Heart Disease In Children

Paediatric Heart Disease

Paediatric Heart Disease is a broad term used to define various types of heart complications and problems in children. Along with adults, children ranging from newborn babies to teenagers are widely reported to have a number of heart complications. Around 3-5 million children are living with chronic and serious complications worldwide. Though paediatric heart conditions are unavoidable, early medical intervention can lead to better outcomes.

Types of Paediatric Heart Disease

Paediatric Heart diseases are typically divided into two categories:

• Congenital Heart Diseases: These are present since birth. Every 1 out of 100 newborns carries congenital heart defects because of the underdeveloped or poor development of blood vessels around the heart. These defects can be mild or severe and interfere with the heart’s ability to work. Some of these defects do not cause any health challenges for years; in fact, some may never pose a health risk. As these defects show no major symptoms, routine medical examinations or screening help to detect these. Some major types of Congenital Heart defects are Aortic Valve Stenosis, Atrial Septal Defect, Ebstein’s Anomaly, etc.
• Acquired Heart Disease: These are most common in adults but children too fall prey to them. One acquires them with age. The most common acquired heart disease in children are:
  1. Rheumatic heart disease: It is the most serious complication of rheumatic fever which is caused by the bacteria responsible for strep throat. The antibodies produced by the immune system to fight this bacteria can result in damaging the heart valve, which leads to rheumatic heart disease. Since the medication for strep bacteria is available; rheumatic heart disease is not that common.
  2. Kawasaki Disease: In this the body’s immune system starts attacking the healthy tissues, leading to inflammation in the coronary artery and heart muscles. It is the leading cause of acquired heart disease among children.
  3. Arrhythmias: It is the condition in which the heartbeat becomes abnormal which can cause the heart to pump less efficiently.

Signs & Symptoms:

Depending upon the child’s age and the type of disease they carry, different signs and symptoms indicate the presence of heart disease.

In Babies:

• Trouble gaining weight
• Bluish colour on lips, tongue, or nail beds
• Difficulty in feeding
• Breathlessness or rapid breathing
• Sweating while eating
• Tiring easily

In Young Children:

• Passing out during physical exercise or excursion
• Heart Palpitations
• Shortness of breath while playing or exercising
• Chest pain
• Having seizures

In Teenagers:

• Abnormal heartbeat
• Passing out while exercising
• Excessive shortness of breath
• Chest pain

In case, any of the symptoms become persistent or visible one should immediately consult the paediatrician. The paediatrician will assess whether the symptoms are indicators of heart disease or not.

Diagnostic Procedures

Diagnosing and evaluating the presence of heart disease in children can be tricky and require a number of tests and examinations. These include:

1. Physical examination: A head-to-toe assessment of the child is done to examine any heart condition.
2. Blood Test: A complete blood analysis is done to check for any other complications that might be causing the heart disease.
3. Electrocardiography or ECG: It is a simple and fast test used to check the electrical activity of a child’s heart.
4. Holter Monitoring: In this, a small device is attached to the chest for at least 24 to 48 hours. It continuously records the heart rate and other activities.
5. Exercise Testing Activity: In this, the ECG is performed while the child is exercising.
6. Tilt Table Test: It is done to find the cause of fainting. In this, the child is made to sit on a special table which constantly changes the child’s position from standing to lying and records heart rate and blood pressure in different positions.
7. Echocardiography: In this high-pitched sound waves are used to get a detailed picture of the heart.
   Ultrafast/Electron Beam CT scan: It is an imaging test that uses X-rays and a computer to get a detailed picture of the heart.
8. MRI: It is a procedure in which a large magnet and radio waves are used to get a detailed image of the organs and tissue in the body.
9. Cardiac Catheterization: In this, a long and flexible tube is put into the blood vessel and guided to the heart to find the exact cause of the heart problem.

Treatments:

After assessing the child’s heart condition and diagnosing the exact cause of the problem, the paediatric cardiologist may suggest the best possible treatment. The treatments usually include:

Medications: A number of medications are given to treat the symptoms and complications of heart disease. These include Blood pressure drugs such as angiotensin-converting enzyme inhibitors; Diuretics to reduce the amount of fluid in the body and Heart rhythm drugs which help in controlling the abnormal heartbeat.

Surgery: In case the medications don’t work or in serious cases, various kinds of heart surgeries are performed to correct the defects. These include:

• Fetal Cardiac Intervention: Rarely, if a serious defect is seen during pregnancy then a procedure could be done to reduce the complications or defects.
• Cardiac Catheterization: It can be used to fix holes in the heart and blockages without open-heart surgery.
• Heart Surgeries: Various kinds of minimally invasive and open heart surgery such as CABG, Angioplasty, Maze Surgery, etc. are performed to repair congenital defects as well as to treat various acquired heart diseases in children.
• Heart Transplant: In case of a serious heart defect, a heart transplant is done.

Though it can be disturbing to learn that your child has a heart disease, early medical intervention can help in containing and treating the condition. The advances in medical sciences have greatly improved the outcomes for paediatric heart diseases therefore professional consultation should be taken in case you suspect your child with such complications. Yashoda Super Speciality Hospital & Research Centre, Nehru Nagar in Ghaziabad has the best cardiology department. With an experienced and skilled team of paediatric cardiologists and cardiac surgeons, it strives to provide the best possible treatment for your child.