Pediatric patients face number of cardiac conditions that can impact their health

While heart disease is traditionally associated with adults, pediatric patients face a number of cardiac conditions that can impact their health.

"The most common pediatric cardiac condition is a congenital heart defect - a structural problem in the heart that can range from small holes between heart chambers to the absence of entire chambers or valves in the heart," said Robert Mangano, M.D., Director, Pediatric Cardiology, Geisinger Health System.

According to the American Heart Association, approximately 36,000 babies are born each year with congenital heart defects.

"Congenital defects are present at birth and are usually formed soon after conception, sometimes before the mother knows she is pregnant," Dr. Mangano said. "Research is being done to determine how much of a role genetics play in the development of defects, but there is no consensus explanation for why congenital heart defects occur."

Severe cases are characterized by low blood pressure, difficulty breathing or feeding, or poor weight gain, and are generally diagnosed a few months after birth, according to Dr. Mangano. Minor defects don't always cause symptoms, and they can be diagnosed during routine check-ups, he added. Sometimes heart defects can be detected in utero, allowing for treatment to begin soon after birth.

"Children with minor defects routinely survive into adulthood, and live normal and comfortable lives," Dr. Mangano said. "Patients with severe defects, however, may require specialized treatment, which can include medication or surgery."

Specific treatment options can vary widely depending on the severity of the defect. "Therefore, a consultation with a pediatric cardiologist is vital in developing a treatment strategy," Dr. Mangano said. Most patients are able to overcome their defect and live healthy lives, he added.

Other pediatric heart conditions include Kawasaki disease and rheumatic fever. Unlike congenital heart defects, these diseases develop after birth.

"Kawasaki disease causes inflammation and irritation in many tissues in the body, including the heart and surrounding blood vessels, and may lead to dangerous coronary artery aneurysms," Dr. Mangano said. "It is characterized by prolonged fever, swollen glands in the neck, inflamed eyes and mouth, and a rash on the back, chest or groin."

The condition can last for up to three weeks. While the symptoms generally resolve themselves, damage to the arteries can still occur. Urgent hospital treatment with concentrated human antibodies and anti-inflammatory medications can prevent serious complications involving the heart, Dr. Mangano said. This condition is not easy to diagnose, and consultation with specialists is very helpful.

Rheumatic fever, another inflammatory disease, is a rare condition that can develop in children if strep throat is untreated or treated poorly, Dr. Mangano said. It can affect connective tissues and lead to scarring of heart valves or other heart damage, which can result in congestive heart failure.

"Joint inflammation and small, hard bumps underneath the skin, a rash, fatigue and weight loss are all potential signs of rheumatic fever," said Dr. Mangano.

Treating strep throat with antibiotics is an easy and generally effective way to prevent rheumatic fever, he added.