What Are Common Pediatric Heart Conditions?

“Having a child diagnosed with a pediatric heart condition is understandably alarming and anxiety-inducing,” said Ines Muia-Chisena, MD, Catholic Health Pediatrician. “However, advances in cardiac care for children mean we have more treatment options to explore.”

She emphasized that pediatric cardiac care aims to ensure a child's high quality of life so they can play, go to school, and enjoy their favorite activities. “All the things a childhood should be,” she said.

What are the types of pediatric conditions?

Heart conditions affect about 1 in every 100 babies born in the United States. They can be congenital (present at birth) or acquired (developing after birth).

Congenital heart defects (CHDs) are abnormalities in the structure of the heart that affect how it functions. They can range from mild to severe. Severe cases, known as critical congenital heart defects, usually require surgery in the first year of life. Some conditions may require multiple surgeries over several years. About one in four babies born with heart issues are born with a critical CHD.

Acquired heart conditions are less common in children. However, a CHD can increase the risk of acquired heart conditions, such as arrhythmias and cardiomyopathy.

What causes pediatric heart conditions?

The heart starts developing at conception and fully forms eight weeks into the pregnancy. Congenital heart defects (CHDs) occur during these first two months before the heart fully develops.

“The exact cause of congenital heart defects is unknown,” said Dr. Muia-Chisena. “However, we know they occur when specific steps during the development process do not happen at the right time or in the correct order.”

Genetic conditions such as Down syndrome and Turner syndrome may lead to CHDs. Gene changes that occur during pregnancy can cause issues at birth. Environmental exposures during pregnancy, maternal medication, diabetes, obesity or smoking may also cause CHDs.

Acquired pediatric heart conditions may be caused by:

Bacterial and viral infections
Childhood illnesses such as rheumatic fever
A family history of heart disease
Genetic conditions
High blood pressure

What are the most common types of pediatric heart conditions?

There are several types of acquired and congenital heart conditions.

Common congenital heart conditions include:

Atrial septal defect. A hole between the upper heart chambers (atria).
Patent ductus arteriosus (PDA). An opening between the two major blood vessels leading from the heart.
Pulmonary stenosis. The heart’s pulmonary valve brings low-oxygen blood to the lungs.
Ventricular septal defect. A hole between the right and lower heart chambers (ventricles).

Common acquired heart conditions include:

Cardiomyopathy. A disease of the heart muscle fibers.
Kawasaki disease. This condition causes a high fever and inflammation of the blood vessels.
Myocarditis. Inflammation of the heart muscle after a viral infection.
Rheumatic heart disease. Permanent damage to the heart valves caused by rheumatic fever.

Some heart conditions can occur at birth or develop during childhood. Common acquired or congenital heart conditions include:

Arrhythmia. An abnormal heart rhythm.
Pulmonary hypertension. An abnormality of the blood vessels in the lungs.

What are the symptoms of pediatric heart conditions?

Doctors and parents usually notice the symptoms of CHDs shortly after birth or during the first months of life.

Symptoms include:

Blue or pale gray fingernails, lips or tongue
Heart murmurs
Rapid breathing
Shortness of breath during feedings, causing slow weight gain
Swelling in the belly or legs
Weak pulse

Call your pediatrician immediately if your baby has any of these symptoms.

In some cases, a CHD diagnosis occurs later in childhood. Symptoms of CHDs in older children include:

Fainting during exercise or physical activity
Shortness of breath during physical activity
Swelling in ankles, feet or hands

The symptoms of acquired heart conditions vary depending on the condition but can include:

Chest pain
Dizziness
Fatigue
Irregular heartbeat
Shortness of breath
Swelling

Acquired heart conditions can develop at any time after birth, so it is important to contact your pediatrician if you notice symptoms in your child.

How are pediatric heart conditions diagnosed?

“Physicians often detect pediatric heart conditions during pregnancy,” said Dr. Muia-Chisena.

Pregnant women may need a fetal echocardiogram between 18 and 24 weeks of pregnancy to check the baby’s heart. A fetal echocardiogram is an ultrasound that uses sound waves to take pictures of the fetal heart. It does not harm the baby.

Your doctor will order a fetal echocardiogram if:

You have a family history of heart issues
You have a health condition that contributes to a CHD
You are taking a medicine that increases the risk of your baby having a CHD
Your baby has a genetic or chromosomal condition

Pediatricians check babies for critical CHDs as part of newborn screening before they leave the hospital. All states require a newborn screening and screening for critical CHDs. A doctor can also diagnose a cardiac condition shortly after birth or during the first months of life. If symptoms are present that may indicate an acquired heart condition, a pediatrician may recommend various tests to ensure an accurate diagnosis.

Common tests include:

Cardiac MRI to show clearly defined images of the heart
CT scan to take high-definition pictures of the blood vessels, heart and lungs
Electrocardiogram to measure electrical activity in the heart
Genetic testing to find DNA changes that may cause heart conditions

How are pediatric heart conditions treated?

“Treatment depends on the type and severity of the heart condition,” said Dr. Muia-Chisena. “In severe cases of CHD at birth, the baby needs immediate treatment.”

She explained that surgery is common in those cases, and a baby may need more than one surgery to repair the heart over time. In milder cases of CHD, a minimally invasive procedure like a cardiac catheterization is considered a treatment option. A pediatric physician will use a long tube (catheter) to reach the heart.

“Cardiac catheterization can improve blood flow and heart function even if the repair is not full and additional, future surgery is needed,” noted Dr. Muia-Chisena.

A pediatric cardiologist will monitor some heart defects that do not require immediate treatment. Call your pediatrician if you are concerned about new symptoms.

For acquired heart conditions, it will depend on the diagnosis and severity of the condition. For cardiomyopathy, surgically removing part of the thickened heart muscle may be recommended. Treatment for arrhythmia may include implantable devices to detect irregular heartbeats, lifestyle changes, and medications. For Kawasaki disease, a medication called gamma globulin may help.

“Each case of a child diagnosed with a pediatric heart condition is treated individually for that child's unique needs,” explained Dr. Muia-Chisena. “A team of dedicated professionals, including a pediatrician, pediatric cardiologist and pediatric surgeon, all work together to determine the safest, most effective treatments to restore health.”

She explained that your child’s team of specialists will ensure you know what symptoms you need to monitor, what lifestyle habits will help keep their heart healthy, and any limiting of activities that may be required.

How do I help my child practice good heart health?

“All children can benefit from heart-healthy habits,” said Dr. Muia-Chisena. "Learning these habits early in life helps ensure they continue as they grow up and enter adulthood.”

Good heart health habits include:

Eat a well-balanced diet incorporating fruits, vegetables and healthy, natural protein sources.
Exercise regularly and opt for physical activity instead of screen time.
Stay hydrated.
Manage stress.
Keep up with health exams.
Play sports safely.

Learn more about Catholic Health's free student athletic cardiac program. The program screens high schoolers for potential heart conditions before starting a sports program.