Heart conditions can be congenital (present at birth) or acquired, meaning they developed over time, usually later in life. Some conditions develop during childhood and are temporary, such as those caused by infection, while others last a lifetime. Many heart conditions are chronic; that is, they last for a long period of time or even a lifetime. Others are acute; they happen suddenly, with variable severity, and end quickly.
Heart conditions can range from the simple to the complex. Here are some of the main types of heart conditions children experience:
- congenital heart disease
- heart rhythm problems (arrhythmias)
- inflammatory heart diseases
- cardiomyopathy
- heart infections
- pulmonary hypertension
- hyperlipidemia (high cholesterol)
- heart tumours
What are some examples of congenital heart disease?
Some examples of heart conditions present at birth include congenital heart defects and heart-related syndromes, such as Down syndrome. Pulmonary hypertension or heart rhythm problems (arrhythmias) can either be present at birth or develop later.
Congenital conditions are not necessarily hereditary, though a family history of heart conditions suggests a genetic component. Often, they simply occur for unknown reasons during the development of the fetus.
About 1 in 100 babies has some kind of congenital heart disease, and many need critical medical attention before they turn 1. About 25% of these cases are cyanotic, meaning that the oxygen level in the child's blood is low.
Congenital heart defects make up the biggest portion of heart disease in children.
What are some examples of acquired heart disease?
Some examples of heart disease that can be acquired later in life include:
- inflammatory heart diseases, such as rheumatic fever and Kawasaki disease
- cardiomyopathy
- heart infections
Heart rhythm problems (arrhythmias) can either be present at birth or develop later.
Acquired heart disease is more common in adults than children.
What is the difference between a sign and a symptom?
Signs and symptoms are not the same thing. A sign is something that can be observed or measured that is a clinical feature of a disease or condition. Examples of signs include redness or a heart murmur, things that a person may not necessarily feel.
A symptom is something a person feels or complains about, such as fatigue or pain. Symptoms cannot be directly observed.
Signs and symptoms provide important information in the assessment of a baby or child and often vary by age and by type of heart condition.
What are possible symptoms of a heart condition?
- rapid heartbeat
- difficulty breathing (shortness of breath)
- cyanosis ("blue spells")
- difficulty with feeding (prolonged or ineffective)
- poor weight gain
- decreased exercise tolerance
- palpitations
- fainting /dizziness (especially exercise-induced fainting)
- chest pain
What are possible signs of a heart condition?
- abnormal breathing
- abnormal heart rate or irregular rhythm (arrhythmia)
- low blood pressure
- sweating with feeds in infants
- cyanosis
- heart murmur
- edema (swelling)
What causes congenital heart disease?
Heart conditions tend to occur early in fetal development. What causes them is not very clear. One key factor that seems to increase the risk is family history, or genetics. If someone in your family has a heart problem, it is slightly more likely that your child will too.
Another possible factor contributing to congenital heart disease is exposure of the fetus during pregnancy. This could include, for example:
- the use of prescription or over-the-counter medications such as Accutane to treat acne, lithium to treat a mental health condition and some anti-seizure medications
- alcohol: babies with fetal alcohol spectrum disorder (FASD) often have congenital heart disease
- exposure to cocaine
- a viral infection like rubella (German measles) during the first three months of pregnancy
- a pre-existing chronic condition, such as diabetes
In general, scientists believe that genetic factors play a bigger role than environmental factors. The key thing to know is that in most cases the problem could not have been prevented. Most heart conditions simply occur by chance.
How is congenital heart disease detected?
Sometimes congenital heart abnormalities are initially detected during pregnancy via an ultrasound. The early detection of abnormalities may also prompt an earlier delivery or delivery at a major centre so that treatment can begin as soon as possible. However, often signs and symptoms are noted by a health-care provider after birth. Congenital heart disease may also be detected through critical congenital heart disease screening.
Can congenital heart disease be detected before birth?
Not all heart conditions can be detected before birth.
The best technology for detecting a heart problem before birth is an echocardiogram (heart ultrasound). This is usually done after a routine ultrasound suggests a potential problem, or for families with a history of significant congenital heart disease.
Detecting a problem early enough means that treatment can sometimes be provided sooner: for example, if it involves an irregular heartbeat. For structural problems, the health-care team can be prepared to act as soon as the baby is born.
Can congenital heart disease be prevented?
Generally, congenital heart disease cannot be prevented. However, if there are factors in the environment that could lead to congenital heart disease, steps can be taken to minimize risks. For example:
- Pregnant individuals should make sure they are vaccinated against rubella and receive regular prenatal care.
- Pregnant individuals with chronic conditions like diabetes or epilepsy should discuss pregnancy ahead of time with their health-care provider so that their treatment can be adjusted accordingly.