Treating heart problems in children

Children can experience a range of heart problems as they grow and develop. While some are completely harmless and resolve themselves over time, others may need to be referred to a specialist paediatric cardiologist for treatment.

Our paediatric cardiologists at Royal Brompton Hospital and Evelina London Children’s Hospital have put together a short guide for parents below detailing the most common heart conditions affecting children and how they are treated.

It includes an overview of congenital heart disease (present from birth), acquired heart disease (develops after birth), arrhythmias (heart rhythm disturbances) and heart murmurs. Read on to learn more.

Congenital heart disease

Congenital heart disease is one of the most common birth defects, affecting 1 in every 100 babies born worldwide.

There are over 30 different types of congenital heart disease and they all affect the structures of the heart or its blood vessels, preventing it from pumping blood as it normally should. The different types can occur on their own or in combination.

“Depending on the type of congenital heart disease, specialist paediatric cardiac surgery may be needed soon after birth to prevent complications – such as in the case of a ventricular septal defect, or a ‘hole in the heart’,” explains Mr Caner Salih, consultant cardiac surgeon and chief of children’s cardiac surgery at our hospitals.

“Symptoms of congenital heart disease vary, particularly in babies and children, and can include a rapid heartbeat and breathing, as well as extreme tiredness and fatigue.” These symptoms can be noticed soon after birth, but mild defects may not cause problems until later in life.

The cause of a child’s congenital heart disease is not often identified, but certain risk factors can include the mother smoking during pregnancy or having poorly controlled diabetes.

Arrhythmias in children

An arrhythmia is any form of abnormality in the rhythm of a child’s heartbeat which prevents their heart from pumping blood as it normally should.

“Arrhythmias in children are quite common, affecting 2 in every 100 school-age children. If your child has an arrhythmia, their heart may beat too fast or too slow, or it may have extra beats or skip a beat,” explains Professor Alain Fraisse, consultant paediatric cardiologist at Royal Brompton Hospital.

“In most cases, arrhythmias in children are isolated occurrences and harmless, not requiring treatment. However, they can sometimes be serious and life threatening, particularly if they affect how efficiently the heart pumps blood to the rest of the body, such as the brain.”

There are many types of arrhythmia and some are forms of congenital heart disease. However, there are other causes which include infections, fever, and side effects of medications.

Symptoms of arrhythmia include a child feeling like their heart is fluttering or skipping a beat (called palpitations), feeling weak and tired, as well as lightheaded or dizzy.

“There are different types of treatment for arrhythmias in children including medicines to control the heart’s rhythm, but also minimally invasive surgical procedures such as cardiac ablation to precisely treat the part of the heart causing the problem,” says Professor Fraisse.

Heart murmurs in children

Heart murmurs are additional or unusual sounds made by the heart as the blood works its way around the tight bends of young child’s heart. It resembles a whooshing or swishing sound.

“Heart murmurs are very common in babies and young children, with most cases being completely harmless and resolving with age as the heart grows and matures,” explains Dr Owen Miller, consultant in paediatric and fetal cardiology at Evelina London Children’s Hospital.

Occasionally, a heart murmur can be a sign of a problem with the heart’s structure which affects the way blood flows through it, such as with some forms of congenital heart disease.

“If a heart murmur is thought to be due to a problem with the heart’s structure, we can conduct an echocardiogram (an ultrasound scan of the heart) to understand whether this is the case. This will help us determine the best treatment plan for your child,” says Dr Miller.

Acquired heart diseases in children

Acquired heart diseases include conditions that affect the heart and its blood vessels over a person’s lifetime.

These diseases are normally associated with adults, such as coronary heart disease which occurs when the arteries of the heart become narrowed with fatty deposits. However, they can sometimes affect children, where they have various causes.

Acquired heart diseases in children can be due to conditions that cause inflammation of the heart and/or its blood vessels, including rheumatic fever, Kawasaki disease and PIMS-TS (which stands for ‘Paediatric Inflammatory Multisystem Syndrome’).

Rheumatic fever is a rare complication following a bacterial throat infection, while PIMS-TS is a condition that occurs weeks after a child has had a COVID-19 infection. Kawasaki disease mainly affects children mostly under 5 and it is not exactly clear what causes it but may be due to an immune reaction to an infectious disease.

The symptoms of each disease and its treatment can vary. As these conditions can affect multiple organs in addition to the heart, children affected are normally referred to a specialist paediatric hospital, like Evelina London Children’s Hospital, where they can receive care from a multidisciplinary team of consultants.

Life-long specialist care for congenital heart disease

Treatments for congenital heart disease have improved immensely in recent decades – 97% of children born with congenital heart disease can now expect to survive into adulthood.

However, this presents challenges for managing patients as they can have complex health needs that require life-long specialist monitoring and care.

Following a successful pilot in 2020, both our adult hospital sites (Royal Brompton and St Thomas’ Hospital) now offer a one-stop adult congenital heart disease (ACHD) service where patients can receive all their routine monitoring diagnostic tests and see their consultant cardiologist and specialist cardiology nurse all on the same day.

“Our ACHD service greatly improves the care offered to our patients. Rather than waiting for multiple diagnostic tests that are sometimes arranged months apart on the NHS, they receive a convenient one-day service designed around them with minimal impact to their routine,” explains Professor Michael Gatzoulis, consultant cardiologist and clinical and academic lead for adult congenital heart disease at Royal Brompton Hospital, who led the development of the service.

With our expertise in cardiology across age groups, children diagnosed with congenital heart disease can receive life-long, joined-up specialist care at our hospitals.

Get in touch

If you are concerned about the health of your child’s heart and would like to speak to one of our paediatric cardiology specialists, please contact our dedicated customer services team.