Download Heart Conditions - Children`s Health Center

Cardiac Disorders in Children
Atrial Septal Defect
An atrial septal defect (ASD), typically called a "hole in the heart," is a congenital heart
defect in which the wall between the two chambers of the atria, the septum, has an
opening in it. This allows oxygenated blood from the left atrium into the right atrium,
where it mixes with the blood that is not oxygenated and increases the blood flow to
the lungs. This creates a heart murmur. According to KidsHealth.org, ASD can be
genetic, but many cases have no single identifiable cause. Treatment depends on where
the hole is in the septum and how big it is. Very small defects can heal on their own, but
most children with this condition require surgery with either catheterization or openheart surgery if the hole has not closed by the time they start school.
Tetralogy of Fallot
Tetralogy of Fallot (TOF) is actually four different heart conditions that occur
concurrently, according to Cincinnati Children's Hospital. These four conditions are
pulmonary stenosis, or the narrowing of the pulmonary valve and the area below the
valve, causing blockage between the right ventricle and pulmonary artery; ventricular
septal defect, which is a hole between the two chambers of the heart; an overriding
aorta, which means the aortic valve is enlarged; and right ventricular hypertrophy, which
is a thickening of the walls of the right ventricle. Symptoms can include heart murmur, a
bluish appearance due to lack of oxygenated blood and rapid breathing. Depending on
the oxygen level in the blood, treatment consists of one or more surgeries, typically
around 6 months of age.
Coarctation of the Aorta
Coarctation of the aorta (COA) is a narrowing of the aorta, the main blood vessel that
enables blood to flow from the heart to the rest of the body. This narrowing may occur
anywhere along the aorta. When this happens, the left side of the heart needs to work
even harder in order to ensure that blood flows through the aorta, even though it is
narrowed. The narrowing can be very minor and not even noticeable or it can be a major
constriction that impacts the left ventricle of the heart. KidsHealth.org estimates that
COA makes up approximately 8 percent of congenital heart problems. Diagnosis typically
occurs when the child is young, but in minor cases, the defect may not be diagnosed until
adolescence. Symptoms may include cold legs and feet, chest pain and trouble catching
the breath, particularly during exercise. Through an electrocardiogram, chest x-ray,
MRI or CT scan, an accurate picture of the heart can be obtained. Severe COAs are
typically treated with surgery soon after birth. In other cases, a balloon angioplasty
may be done, a stent may be placed in the heart, or the narrowed part of the aorta may
be removed and the two ends joined
Kawasaki Disease
Kawasaki disease, also called Kawasaki syndrome or mucocutaneous lymph node
syndrome, is one of the main causes of acquired heart disease in children in the United
States, according to the American Heart Association (AHA). The large majority of
children with this disease are diagnosed by the time they are 5 years old, and it is
rarely diagnosed in children over 8 years of age. Symptoms include swollen hands and
feet, rash, irritation and redness in the whites of the eyes, swollen lymph nodes and
inflammation in the mouth and throat. Although a definitive cause is not known, it is
hypothesized that a virus causes this disease. The AHA estimates that 15 to 25 percent
of children who have Kawasaki disease have heart damage; in most cases, the coronary
arteries are weakened. The heart may also be inflamed, as well as the sac surrounding
the heart, and abnormal heart rhythms called arrhythmias may occur. These heart
problems typically resolve in five to six weeks but can be life-long in some individuals.
Treatment can include aspirin to reduce fever and inflammation, and intravenous gamma
globulin can be given early in the disease to help reduce the risk of coronary artery
damage.
Infant Heart Problems
Cause:
The fetal heart forms between the sixth and 12th week of development, which is often before
a woman realizes that she is pregnant. While a majority of heart defects have no identifiable
cause, exposure and infection to certain bacteria, viruses and parasites during early pregnancy
will put the fetus at risk for abnormal heart development. Group B Strep, Chickenpox, certain
vaccinations, Listeria---a bacteria found in contaminated food, toxoplasmosis---caused by a
parasite, cytomegalovirus---a common virus, can all cause infant heart problems. The CDC also
says poorly controlled diabetes in the mother also increases the risk of infant heart
abnormalities
Types
Types of infant heart problems include hypoplastic left heart syndrome, which relates to
several infant heart problems that cause an underdeveloped left heart structure. This condition
results in decreased oxygen-rich blood flow to the body, says the CDC. Another condition is a
ventricular septal defect, which is a hole in the partition separating the ventricles, the main
pumping chambers of the heart. An atrial septal defect is a perforation or hole in the partition
separating the two atria, or upper chambers of the heart. Transposition of the great arteries
occurs when the pulmonary artery and the aorta arise from the wrong sides of the heart.
Symptoms
Many of these infant heart problems involve too much blood in the lungs and not enough blood in
the body, leading to difficulty breathing and severe fatigue. These symptoms often indicate an
oxygen deficiency, which compromises how the cells generate energy. Symptoms also include
difficulty feeding, which can lead to poor nutrition and development.
Complications
A serious heart condition can be life threatening if not corrected. A less severe problem can
cause stunted growth and underdeveloped muscles and limbs. Repeated infections due to
complications and impaired circulation can cause permanent lung and organ damage. The infant
will also tire easily and not gain weight appropriately. According to the National Heart, Lung and
Blood Institute, more than 35,000 babies are born annually in the United States with congenital
heart defects with varying levels of severity.
Diagnosis
Ultrasound will often uncover these infant heart problems before birth. This approach is useful
because it allows doctors to prepare for emergency treatment at birth, before the condition
can cause permanent damage to other organs. In some cases, these heart problems will not
become evident until after the baby is born. Tests such as arterial blood gases,
electrocardiography, echocardiography and cardiac catherization will confirm the diagnosis and
level of severity.
Treatment
Minor heart conditions such as small septal defects may become less severe and resolve on their
own as the infant grows, says the CDC. Medication and supplemental oxygen will support
circulation and lung function, sometimes improving the infants' condition and eliminating the
need for surgery. Other defects are likely to worsen and require immediate surgical
intervention. In severe cases, a heart transplant is the only option.