At least 8 out of every 1,000 infants born have a heart defect. This results in about 40,000 children each year who are born with a heart defect. The good news is that most of these children can benefit from surgery, even if the heart defect is severe and about 1 million Americans with cardiovascular defects are alive today.
Congenital heart disease is a heart defect is a structural problem that is present at birth. Defects can range from "holes" between chambers of the heart, to a more severe defect, such as the absence of one or more chambers or valves. Types of congenital heart defects include patent ductus arteriosis, atrial septal defects and ventricular septal defects.
Acquired heart disease is a heart disease develops sometime during childhood. Types of acquired heart disease include Kawasaki disease, rheumatic fever and infective endocarditis.
Most significant congenital heart defects are usually found during the first few months after birth. After birth, some babies may become blue or have very low blood pressure. Defects may also cause breathing difficulties, feeding problems or poor weight gain and are generally noticed during routine medical check ups. Some heart murmurs may be due to defects, but are usually normal in children.
Significant heart defects can be found anytime during childhood. In a diagnostic evaluation, a pediatric cardiologist will usually take a child's medical history and give a physical exam. Included in the diagnosis, a doctor may want an X-ray, electrocardiogram (EKG or ECG), Doppler echocardiography or blood tests. After the exam, the pediatric cardiologist will explain the child's heart condition and discuss the program care your child may require. In some cases initial tests do not provide enough information for diagnosis and hospital testing may be required.
Many times, children who have heart or blood vessel defects do not require surgery. Those children who need surgery benefit from medical treatment before and after an operation. Many medical treatments, medicines, limits on diet or exercise are available to help the heart work properly.
With congestive heart failure, the heart does not pump blood sufficiently for the body to receive nourishment needed to perform normal work and activity. Children with this condition usually become tiered easily, have rapid or labored breathing, build up fluid or have a combination of these symptoms. Medicines such as diuretics and digoxin are sometimes prescribed.
With heart rhythm problems, a very rapid heart rate (tachycardia) may occur, which reduces the heart's ability to pump. Medication is sometimes needed to slow the heart rate to normal, 50-150 beats per minute depending on age. The opposite, a very slow heart rate (bradycardia), may also occur. This also reduces the heart's ability to pump. An artificial pacemaker may be needed in some cases.
Sometimes surgical treatment is necessary and is usually performed in the same hospital the child's diagnostic tests were performed. Children are usually admitted just before the operation and commonly stay 5-10 days after surgery for recovery.
Routine medical care is important for all children, but to be sure your child is making good progress periodic heart checkups are recommended. Depending on a child's problem periodic tests may be needed and may include:
- Blood tests
- Standard electrocardiogram
- 24-hour ambulatory electrocardiogram
- Chest X-ray
- Exercise testing
Most children with heart defects can be fully active and are encouraged to participate in physical activity that helps keep their hearts fit. Healthy activities include swimming, bicycling, running, rope jumping and tennis. In some cases, a child may be advised to avoid strenuous physical activities such as competitive sports.
Almost all children with heart defects are able to attend regular schools and do not suffer from any physical or mental limitations that prevent them from participating in school. In rare cases a child will have special educational needs and the school will help make the changes to meet their needs. Some examples include limiting a child's stair climbing or provide special transportation.