Though the term "heart disease" often brings to mind adult disease, children are also susceptible to health conditions that can adversely affect the heart. Although a few of these conditions are benign and can exist in a healthy child, many are serious and require treatment by a medical or surgical team in a tertiary care hospital.
Congenital Heart Disease
Congenital heart disease causes defects in a child's heart that occur during prenatal development, although not all affected children manifest problems at birth. Heart defects may range from the relatively benign atrial septal defect, which is a small hole in the wall between the right and left chambers of the heart, to the more severe Tetralogy of Fallot, a condition with four separate components: a thickening of the heart wall, a hole in the septum between the right and left chambers, a misalignment of the vessel that leads to the body's circulatory system, and a narrowing of the vessel that leads to the lungs. Most congenital defects require heart surgery to correct. They can result from genetic abnormalities, sporadic mutations, or maternal drug or alcohol abuse during pregnancy.
Mitral Valve Prolapse
The four valves of the heart ensure that blood flows in the correct direction, preventing deoxygenated blood from traveling back through the body without replenishing its oxygen supply. Mitral valve prolapse is a common but relatively benign heart condition that affects one of these valves. As suggested by its alternate name, floppy mitral valve, the condition affects the mitral valve, making it more elastic than usual. Commonly discovered in adolescence, this condition is more common in females. Though it may may present an abnormal sound, called a "heart murmur," to an examining physician, it presents minimal danger to the patient and usually requires no specific treatment.
Cardiomyopathies
These are intrinsic diseases of the heart muscle that prevent it from contracting and pumping in an appropriate manner. Many of them are genetic in cause. The most well known member of this disease family is hypertrophic cardiomyopathy. Children with this condition may have a history of suddenly losing consciousness or of chest pain. These children are prone to rhythm disorders and may require a pacemaker to prevent sudden cardiac death, especially in athletes. Children, especially male children, who have a family history of sudden cardiac death upon exertion at a young age should be investigated and monitored for this condition.
Rheumatic Heart Disease
Rheumatic heart disease used to be common in the United States, but is now relatively rare. The disease follows an infection of the throat by streptococcal bacteria. Children first have a syndrome that affects the heart and joints, and presents with a skin rash. Many of these symptoms subside soon after onset, but over the years, progressive damage can occur to the heart valves. Prevention of this particular condition depends on prompt recognition and treatment of streptococcal throat infections with antibiotics.
Infectious Endocarditis
Endocarditis results from an infection of the heart by bacteria. The disease occurs more commonly in children with a pre-existing heart disease. This disease is very serious and can be rapidly fatal unless promptly treated. Children at risk often take periodic antibiotics to prevent this dreaded complication.
Kawasaki's Disease
Kawasaki's disease is a relatively uncommon cause of heart disease in children. The disease affects the blood vessels that nourish the heart. It is potentially fatal and can occur rapidly. Children may have fever, swollen hands and feet, and a cherry-red tongue. These children need management under the care of a knowledgeable physician to improve their chances of survival. The mainstays of Kawasaki's treatment include immunotherapy and aspirin. Aspirin is usually contraindicated in children, to prevent Reye's syndrome. However, because the risk of permanent damage or even death from Kawasaki's disease is higher than the risk of Reye's syndrome, the use of aspirin in these children is considered justified.
Pericarditis
Pericarditis is an inflammation of the tissue that surrounds the heart. It most commonly results from a viral infection, and causes what may seem to be an innocent cold at first. Children may complain of chest pain that gets worse when they inhale. Though alarming, pericarditis can usually be treated symptomatically. More serious cases may need drainage of the extra fluid around the heart by a doctor under sterile conditions.
References
- "Nelson Textbook of Pediatrics, 18th Edition"; Robert M. Kliegman et. al.; 2008
- Cincinnati Children's Heart Institute: Kawasaki's Disease/Syndrome
