Heart Disorders Acquired Children

Overview

Acquired heart disorders in children are heart problems that develop after birth, rather than being present from birth. The word acquired means the heart changes or becomes damaged later. They can affect the heart muscle, valves, rhythm, or the way the heart pumps blood. Many children do well with early care, but always speak to a qualified healthcare provider if you are worried about your child.

Acquired heart disorders in children are not common overall. Some types are rare, and the chance of a child having one depends on the cause, age, and other health factors.

They can affect children of any age, including babies and teenagers. Some types are more likely after certain infections, inflammatory illnesses, or in children with particular family or health histories.

Symptoms

Common symptoms

• Breathing faster or harder than usual, especially with feeding, playing, or lying down
• Feeling very tired, weak, or unable to keep up with normal play
• Palpitations (being aware of the heartbeat, or feeling it race or skip)
• Chest pain or discomfort
• Swelling in the legs, ankles, or around the eyes
• Fainting or near-fainting
• A cough that does not settle or frequent chest infections

Symptoms in children

• Babies may feed poorly, sweat during feeds, or gain weight slowly
• Young children may become breathless during play or seem unusually sleepy
• Older children may complain of a racing heart, chest pain, or dizziness
• Some children may avoid sports or play without being able to explain why

Symptoms in older adults

• This article focuses on children. In older adults, heart problems are often caused by different conditions, such as coronary artery disease, and need separate medical advice.

Causes

Main causes

• Infections, especially viral infections that inflame the heart muscle (myocarditis)
• Rheumatic fever, which can happen after untreated strep throat and can damage heart valves
• Kawasaki disease, an inflammatory illness in young children that can affect the heart arteries
• Other inflammatory or autoimmune conditions that involve the heart
• Some medicines, medical treatments, toxins, or nutritional problems that can affect the heart
• Abnormal heart rhythms that start after birth or after another illness

Risk factors

• A recent viral illness with ongoing tiredness, breathlessness, or chest pain
• Untreated or poorly treated strep throat
• Being under 5 years old for Kawasaki disease, which is most common in young children
• Family history of cardiomyopathy (heart muscle disease) or sudden cardiac death at a young age
• Certain long-term illnesses, immune conditions, or cancer treatments
• Living in or travelling to areas where rheumatic fever is more common

When to see a doctor

See a doctor urgently if:

• Your child has new breathlessness, chest pain, palpitations, or fainting
• Your child has a fever for 5 days or more with a rash, red eyes, or cracked lips
• Your baby is feeding poorly, sweating during feeds, or not gaining weight
• Your child is much more tired than usual and cannot do normal activities

Book a routine appointment if:

• Your child has a heart murmur (an extra sound heard by a doctor) found during a check-up
• Your child has a strong family history of heart muscle disease or sudden cardiac death at a young age
• Your child has had a recent infection and you are worried about ongoing tiredness or breathlessness
• Your child needs advice about school, sport, or travel after a heart problem

Diagnosis

A doctor will ask about symptoms, recent illnesses, family history, and medicines. They will examine your child, including listening to the heart and checking breathing, pulse, and blood pressure. If they suspect a heart problem, they may refer your child to a children's heart specialist (paediatric cardiologist).

Tests that may be done

• Blood tests to look for infection, inflammation, or heart muscle strain
• ECG (electrocardiogram): sticky patches on the chest record the heart's electrical rhythm
• Echocardiogram (ultrasound of the heart): sound waves create pictures of the heart muscle, valves, and blood flow
• Chest X-ray to see heart size and lungs
• Holter monitor or event monitor: a small wearable device records the heart rhythm over hours or days
• Exercise test: checks how the heart works during activity, if your child is old enough
• Cardiac MRI: detailed pictures of the heart using magnets, sometimes with a dye
• Genetic counselling or testing if a family heart muscle problem is suspected

What to expect at your appointment

Some tests are quick and painless. Your child may need to lie still, and younger children may need a gentle sedative for some scans. The care team will explain each step and answer questions. Results may take days, and your doctor will discuss what they mean.

Treatment

Treatment depends on the type of heart problem, the cause, and how your child feels. The aim is to support the heart, treat any underlying cause, relieve symptoms, and help your child grow and play as safely as possible.

Self-care at home

• Follow the care plan and keep all appointments, even when your child feels well
• Ask the care team before starting new sports, exercise, or travel
• Keep up with routine vaccinations and recommended flu vaccine if advised
• Encourage good hand hygiene to lower the risk of infections
• Protect your child from cigarette smoke and vaping
• Make sure your child gets enough sleep and rest during recovery

Medical treatments

Treatment may include medicines prescribed by a children's heart doctor to help the heart pump, control blood pressure, remove extra fluid, or steady the heart rhythm. Some children need oxygen, nutrition support, or treatment in hospital. Your care team will explain the choices and monitor your child closely.

When is surgery considered?

Surgery or other procedures may be needed if there is valve damage, a heart rhythm problem that needs a device, or severe heart failure. Some children need a procedure to place a pacemaker or ICD (a small device that treats dangerous rhythms), or in rare cases a heart transplant. The care team will discuss benefits and risks.

Living with this condition

Most children with an acquired heart problem can go to school and take part in family life. Your child may need check-ups, medicines, or limits on strenuous sport for a time. Follow the care plan and ask the team before starting new activities.

Lifestyle tips

• Keep up with routine vaccinations and recommended flu vaccine if advised
• Encourage good hand hygiene to lower the risk of infections
• Protect your child from cigarette smoke and vaping
• Make sure your child gets enough sleep and rest during recovery
• Keep all follow-up appointments, even when your child feels well
• Ask the care team about safe exercise, school sports, and travel

Diet and exercise

Offer a balanced diet with plenty of fruit and vegetables, whole grains, and protein. Limit salty processed foods and sugary drinks. Children should be active as advised by their care team. If your child needs to avoid strenuous exercise for a while, ask what safe movement looks like.

Mental health and emotional wellbeing

A heart problem can make children and parents feel anxious, scared, or sad. Children may worry about being different, missing school, or keeping up with friends. These feelings are common. Talk to your child's doctor or school about support. If worry or low mood is affecting daily life, ask for help. If your child or family is in crisis or has thoughts of self-harm, contact your local emergency number or a local crisis service right away.

Prevention

Some acquired heart problems cannot be prevented, but you can lower some risks. Treat strep throat promptly, keep vaccinations up to date, and get medical advice for ongoing symptoms after an infection.

Vaccines

Keep up with routine childhood vaccinations and any vaccines your child's doctor recommends, such as flu vaccine if advised. Vaccines can prevent some infections that may lead to heart inflammation.

Screening programmes

There is no routine screening for all children. If your child has a strong family history of heart muscle disease or sudden cardiac death at a young age, or has had certain inflammatory illnesses, the doctor may recommend heart checks.

Complications

If left untreated

• Heart failure, where the heart cannot pump blood as well as it should
• Heart rhythm problems that can cause dizziness or fainting
• Damage to heart valves
• Blood clots that can travel to the brain or lungs
• Poor growth or development in babies and young children
• Rarely, sudden cardiac arrest

Long-term outlook

With early diagnosis and good care, many children recover well or live full lives with monitoring. Some may need long-term heart check-ups or treatment. The care team will help you understand your child's outlook.

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