Problems of the Heart and Circulatory System
Problems with the cardiovascular system are common — more than 64 million Americans have some type of cardiac problem. But cardiovascular problems don't just affect older people — many heart and circulatory system problems affect children and teens, too.
Heart and circulatory problems are grouped into two categories: congenital, which means the problems were present at birth, and acquired, which means that the problems developed some time during infancy, childhood, adolescence, or adulthood.
Congenital heart defects. Congenital heart defects are abnormalities in the heart's structure that are present at birth. Approximately 8 out of every 1,000 newborns have congenital heart defects ranging from mild to severe. These defects occur while the fetus is developing in the mother's uterus and it's not usually known why they occur. Some congenital heart defects are caused by genetic disorders, but most are not. What all congenital heart defects have in common, however, is that they involve abnormal or incomplete development of the heart.
A common sign of a congenital heart defect is a heart murmur — an abnormal sound (like a blowing or whooshing sound) that's heard when listening to the heart. Usually a heart murmur is detected by a doctor who's listening to the heart with a stethoscope during a routine exam. Murmurs are very common in children and can be caused by congenital heart defects or other heart conditions.
Arrhythmia. Cardiac arrhythmias, also called dysrhythmias or rhythm disorders, are abnormalities in the heart's rhythm. They may be caused by a congenital heart defect or they may be acquired later. An arrhythmia may cause the heart's rhythm to be irregular, abnormally fast, or abnormally slow. Arrhythmias can occur at any age and may be discovered during a routine physical examination. Depending on the type of rhythm disorder, an arrhythmia may be treated with medication, surgery, or pacemakers.
Cardiomyopathy. Cardiomyopathy is a chronic disease that causes the heart muscle (the myocardium) to become weakened. Usually, the disease first affects the lower chambers of the heart, the ventricles, and then progresses and damages the muscle cells and even the tissues surrounding the heart. In its most severe forms, this condition may lead to heart failure and even death. Cardiomyopathy is the #1 reason for heart transplants in children.
Coronary artery disease. The most common heart disorder in adults, coronary artery disease is caused by atherosclerosis. Deposits of fat, calcium, and dead cells, called atherosclerotic plaques, form on the inner walls of the coronary arteries (the blood vessels that supply the heart) and interfere with the smooth flow of blood. Blood flow to the heart muscle may even stop if a thrombus, or clot, forms in a coronary vessel, which may cause a heart attack. In a heart attack (or myocardial infarction), the heart muscle becomes damaged by lack of oxygen, and unless blood flow returns within minutes, muscle damage increases and the heart's ability to pump blood is compromised. If the clot can be dissolved within a few hours, damage to the heart can be reduced. Heart attacks are rare in children and teens.
Hyperlipidemia/hypercholesterolemia (high cholesterol). Cholesterol is a waxy substance that's found in the body's cells, in the blood, and in some of the foods we eat. Having too much cholesterol in the blood, also known as hypercholesterolemia or hyperlipidemia, is a major risk factor for heart disease and can lead to a heart attack.
Cholesterol is carried in the bloodstream by lipoproteins. Two kinds — low-density lipoproteins (LDL) and high-density lipoproteins (HDL) — are the most important. High levels of LDL cholesterol (the bad cholesterol) increase a person's risk for heart disease and stroke, whereas high levels of HDL cholesterol (the good cholesterol) can protect against these.
A blood test can indicate if someone's cholesterol is too high. A child's cholesterol level is borderline if it's 170 to 199 mg/dL, and it's considered high if it's above 200 mg/dL.
About 10% of teens between 12 and 19 have high cholesterol levels that put them at increased risk of cardiovascular disease.
High blood pressure (hypertension). Over time, high blood pressure can cause damage to the heart and arteries and other body organs. The symptoms of hypertension can include headache, nosebleeds, dizziness, and lightheadedness. Infants, kids, and teens can have high blood pressure, which may be caused by genetic factors, excess body weight, diet, lack of exercise, and diseases such as heart disease or kidney disease.
Kawasaki disease. Kawasaki disease (also known as mucocutaneous lymph node syndrome) affects the mucous membranes (the lining of the mouth and breathing passages), the skin, and the lymph nodes (part of the immune system). It can also lead to vasculitis, an inflammation of the blood vessels. This can affect all major arteries in the body — including the coronary arteries. It can also cause inflammation of the heart muscle, called myocarditis. When coronary arteries become inflamed, a child can develop aneurysms, which are weakened and bulging spots on the walls of arteries. This increases the risk of a blood clot forming in this weakened area, which can block the artery, possibly leading to a heart attack. In addition to the coronary arteries, the heart muscle, lining, valves, or the outer membrane that surrounds the heart can become inflamed. Arrhythmias or abnormal functioning of some heart valves can occur. Kawasaki disease has surpassed rheumatic fever as the leading cause of acquired heart disease in children in the United States.
Rheumatic heart disease. Usually the complication of an untreated strep throat infection, rheumatic fever can lead to permanent heart damage and even death. Most common in children between 5 and 15 years of age, it begins when antibodies the body produces to fight the strep infection begin to attack other parts of the body. They react to tissues in the heart valves as though they were the strep bacteria and cause the heart valves to thicken and scar. Inflammation and weakening of the heart muscle may also occur. Usually, when strep throat infections are promptly treated with antibiotics, this condition can be avoided.
Stroke. Strokes occur when the blood supply to the brain is cut off or when a blood vessel in the brain bursts and spills blood into an area of the brain, causing damage to brain cells. Children or infants who have experienced stroke may be suddenly numb or weak, especially on one side of the body, and they may experience a sudden severe headache, nausea or vomiting, and difficulty seeing, speaking, walking, or moving. During childhood, strokes are rare.
Getting plenty of exercise, eating a nutritious diet, maintaining a healthy weight, and getting regular medical checkups are the best ways to help keep the heart healthy and avoid long-term problems like high blood pressure, high cholesterol, and heart disease.