Pediatric Cardiology

What is paediatric cardiology?

Paediatric cardiology is a medical specialty dedicated to the treatment, monitoring and prevention of many heart and related diseases affecting infants, children and adolescents.

Paediatric cardiologists are specially trained to look for heart problems in young people.

What are the most common heart conditions in children?

Heart diseases in children are most often congenital heart defects, but also cardiomyopathies, pulmonary arterial hypertension, all heart rhythm abnormalities as well as cardiac complications of chronic diseases in children.

A distinction is generally made between congenital heart defects and acquired heart disease.

Congenital heart defects

Congenital heart defects (CHD) are present at birth and can damage the structure and function of a baby's heart. They usually change the way blood flows through the heart and to the rest of the body and can vary in severity. The most common are

• Heart valve disease (narrowing of the aortic valve)
• Hypoplastic left heart syndrome
• Atrial septal defects
• Ventricular septal defects
• Persistent ductus arteriosus
• Tetralogy of Fallot

Acquired heart disease

Acquired heart disease is a condition that develops over a lifetime. They may be minor or require immediate medical attention. Some examples are

• Arrhythmia: tachycardia (fast heartbeat), bradycardia (slow heartbeat), long Q-T syndrome.
• Atherosclerosis
• Kawasaki disease
• Rheumatic heart disease
• Pericarditis
• Heart murmur
• Viral infections

What are the symptoms of heart disease in children?

Some heart conditions have a variety of signs and symptoms, while others have no symptoms at all.

However, we recommend that you consult a paediatric cardiologist if your child has one or more of the following symptoms

• Dizziness
• Shortness of breath
• High blood pressure
• Changes in heart rhythm
• Chest pain
• Fainting
• Exercise problems or inability to exercise
• Poor nutrition
• Rapid breathing
• Lung infection
• Low or abnormal weight gain

If there is a suspicion of heart disease, the paediatrician may suggest various tests such as an electrocardiogram (ECG), 24-hour heart rate recording, echocardiography, stress test, magnetic resonance imaging (MRI) or cardiac catheterisation.

What are the treatments for heart disease in children?

In the case of heart disease, several treatment options are available depending on the type of disease and the age of the child.

The doctor may also advise supervised waiting, i.e. waiting before treating the condition to see how it develops. Some disorders disappear on their own without treatment. Others may require immediate treatment.

Medication

Some congenital and acquired heart defects are minor and can therefore be treated and corrected with medication. These drugs enable the heart to function and work more efficiently. The most commonly used are angiotensin converting enzyme (ACE) inhibitors, angiotensin II receptor blockers (ARBs) and beta-blockers.

Surgery

Surgical treatment aims to correct the blood flow, or the relevant problem related to congenital heart disease, to help the child live and grow. Some surgeries are called palliative surgery or palliation, which means the alleviation of a disorder when its cause cannot be fully eliminated or corrected.

Interventional catheterisation (KT)

Interventional catheterisation (KT) involves the introduction of various catheters and equipment into the bloodstream to perform procedures on the heart and vessels.

Nowadays, it allows certain surgical interventions to be avoided. However, very often it is complementary to surgery.

Pacemaker

When the electrical conduction of the heart is deficient, it will sometimes be necessary to insert a pacemaker to control and regulate the heart rhythm.

Heart transplantation

If the child's condition is more serious and irreparable, a heart transplant may be the best alternative to consider.