Understanding heart problems in children

The rising prevalence of heart diseases among adults is a growing concern for experts globally. Adults develop diseases of the heart due to various reasons like sedentary life style, obesity, alcohol and smoking. But sadly many children also suffer from heart diseases for no fault of their own. Many children develop defects in the heart while in their mother’s womb. Alcohol, smoking, or some drugs taken during pregnancy by the mother can induce physical defects in the heart of the baby. Infections like German measles and syphilis, occurring during pregnancy can also cause heart diseases in the babies. Heart problems can be of wide variety in children. There can be defect in the partition separating the different chambers of the heart, patency of the tube involved in fetal circulation after birth (PDA), narrowing of the heart valves, among others. With a mild problem, the affected baby can grow into an adult with few or no symptoms. But in severe cases the child may not survive few months after birth. Functioning of the heart is impaired due to these disorders, leading to cardiac failure. In older children, rheumatic fever is the most common cause for heart disease. It is a sequel to sore throat caused by microbe called Group B- haemolyticus streptococcus viridians. Kidney problems in children can cause hypertension and cardiac failure. Hypothyroidism in a child born to a hypothyroid mother is yet another cause for heart diseases in children. Severe malnutrition in children affects the heart size and its functioning. Symptoms of heart diseases in children are the same as for adults. A small baby is unable to suckle on the breast because of breathlessness. An older child may initially get breathless on severe exertion. Gradually, amount of exertion producing breathless is reduced and over time, the body becomes breathless even while resting. Along with this, the body develops swelling all over, beginning with the feet. In those kinds of congenital diseases where there is intermixing of pure and impure blood due to septal defects, the child develops bluish discoloration of tongue and lips along with breathlessness. The affected child is more prone to develop infections of the lungs like pneumonia or bronchitis, among others. He tends to eat less as there is no appetite due to reduced blood flow to the gut resulting in malnourishment. Gradually, the kidneys and liver can fail because of reduced blood flow to these parts. Physical as well as mental growth of such children can be retarded. People at large are ignorant about heart diseases in children. Unless a child becomes very sick parents hardly suspect any problem. When a child complaints of breathlessness and early fatigue, it is taken lightly by the parents. Swelling on the face and feet is unfortunately occasionally mistaken by the family since “child is looking healthy and putting on weight.” Diagnosis of heart disease in any child is made clinically and confirmed by X-rays, cardiac echo and other imaging techniques. The definitive treatment of heart disease in a child is surgical correction of the defect. But this is feasible only in children who are fit enough to undergo major surgery. Minimum maintenance dose of drugs is required for cardiac failure. Children who are not fit for surgery are given these drugs for their life time. Every pregnant woman has to be very vigilant so as to avoid drugs and substances that can harm the unborn baby. Any child showing signs of any abnormality in feeding, walking, running or sleeping, should be investigated for congenital heart disease. Early treatment of streptococcal sore throat can prevent heart and kidney problems in a child. Dr Rachna Pande,specialist – internal medicineE-mail: rachna212002@yahoo.co.uk

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Understanding heart problems in children