Cardiology: Heart Disease
The expert physicians at Children’s Specialty Care Center at Texas Health Presbyterian Hospital Dallas use the newest research and techniques to treat the following kinds of pediatric heart disease.
Congenital heart disease
Congenital heart disease is the most common birth defect in the United States. There are two main types:
- Cyanotic, which includes Ebstein’s anomaly, pulmonary atresia and truncus arteriosus
- Non-cyanotic, which includes aortic stenosis, ventricular septal defect and coarctation of the aorta
Children with these conditions typically do not have other birth defects, but they may have genetic and chromosome syndromes like Trisomy 13 or Down syndrome. There is often no obvious cause of congenital heart disease, but it may be linked to:
- Poorly controlled blood sugar in mothers with gestational diabetes
- In utero exposure to infections
- In utero exposure to drugs, such as retinoic acid and alcohol
The congenital condition is found through an ultrasound and is present at birth. Some forms of congenital heart disease may never cause symptoms, while others may not manifest until late childhood. Symptoms vary widely depending upon the type of condition.
Treatment for congenital heart disease includes careful monitoring (for those conditions that may heal over time), medication and surgery.
Acquired heart disease
Acquired heart disease occurs after birth. In children, the two most common types are rheumatic heart disease and Kawasaki disease.
Kawasaki disease is typically present before the age of 5. Symptoms of the condition include
- Persistent fever
- Inflammation of the lips
- “Strawberry tongue”
- A rash on the torso
- Swelling of the palms
- Peeling of the skin around the fingers
- Joint pain
- Diarrhea or vomiting
A physician can diagnose the condition by checking for symptoms. Treatments include high-dose aspirin and gamma globulin, which are antibodies found in the blood that fight infection. Kawasaki disease can result in arterial damage or an aneurysm.
Rheumatic heart disease is caused by Type A streptococcus and usually occurs between the ages of 5 and 15. If symptoms appear they will include
- Shortness of breath
- Chest pain
- Pain or inflammation of the joints
A physician will check symptoms to provide a diagnosis and may order tests, such as an X-ray or MRI. Treatment includes antibiotics, as well as treatment for accompanying conditions such as arthritis or carditis (inflammation of the heart). If left untreated, the condition can result in scarring of the heart.
Inherited heart disease
If a family member is diagnosed with heart disease or a heart disorder, particularly one that can cause sudden cardiac arrest, it is recommended that a child be screened for risk factors. Conditions that can be assessed include
- Heart disease
- Cardiac amyloid
- Conditions causing heart-valve malformations
- Brugada syndrome
- High cholesterol
Screening for heart conditions can include a stress test, EKG and a monitor that tracks the heart rate over time or during a particular event.
If a child is found to have inherited a particular condition, a physician may recommend treatment to prevent progression of the disease. The treatments can include
- Drug therapy to slow the heartbeat, to keep it normal and prevent blood clots
- Implantable devices, such as a pacemaker
- Lifestyle changes, such as reducing caffeine intake, increasing physical activity, reducing stress and maintaining a healthy weight