Kids Health Info

Heart problems in children

  • About one in every 100 children has a heart problem (also called a heart defect). Heart defects can usually be treated with medicine, procedures or surgery. Common symptoms include a blue colour of the skin and lips, shortness of breath and difficulty feeding. However, many children have no symptoms and parents do not even know their child has a heart defect. Most tests for heart problems are simple, quick and are not painful. Many children with heart defects live a normal and full life.

    How the heart works

    The heart has four chambers (like rooms), two on each side of the body. The right side sends blood to the lungs to collect oxygen from the air we breathe, and the left side collects the fresh blood back from the lungs and pumps it to the rest of the body.

    Blue blood and red blood

    Blood from the lungs, which is full of oxygen, is often called 'red' blood, as it looks bright red. Blood that has returned from the body back to the heart does not have much oxygen so it looks darker (like a blue colour) and is often called 'blue' blood. 'Walls' in the heart keep this 'red' and 'blue' blood separate and 'valves' (like one-way doors) keep the blood flowing in the right direction.

    Heart Lungs Body diagram

    What is a heart defect?

    Sometimes there is a defect (problem) in the walls of the heart (i.e. a 'hole in the heart') or to the valves (i.e. they may be too narrow or completely blocked), which means either the blue and red blood gets mixed up or the heart may not pump very well.

    When these problems occur, the body may not get as much oxygen as normal.

    What causes a heart defect?

    • Usually a heart defect develops when the baby is still growing in the womb. Often, doctors cannot tell why this has happened and it is not caused by anything the mother did during her pregnancy.
    • Sometimes heart problems are due to genetics (i.e. a family history of heart defects).
    • Sometimes certain illnesses in childhood cause damage to the heart.
    • Very occasionally children get problems with their heart after a viral (virus) infection. This is extremely rare.

    Signs and symptoms of heart defects

    Many children appear healthy and their parents do not know they have a heart problem. If children do have symptoms, they often develop in the first few weeks after they are born.
    Common symptoms include:

    • 'Blue baby' - blue skin and blue around the lips.
    • Difficulty feeding.
    • Shortness of breath.

    These symptoms result from a reduced oxygen supply to the body, which happens because:

    • blood does not have as much oxygen as usual; or
    • the heart does not pump as well as it should.

    Testing for heart defects

    There are several tests performed for heart problems, most of which are simple, quick and are not painful:

    • Chest X-ray: a simple and quick X-ray of the chest 
    • ECG: 11 wires are attached (with sticky dots like Sellotape) on the skin of the chest, arms and legs which record electrical activity of the heart. It takes less than 10 minutes and your child cannot feel anything more than the sticky dots but must lie quite still for about a minute (this is tricky with small children as they move and wriggle around).
    • Ultrasound scan: called an 'Echocardiogram (often called 'an echo'). A handheld scanner is placed on the chest and stomach and gives a picture of the heart on a TV monitor. Your child will feel some pressure as the scanner is pushed quite firmly. It is not painful but may be a bit uncomfortable.

      Because your child must lie very still, sometimes they are given some medicine (sedation) to make them feel sleepy. This is usually a liquid they drink or a small squirt given up the nose by syringe. There are no needles.

    Treatment for heart defects

    If your family doctor or paediatrician thinks it is not urgent, you may need to wait several weeks for an appointment with the heart specialist. If symptoms develop very quickly, or if your baby is a newborn, your doctor will arrange tests and treatment much more quickly. Most heart defects can be fixed with medicine. Sometimes surgery or other procedures may be needed. In some cases there is no need for any treatment.

    Medicine
    For some heart problems children can take medicine which can be stopped once the problem has improved. Sometimes medicines need to be taken for many years or even for all their life.

    Surgery
    Heart surgery can provide a life-long cure for some heart conditions. A heart surgeon will discuss the risks and benefits with you in detail. In very rare cases where surgery, procedures or medicine does not help, a child may need a heart transplant.

    Other Procedures
    Some procedures involve putting a thin tube, called a catheter, through the veins to the heart to treat the heart defect. Your child is given a general anaesthetic for this procedure.

    How serious is it for a child to have a heart defect?

    Some parents worry that their child might die suddenly. Fortunately, this is extremely rare for children. Most children with heart problems can have effective treatment and many live an active and healthy life.

    Many parents feel very protective of their child if they have a heart problem. Yet many children can be independent, play competitive sports and do almost all of the things that other children do. If your child's school or another professional is concerned or gives you different advice, talk with the cardiologist (heart specialist) and ask for a letter about what your child can or cannot do.

    Follow-up

    After they have been treated, children with heart problems usually see their GP/family doctor or paediatrician with visits to their cardiologist every year or so. If you have concerns you should speak with your family doctor or cardiologist.

    Key points to remember

    • Heart defects are quite common in children (about one in 100).
    • Treatment for heart defects depends on the cause of the problem. In some cases treatment may not be necessary. In others, your child may need medicines, medical procedures or surgery (and sometimes a combination of all).
    • Children with minor heart problems often live long and normal lives without treatment.
    • Children who need treatment often have basically normal lives with little or no restrictions to what they can do.

    For more information

     

    Produced by RCH Dept. of Cardiology. Thanks to the parents who gave feedback to update this factsheet. First published 2004. Updated October 2010.

Disclaimer
This information is intended to support, not replace, discussion with your doctor or healthcare professionals. The authors of these consumer health information handouts have made a considerable effort to ensure the information is accurate, up to date and easy to understand. The Royal Children's Hospital, Melbourne accepts no responsibility for any inaccuracies, information perceived as misleading, or the success of any treatment regimen detailed in these handouts.