For most people, mention February and images of pretty red and pink hearts come to mind. So it is no wonder that former President Lyndon B. Johnson proclaimed February to be National Heart Month in 1963. In the nearly forty years that have elapsed, public awareness of heart disease and prevention strategies has increased dramatically, and the mortality rate from coronary disease has dropped nearly 60%. Yet, heart disease is still the nation’s No. 1 killer. And as sad as it is to lose someone close as a result of heart disease, it is even more tragic to see a child with heart problems.
Heart “diseases” in children may be acquired or congenital. An acquired condition develops during childhood, and congenital heart disease (more aptly termed “defect”) is present at birth. An acquired heart disease frequently is the result of another illness, such as rheumatic fever, infective endocarditis, or Kawasaki disease, a viral infection that is fairly common in children under the age of 5. In addition, irregular heartbeats, or arrhythmias, may be acquired later
Congenital heart defects are structural problems present at birth. While not all cases of childhood heart disease are the result of a congenital defect, the vast majority of them are congenital in nature. In fact, they represent the most common birth defect in this country. Nearly 2 times as many children die from congenital heart defects each year as from all forms of childhood cancers combined. At least 8 of every 1000 babies born each year in the United States have a heart defect. While the vast majority of these defects are considered to be mild and require no treatment, a large number of the 40,000 children born annually with a defect can benefit from surgery. Since the 1960’s and 1970’s, the risk of dying from congenital heart surgery has decreased from about 30% to approximately 5%.
Parents or doctors typically notice an apparent congenital problem during the first few months of life, but some defects may not be found until later in childhood or adolescence. Symptoms of a heart defect include breathing difficulties, feeding problems, or poor weight gain. Some babies will appear blue or their blood pressure shortly after birth will be very low. Whatever the cause, most heart defects either cause an abnormal pattern of blood flow through the heart, or obstruct the flow of blood in the heart or surrounding vessels. If a heart problem is suspected, an examination with a pediatric cardiologist is recommended. Tests such as a chest X-ray, electrocardiogram, or blood tests will probably be done. Whether the defect is mild or severe and requires surgery, children with coronary disease should continue to be monitored by a physician. Routine physicals and standard immunizations should continue according to the timetable doctors recommend for all children. Additional immunizations, such as annual flu shots, also may be advised. And children who have had corrective heart surgery may need to take a preventive dose of antibiotics prior to additional surgeries and some dental procedures.
One of the main points for parents to keep in mind if they have a child with a congenital heart defect is that most of these children can be fully active. Rather than imposing restrictions on activity, many pediatric cardiologists encourage their young patients to enjoy physical activities that can be lifelong pursuits while keeping the heart fit. Some examples of these activities include swimming, running, bicycling, playing tennis, and jumping rope. In fact, being physically active while learning and employing healthy eating habits not only helps children with congenital heart defects, but these measures can also prevent or reduce the severity of acquired heart disease, even into adulthood. Research has shown that the build-up of fat in the arteries, leading to adult-onset coronary disease, frequently begins in childhood. Also, elevated levels of LDL (the unhealthy cholesterol) in children sets the stage for the fatty arterial build-up leading to atherosclerosis later on. A healthy diet and an active lifestyle in both children and adults not only can prevent heart disease, but should reduce the incidence of a number of other conditions, such as diabetes, high blood pressure, and obesity, that adversely affect the heart as well.
For further information about heart disease and children, call the American Heart Association at 1-800-AHA-USA1 (1-800-242-8721) or find them on the Internet at www.americanheart.org/children. Additional information is available at the Central Connecticut Health District at 721-2822.