BALTIMORE — As a pediatric cardiologist, I diagnose and treat children with heart conditions. I also assist families and children with implementing strategies to help prevent the onset of heart-related disease.
Parents, family members and children are counseled regarding the child’s specific heart findings and when necessary, management and treatment strategies are put into action.
News that Jimmy Kimmel’s son was born with a heart defect was on the front page of the news several weeks ago. Knowledge that his newborn son would need to undergo heart surgery at such a young age gripped the family and those hearing this story.
It is important to note that while not all children with defects of the heart will require heart surgery, many will require lifelong follow-up with a cardiologist. Some may require procedures of the heart such as cardiac catheterization or heart surgery.
In the field of pediatric cardiology, we often talk about two types of heart disease: congenital and acquired.
Congenital heart disease (CHD) refers to defects of the heart that occurred when the heart was forming (first three to eight weeks of pregnancy). CHD can present early or later in a child’s life, depending on the severity of the disease. CHD is actually the most common birth defect in the United States, occurring in 40,000 of the four million live births a year, or nearly one percent of U.S. births.
The other type of heart disease that will impact an even larger number of children and adults is acquired heart disease. Approximately 92.1 million people have at least one type of cardiovascular disease.
Known risk factors for cardiovascular disease include:
•Elevated blood pressure and hypertension
•Lack of physical activity
•Unhealthy weight/obesity/morbid obesity
•Elevated blood glucose/Diabetes
•Poor sleep and obstructive sleep apnea
It is not uncommon for parents, teachers and other providers to assume that a child is “fine.” Many of the conditions that put children at risk for long-term heart-related problems don’t cause symptoms.
For instance, most children with elevated blood pressure or high cholesterol are unaware that they have either of these conditions.
Parents should know that even if your child’s heart developed normally, decisions that we make in terms of what and how much we feed our children can also have an impact on their heart health.
Children who are of an unhealthy weight or who are obese (weight for height greater than the 95th percentile) are at a much higher risk for diabetes, hypertension, high cholesterol, obstructive sleep apnea, and early heart disease as adults.
We as parents must encourage good nutrition and avoid giving our children excessive calories (children are not little adults). Children need far fewer calories in order to grow normally. Avoiding sugar-sweetened beverages is important and avoiding or limiting high fat foods is crucial to maintaining a healthy weight.
Simple ways to keep our children healthy, include:
•Try to exercise every day
•Eat the green stuff: spinach, broccoli, green beans
•Avoid sugar-sweetened beverages
•Get a good night’s rest
Tips to help your child lead a healthier life according to the American Heart Association “Life’s Simple 7”: Questions to Ask Yourself as a Parent”
•One out of every 10 children has elevated blood pressure or hypertension. Do you know your child’s blood pressure? Is it abnormal?
•One out of at least 250 children has high cholesterol. If your child is over the age of 10 years, or there is a family history of high cholesterol and your child is over four years of age, do you know your child’s cholesterol level? Is it abnormal?
•Children 12-to-19 years of age should get one hour of physical activity each day. Does your child exercise for less than one hour per day, each week?
•How much does your child weigh? What is his or her body mass index? Is it greater than the 95th percentile? Check Out: https://nccd.cdc.gov/dnpabmi/Calculator.aspx
•Does your child smoke?
•Does your child snore?
•Does your child ever stop breathing when he or she sleeps? Does he or she find it hard to stay awake during the day?
If you answered yes to any of these questions, your child may benefit from lifestyle intervention that could potentially have a positive impact on his or heart long-term cardiovascular health.
The most important information that I can share with families is that while youth is protective, decisions we make or help our children to make at an early age can have a dramatic impact on whether they develop heart disease as an adult. No parent wants their child to suffer a heart attack or stroke as an adult, but it is important to note that the risk factors for heart attack and stroke can develop in early childhood.