Childhood Heart Diseases: Symptoms & Treatment

Pediatric heart diseases are health conditions stemming from structural defects that occur during development in the womb, or from infections and rhythm disorders that develop after birth. Thanks to early diagnosis and modern pediatric cardiology practices, the vast majority of these conditions can be successfully treated, allowing children to lead healthy, active lives.

Congenital heart diseases refer to structural abnormalities formed during the heart's developmental stages in the mother's womb.
Acquired heart diseases can emerge due to reasons like infections, rheumatic fever, or Kawasaki disease.
Murmurs, a bluish tint to the skin (cyanosis), quick fatigue, and palpitations are among the most common symptoms.
Pain-free, radiation-free methods like ECHO (Echocardiography) and ECG are frequently used during the diagnostic process.
Treatment options range from medical monitoring and interventional angiography to surgical procedures.

What Are Childhood Heart Diseases?

Heart diseases seen in children are fundamentally divided into two main groups: congenital (present at birth) and acquired (developed later) heart diseases. The majority of congenital heart diseases are structural defects caused by disruptions during the heart's developmental stages in the womb. This group includes developmental disorders of the heart chambers, holes in the walls between chambers, narrowed or leaky heart valves, and abnormalities in the development and placement of the major blood vessels leaving the heart (the aorta and pulmonary artery).

Acquired heart diseases, on the other hand, develop after birth, typically as a result of infections or systemic illnesses. This category includes acute rheumatic fever (often known as heart rheumatism), Kawasaki disease—which can involve abnormalities in the coronary arteries supplying the heart—and heart conditions secondary to issues like obesity, hypertension, and diabetes. Additionally, narrowings and blockages in the heart vessels due to cholesterol metabolism disorders can also occur in childhood, albeit rarely.

Causes and Risk Factors

The causes of childhood heart diseases vary depending on the type of condition. Although a definitive cause cannot be identified in most congenital heart disease cases, a combination of genetic predispositions and environmental factors plays a role. A family history of heart disease, genetic syndromes (such as Down syndrome), and chromosomal anomalies are primary elements that increase the risk.

The expectant mother's health during pregnancy also directly impacts the baby's heart development. Viral infections like rubella contracted during pregnancy, uncontrolled diabetes, uninformed medication use, and alcohol or substance consumption elevate the risk of congenital heart anomalies. In acquired heart diseases, untreated streptococcal infections (strep throat) can lead to acute rheumatic fever, potentially damaging the heart valves. Furthermore, severe respiratory tract infections during childhood, especially illnesses like the RSV virus, can further complicate the process for children with pre-existing structural heart issues.

Symptoms of Childhood Heart Diseases

While some significant heart diseases in childhood may present no symptoms at all, certain complaints that worry parents might actually have no clinical significance. Findings detected during routine examinations or symptoms that affect a child's daily life should be evaluated in detail by a pediatric cardiology specialist.

Murmur

Murmurs are extra sounds, similar to a blowing noise, heard by a physician using a stethoscope during a heart exam. Their characteristics include:

They can be heard in more than half of all children throughout childhood.
Most of the time, they are functional (innocent) heart murmurs that develop due to the heart beating quickly, rather than indicating a structural defect.
Pathologic (abnormal) murmurs, however, stem from structural heart diseases such as holes between the heart chambers or narrowed heart valves.
An experienced pediatrician can largely determine whether a murmur is innocent or pathologic during a physical examination.

Chest Pain

Unlike in adulthood, only a very small fraction of chest pain in childhood is related to heart diseases. Key features are as follows:

Idiopathic (unexplained) pains and those related to musculoskeletal disorders are the most common causes.
Growing pains or muscle strains in the rib cage are frequently mistaken for heart pain.
Rare heart-related causes include severe valve narrowing, thickening of the heart muscle, blockages in the heart vessels, or inflammation of the heart lining (pericarditis).

Cyanosis (Bluish Discoloration)

This is a color change that occurs when the blood's oxygen content decreases for various reasons. Things to watch out for include:

It appears as a bluish or purplish tint on the skin, lips, oral mucosa, and the inner parts of the eyelids.
An increase in cyanosis, especially when babies cry or feed, is a crucial sign of congenital heart diseases.
While it can be secondary to heart conditions, it may also stem from non-cardiac causes like respiratory system diseases.

Fainting (Syncope)

Disruptions in meeting the brain's need for oxygen and glucose can lead to a temporary loss of consciousness. In cases of syncope, the following are observed:

Non-cardiac causes (autonomic nervous system disorders, neuropsychiatric conditions) are more common in children.
Fainting that occurs during or immediately after exercise can be a harbinger of serious heart-related conditions.
Heart rhythm disorders or blockages preventing blood from exiting the heart can pave the way for fainting.

Palpitations and Rhythm Disorders (Arrhythmias)

The uncomfortable sensation of feeling one's own heartbeat is defined as a palpitation. Symptoms of rhythm disorders in children are as follows:

It manifests as fast, irregular, and sometimes stronger-than-normal beats in the chest.
Although most palpitations are harmless (often stemming from excitement, stress, or caffeine consumption), they can also be a sign of serious arrhythmias.
If a child suddenly turns pale, sweats, and describes a feeling like a "bird fluttering" in their chest, a cardiological evaluation is necessary.

Diagnosis: How Is It Diagnosed in the Hospital?

Advanced, pain-free, and rapid-result technologies that do not harm the patient are used to diagnose childhood heart diseases. Depending on the child's symptoms and physical examination findings, a physician may request one or more of the following tests.

Physical Examination and Saturation Measurement

This is the first and most critical step of the diagnostic process. Examination details include:

The patient's general appearance, respiratory rate, heart rhythm, and blood pressure are routinely evaluated.
Signs like clubbing of the fingers, growth delays, or indicators of genetic diseases are investigated.
Using devices called pulse oximeters, the oxygen saturation in the patient's blood is determined painlessly via light sensors on the fingertip, without drawing blood.

ECG (Electrocardiography)

A fundamental diagnostic tool that measures the heart's electrical activity. The process is as follows:

The heart's electrical activity is printed on paper via small electrodes attached to the arms, legs, and chest.
The procedure is completely painless and is completed in just a few minutes.
It provides clear information about rhythm disorders, heart muscle enlargement, or inflammatory conditions in children.

ECHO (Echocardiography)

Also known as a heart ultrasound, this method is the most essential imaging tool in pediatric cardiology. Its features include:

Anatomic and functional disorders are easily diagnosed by obtaining real-time images of the heart using ultrasonography.
The development of the heart chambers, the presence of holes in the walls between chambers, and the condition of the heart valves are clearly examined.
Because it does not involve radiation, it poses absolutely no harm to the patient or those nearby.
With fetal echocardiography, many heart diseases can be diagnosed while the baby is still in the mother's womb, allowing for post-birth treatment planning.

Rhythm Holter and Blood Pressure Holter

Used to obtain long-term recordings when momentary measurements are insufficient. The application steps are as follows:

A Rhythm Holter records heartbeats for 24 hours via electrodes attached to the patient's chest wall. The device is small and does not interfere with the child's daily activities.
A Blood Pressure Holter measures and records blood pressure at specific intervals over 24 hours, which is especially useful for children who have a fear of hospitals (white coat hypertension).
At the end of the period, the data on the device is transferred to a computer program and evaluated by a specialist physician.

Cardiac Catheterization and Angiography

An advanced procedure used for both diagnostic and therapeutic purposes. The process works as follows:

Most often performed under sedation and anesthesia, it involves reaching the heart using thin catheters inserted through the large blood vessels in the groin.
Pressure measurements and oxygen levels of the heart chambers and major vessels are determined.
By administering a contrast dye visible under X-rays, detailed images of the heart and blood vessels are obtained.

Treatment Methods

The treatment plan for childhood heart diseases is tailored individually based on the type of disease, the child's age, weight, and overall health status. The treatment journey spans a wide spectrum, from medical monitoring to complex surgical operations.

Medical Treatments (Medication)

Medications are used in the management of heart failure, rhythm disorders, heart rheumatism, or infectious conditions. Drugs are prescribed to lighten the heart's workload, regulate its rhythm, or keep blood pressure under control. Regular medication use and physician follow-ups are of vital importance in this process.

Interventional Catheterization (Angiography) Procedures

Thanks to advancing medical technologies, many conditions that previously required open-heart surgery can now be treated via angiography. Using specially designed catheters and devices (such as umbrella or plug-like apparatuses), holes in the heart can be closed. Additionally, balloon angioplasty can relieve narrowings in heart valves or vessels, and when necessary, stents can be placed in narrowed vessels to ensure proper blood flow.

Surgical Treatments (Heart Surgeries)

When interventional methods are insufficient or the structural defect in the heart is highly complex, open or closed heart surgeries are utilized. From the newborn period onward, many conditions—such as heart holes, severe valve insufficiencies, vessel narrowings, or the transposition of the heart's major vessels—can be successfully treated by our pediatric cardiovascular surgery team.

Childhood heart diseases are conditions that can largely be brought under control with early diagnosis and the right treatment approaches. It is vital for families to be aware of the symptoms, not to skip routine doctor check-ups, and to consult a specialist pediatric cardiologist without delay in suspicious situations. Thanks to modern medical technologies, many heart conditions are now permanently resolved before children even step into adulthood.

Complications and Risk Groups

Untreated or delayed childhood heart diseases can increase the heart's workload, eventually leading to heart failure. Children who develop heart failure may experience growth and developmental delays, frequent recurrent lung infections, and feeding difficulties. Furthermore, children with structural heart defects have a higher risk of developing infective endocarditis (inflammation of the inner lining of the heart) compared to the normal population.

Premature babies, children with genetic differences like Down syndrome or Turner syndrome, and babies diagnosed with intrauterine growth restriction are in the high-risk group for congenital heart diseases. Therefore, it is of great importance that babies with risk factors undergo a detailed cardiological examination immediately after birth.

When to See a Doctor?

If you suspect a heart-related issue in your child, it is necessary to observe the symptoms closely and consult a specialist without losing time. You should visit a pediatric cardiology outpatient clinic if you notice any of the following symptoms:

Excessive sweating during feeding in infants, letting go of the breast quickly, and panting.
A bluish tint around the lips, on the tongue, or at the base of the nails while crying or exerting effort.
Tiring very quickly during physical activities compared to peers, and feeling the need to stop playing and rest.
Unexplained, frequently recurring, and long-lasting respiratory tract infections.
The child feeling severe palpitations in their chest or complaining of chest pain.

If your child faints suddenly, experiences shortness of breath along with chest pain, or develops sudden and widespread cyanosis across their body, you should call 112 emergency medical services immediately or rush to the nearest hospital's emergency department without delay.

The Process at BHT CLINIC

At BHT CLINIC İstanbul Tema Hastanesi, the diagnosis, monitoring, and treatment of all heart diseases—spanning from the fetal (prenatal) period through the newborn, infant, adolescent, and young adult stages—are meticulously carried out by our experienced team. Our hospital utilizes special examination areas where children can feel safe, alongside state-of-the-art imaging equipment.

Particularly for couples with a family history of genetically inherited heart diseases, the risk of certain congenital conditions can be evaluated using preimplantation genetic diagnosis (PGD) during the IVF process. The procedures carried out at our BHT CLINIC IVF (In Vitro Fertilization) center can be planned in coordination with our pediatric cardiology specialists through a multidisciplinary approach. For all evaluations regarding your child's heart health, click to book an appointment with the BHT CLINIC Pediatric Cardiology department. Our 24/7 emergency department and our call center at 0850 811 34 00 are by your side for all your healthcare needs.

Frequently Asked Questions

Do heart holes in children close on their own?

Yes, some small-diameter holes, especially those located between the atria (ASD) or between the ventricles (VSD), can close spontaneously within the first few years as the child grows. However, the size and location of the hole, as well as the workload it places on the heart, must be monitored by a physician through regular ECHO follow-ups. Holes that do not close on their own or that strain the heart are closed using interventional or surgical methods.

Is an innocent murmur dangerous?

Innocent (functional) murmurs are not dangerous and do not mean there is a structural defect in the heart. They are usually heard due to the heart working faster during febrile illnesses, anemia, or periods of rapid growth. They do not restrict the child's daily activities, sports participation, or quality of life.

Do rhythm disorders in children go away?

Some rhythm disorders seen in children may resolve as they grow older or when the underlying cause (e.g., an infection or thyroid issue) is treated. However, certain arrhythmias can be permanent and may require treatment with regular medication or specific interventional procedures like radiofrequency ablation.

Does an ECHO (Echocardiography) involve radiation?

No, an echocardiography (ECHO) is an ultrasonographic imaging method performed entirely using sound waves. It contains no radiation, is painless, and has no side effects. Therefore, it can be safely used and repeated multiple times in babies, children, and even fetuses in the womb.

Can congenital heart diseases be detected in the womb?

Yes, through a method called fetal echocardiography, the baby's heart can be examined in detail between the 18th and 24th weeks of pregnancy. In this way, many significant congenital heart diseases are diagnosed before the baby is even born, allowing the birth to be planned at a fully equipped center with pediatric cardiology and surgery capabilities.

This article is for informational purposes only; please consult your physician for diagnosis and treatment.

Childhood Heart Diseases: Symptoms, Diagnosis, and Treatment Methods