• Rukmani Birla Hospital,Gopalpura Bypass Road, Near Triveni Bridge,Gopalpura,Jaipur – 302018.

Paediatric Cardiology

When we think of heart disease, we rarely ever picture young children suffering from the ailment. We think of cardiovascular diseases as something that builds up over time with smoking, a sedentary lifestyle, high cholesterol levels, etc. However, the truth is that heart disease and attacks can afflict anyone, including little kids and teenagers who may otherwise appear healthy.

Sometimes, heart problems in children are present from the birth, i.e. congenital. Often, heart issues will remain undetected until symptoms appear.

What is heart failure?

The term ‘heart failure’ is used to describe a heart that has ceased working properly. In adults, heart failure is often a result of high blood pressure, diabetes, smoking, coronary artery disease, etc. In infants, toddlers and teenagers, it happens for other reasons.

Children and teenagers can certainly experience heart failure, although it’s rare and often the result of a congenital heart defect.

Heart failure in children – Causes

For the growth and development of a child, the heart must maintain normal function and provide blood flow in the body. Sometimes, it does not function normally, a condition termed as ‘heart failure’. However, this doesn’t mean that the heart has altogether stopped working.

In children, there are two major causes of heart failure. The first is called over-circulation failure, which happens when, due to a congenital defect, blood mixes between the heart’s left and right chambers. Low blood (anaemia) can also cause an over-circulation failure.

The second is called pump failure, where the heart muscle is damaged and is not able to contract normally. This can be the result of a viral infection or defective coronary arteries that prevent effective blood flow to the heart muscle.

Sometimes, abnormal heart valves can also lead to heart failure; such valves do not close properly and cause blood to leak backwards. Some drugs like those used in cancer treatment may also damage the heart muscle. In some rare cases, children with muscular dystrophy develop problems with their heart muscle, which causes the hurt to become inefficient at pumping blood.

Risk factors for heart failure in children

Paediatric cardiologists note that risk factors for heart problems can start developing at a young age. Apart from genetics, one of the earliest risk factors is maternal smoking while the child is in utero.

Another risk factor is inadequate sleep. Children who don’t get enough sleep are more likely to have belly fat, high blood pressure, and an increased risk of diabetes. All of these can start a chain reaction leading up to heart failure.

Symptoms of heart failure in kids

Some common symptoms of heart disease that kids experience are –

  • Breathing difficulties
  • Low blood pressure
  • Poor growth
  • Excessive sweating
  • Respiratory infections
  • Pneumonia
  • Fatigue, especially after a viral infection

How is heart failure diagnosed?

Physicians typically use chest X-rays to determine damage to the heart. It is best to visit a paediatric heart specialist for proper evaluation and testing. Doctors may suggest some tests such as an electrocardiogram (EKG or ECG), ultrasound of the heart (echocardiogram), etc. None of these tests is painful. Sometimes, more detailed tests may be required, such as a heart catheterization study, where a small plastic tube (catheter) is placed inside the heart to record pressures and amount of oxygen in the heart.

How is heart failure treated?

If heart failure is a result of over-circulation due to a congenital defect, a surgery is often recommended. Medications such as diuretics and afterload reducers are prescribed to improve the heart’s pump function. Because over-circulation causes poor growth, doctors also recommend nutritional supplements to ensure the child’s growth.

If the heart condition is the result of a pump failure, similar medications are prescribed along with those for lowering blood pressure. Sometimes, a surgery is also required. When the heartbeat is too slow, a pacemaker is placed to maintain a normal heart rate. This needs a surgery.

In rare cases, when the pump failure is the result of irreversible muscle damage, medications don’t improve the heart function, which continues to worsen. In such a situation, a special pacemaker is required to improve the heart’s pump function. However, if the situation doesn’t improve, the doctor may suggest a heart transplant.

What should you do as a parent?

It’s important for parents to understand the causes, risk factors, and treatments of heart failure for children. At an early age, they must instil heart-healthy habits in children. Physical activity and good dietary habits should be encouraged.

Many paediatric cardiologists recommend breastfeeding infants, which has been found to lower a child’s risk of developing heart disease.

As parents, it is your responsibility to provide proper medical care if your child has suffered heart failure. With timely interventions and a healthy lifestyle, children with heart failure can lead healthy and active lives.

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