardiogram (ECG), which records heartbeat. Treatments for arrhythmia are often unneeded and can be resolved by treating their underlying reason, such as a fever. However, treatments that target arrhythmia involve the use of medications, cardiac catheterization and radiofrequency energy, implantable devices, or surgery. Depending on the presence of any other health problems, the general outlook for children with arrhythmia is positive because arrhythmia is commonly treatable.
Kawasaki disease is an illness that causes inflammation to the blood vessels, and most commonly the coronary arteries. It is usually diagnosed when a child experiences a fever above 101℉ for more than five days, along with several other symptoms, including a rash on the torso, swollen and red hands and feet, bloodshot eyes, and swollen lymph glands in the neck. There is no suspected cause of Kawasaki disease, and diagnosis usually involves eliminating the prospect of other conditions that could be presenting the child’s symptoms. This illness can cause damage to the patient’s heart muscle and the blood vessels it affects. Immediate treatment is required to prevent this damage and the possibility of an aneurysm and a heart attack. The treatment for Kawasaki disease usually incorporates intravenous immunoglobulin and aspirin in conjunction with steroids or infliximab if needed. Patients whose Kawasaki disease is identified and treated early on are expected to yield positive results in terms of quality of life in the future.
Rheumatic Heart Disease
Rheumatic heart disease can arise from a recent strep infection or rheumatic fever, which occurs a few weeks after the initial strep infection. If the fever is prolonged, the valves of the heart are at risk of being damaged by the body’s immune cells. In this case, the immune response built to fight rheumatic fever causes inflammation in the entire body, which can result in ongoing valve damage. The inflammation, damage, and scarring of the heart’s valves can cause the narrowing or leaking of the valve, which diminishes its function. The most common symptoms of rheumatic heart disease are strep infections and rheumatic fever followed by shortness of breath, chest pain, and swelling. Diagnosis involves a blood test or throat culture used to detect the presence of strep bacteria, a heart murmur heard through a stethoscope, and other tests including electrocardiograms, echocardiograms, chest x-rays, or MRI scans. Treatments include the use of antibiotics, anti-inflammatory medications, and surgery to repair, or even replace, the damaged heart valve.
The pericardium is a thin, sac-like tissue that surrounds, protects, and lubricates the heart to prevent damage. Pericarditis occurs when the pericardium is inflamed or infected, causing an increase in the fluid between the pericardium and the heart. This causes the heart to compress, resulting in interference of normal heart function. Pericarditis usually arises following surgery (if the child went through heart surgery) but can also occur due to a bacterial or viral infection, chest trauma injury, or other underlying conditions, including lupus. Symptoms of pericarditis include mild to severe chest pain along with fever, irritability, loss of appetite, or weakness. Cardiologists utilize data from blood tests, chest x-rays, and echocardiograms to evaluate the presence and severity of inflammation to the pericardium. Following diagnosis, this condition can be treated using medications that reduce pain and inflammation, aspirations that remove excess fluid, and surgery.
Atherosclerosis occurs when the arteries become clogged and hardened due to the build-up of fat and cholesterol. Although this disease is primarily seen in adults, the rise in childhood obesity has resulted in several cases of atherosclerosis in adolescents. When the arteries are clogged, they unable to efficiently transport blood throughout the body, resulting in less blood reaching the tissues. In severe cases when the arteries are completely blocked, cardiac arrest, stroke, and tissue death can occur. Oftentimes, children do not reach this stage; disease onset is usually mild and can be reversed by following a healthy diet. Atherosclerosis can result from cancer treatment, obesity, high blood pressure, and other underlying conditions. Its symptoms include high blood pressure, high cholesterol, and chronic conditions like diabetes. Diagnosis usually involves blood tests for cholesterol levels and a range of scans including CT, MRI, and angiograms. Children that actively pursue a healthy lifestyle can reverse the effects of atherosclerosis and prevent more dire diseases in the future.
The aforementioned heart diseases can occur due to several reasons. Conditions like congenital heart disease and Kawasaki disease are attributed to genetics, so a family history of heart disease puts children at a risk for heart problems as well. Other conditions, such as rheumatic heart disease and pericarditis, could be the result of an infection. On the other hand, diseases like atherosclerosis are attributed to an unhealthy diet and sedentary lifestyle. As such, there are three major steps to take to prevent heart disease from affecting your child. First, speak to your cardiologist if you or a family member have been diagnosed with heart disease and whether the condition puts your child at a risk. Second, make sure that if your child has a fever or infection, that they receive optimal care to resolve the disease to prevent more severe infections in the heart. Lastly, implement important lifestyle habits that involve a nutritious diet and frequent physical activity that allow your child to stay physically fit and healthy.
This article does not provide medical advice. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. If you need cardiovascular care, please call us at 832-644-8930.
Nabeeha Hasan is a freshman at the Honors College at the University of Houston. She is pursuing a dual degree in biomedical sciences & economics and plans to join an MD-MBA program post-undergrad. She has completed a literature review investigating the gut-brain axis and has done extensive research on treatments for Multiple Sclerosis. She hopes to use her knowledge to foster the advancement of the field of medicine. In her free time, Nabeeha enjoys traveling, reading, and spending time with family and friends.