Kids can have heart disease, too

Kids can have heart disease, too

By Donya Betancourt

SANUR, Bali (JP): It seems like a strange question, as we are
so accustomed to seeing older people with heart problems, but can
children have heart disease?

Unfortunately, the answer is yes.

Heart disease found in newborns and younger children can be
categorized as "congenital" and "acquired" heart disease.
Congenital means existing at birth, and it occurs in about eight
out of every 1,000 births around the world.

In most cases, the doctors do not know why the heart failed to
develop properly. The defects develop during pregnancy; some
cases are associated with genetic disorders, some may come from
exposure to the wrong medication during the first trimester of
pregnancy, for example, the anticonvulsant phenyltoin, skin
medication acutane or the manic-depressive medication lithium,
but most are not associated with any one particular cause.

Acquired heart disease can be from a viral infection to the
heart muscle, rheumatic heart disease or a secondary affect from
an other illness such as hypertension, Kawasaki disease
(infantile polyarteritus) or diabetes.

Knowing that your child has a congenital heart defect can be
frightening, but if you understand the heart muscle and are able
to picture how it looks and works then you can make a plan and
know how to share information with your child's doctor.

The heart is a muscle sac divided into four chambers, two
upper and two lower. The two upper chambers are the right and
left atrium, the two lower chambers are the right and the left
ventricles, and the septum is the wall that separates the left
and right sides of the heart.

There are a total of four valves that act as one-way gates for
blood flow at the atrium and ventricle chamber openings. The
following describes the blood journey through a normal heart. The
heart functions as a blood pump. It is made of very strong muscle
and this muscle contracts (squeezes) blood from the right to left
heart valve in a one-way direction. Blood from the body returns
to the heart via veins to the right atrium, when the right atrium
contracts, the blood will move through the tricuspid valve to the
right ventricle.

When the right ventricle contracts, the blood moves through
the pulmonic valve to a large blood vessel, the pulmonary artery,
and from there to the lungs. Once the blood is in the lungs it
picks up the oxygen it needs and returns to the heart via the
left atrium and passes through the mitral valve to the left
ventricle. From the left ventricle, the blood flows through the
aortic valve to another large blood vessel called the aorta, and
supplies oxygen-rich blood to all of the body. Blood through the
heart is on a one-way path, and the path is from the heart to the
lungs and then back to the heart again. Blood on the right side
of the heart is oxygen-poor and on the left is oxygen-rich.

Now, what can go wrong? The heart develops in the first eight
weeks of fetal life, and defects can occur in the chambers, the
septum in the middle of the heart, the valves or the blood
vessels. There are approximately 30 separate types of congenital
heart disease, so what are the effects from a defective part in
the heart? Blood can mix from the left side with the right side,
there can be blockage of the blood flow, abnormal blood flow from
the vessels leaving the heart, or a combination of them all.

The symptoms depend on what the defect is -- some defects may
never cause a problem, others may not become a problem until
later in life and some cause major problems immediately or soon
after birth.

Pain is not common, and many newborns with congenital heart
disease have no symptoms. Some may have rapid breathing or tire
quickly after eating but mostly they feel no different than any
other newborn. Most heart defects can be corrected or rectified
with surgery, and many children with congenital heart defects
live normal, productive and healthy lives.

Part two of this article next week will examine the different
types of heart disease in children. The writer is a pediatrician
based in Sanur, Bali. If you have questions, please contact her
at drdonya@hotmail.com, or you can reach her at
features@thejakartapost.com.