Heart disease in children can be either in the form of congenital heart disease (CHD) or acquired heart disease. While the prevalence of CHD has remained almost the same there has been a concerning rise in the prevalence of acquired heart conditions among children. In India, with a congenital heart disease birth prevalence of 9/1000, over 200,000 children are born with this condition annually and around one-fifth of them require intervention within their first year. Factors like genetics particularly a family history of heart problems, maternal exposure to certain drugs or radiation, and syndromic associations contribute to CHDs. Additionally, poor diet, limited physical activity, exposure to second-hand smoke, environmental factors, and obesity significantly increase the likelihood of acquired heart conditions in children. Dr Amit Misri, Associate Director - Pediatrics Cardiology, Heart Institute, Medanta, Gurugram, has explained a few common types of heart conditions in children and how to manage them.
Common types of heart conditions in children:
- Congenital heart conditions encompass a wide spectrum of defects present at birth, ranging from simple issues with minor symptoms to complex cases requiring early intervention either percutaneous or surgical. These include heart valve disorders, where valves don't open or close properly, atrial septal defects, which create a hole between the upper heart chambers, and ventricular septal defects, involving a hole between the lower chambers.
- Arrhythmias, irregular heart rhythms disrupting normal function, can occur at any age due to genetics, health problems, or medications. They may lead to reduced blood flow, blood clot formation, and heart failure, with causes including genetic factors, structural heart conditions, and electrolyte imbalances.
- Rheumatic heart disease results from repeated and untreated streptococcal infections, causing inflammation and valve damage, potentially leading to heart failure, arrhythmias, and infective endocarditis. Prompt treatment of streptococcal infections is vital for prevention.
- Cardiomyopathies like hypertrophic involve thickening of the heart muscle, potentially obstructing blood flow, and may go unnoticed in children, often emerging in adulthood with symptoms like chest pain, arrhythmias, and heart failure. In another form of cardiomyopathy called dilated cardiomyopathy, the heart gets dilated with reduced cardiac function.
- Atherosclerosis, the buildup of artery-clogging plaques, can affect children with conditions like diabetes, obesity, and hypertension. It may lead to severe complications like heart attacks and strokes, influenced by factors such as diet, exercise, genetics, and smoking.
Management of heart conditions in children
The comprehensive treatment of childhood heart conditions involves collaboration among specialists, including pediatric cardiologists and surgeons. A tailored care plan may include medications to regulate heart function, manage symptoms, and control blood pressure to stabilise the child. This is followed by surgical or minimally invasive catheter-based procedures to repair defects and enhance heart function; however, the treatment approaches may depend on the condition's type and severity.
Recognising childhood heart conditions can be challenging due to their complexity and symptom overlap with other issues. Therefore, parents, caregivers, and healthcare providers must be aware and stay vigilant about risk factors and common types of heart conditions in children. Timely intervention is essential to prevent complications and promote children's overall health. This proactive approach ensures strong and healthy hearts, setting the stage for a vibrant, long life.
