Heart

Maggie McKay (Host): Being a parent can be nerve-wracking on so many levels, but especially when your child is sick or you have a gut feeling something's not right today, we're going to discuss heart health awareness. Welcome to Baptist health radio. As the most preferred healthcare provider in Northeast Florida, we're here to help you stay informed with the latest news views and resources for your health and wellbeing.

Dr. Robert English is a pediatric interventional cardiologist with the Terry Heart Institute at Wolfson Children's Hospital of Jacksonville. Thank you so much for being here, doctor.

Dr. Robert English: Oh, thank you for the opportunity.

Maggie McKay (Host): Absolutely. So just to get started, what are the different heart conditions that children can have? And can you explain the difference between congenital heart disease or defects and acquired heart disease?

Dr. Robert English: Certainly. There are all types of defects that a child can be born with. They can have abnormalities of the heart valves. They can have holes in the walls that separate the various chambers of the heart. They can have abnormalities of the veins and the arteries that are connected to the heart. And these types of abnormalities are anatomical in nature. So when you're born with an anatomical abnormality of the heart, that's what we call a congenital heart defect. Children can also have abnormalities of the heart's electrical system or they can have abnormalities of the heart's ability to squeeze or pump blood.

So when a child has an abnormality of the heart that is something that wasn't present at birth, we call that acquired heart disease. Structural problems or anatomical problems are almost never acquired. Typically, acquired heart problems are due to an infection that might weaken the heart muscle or which cause the arteries supplying the heart muscle to develop aneurysms in them.

Maggie McKay (Host): That's so scary. How common is congenital heart disease?

Dr. Robert English: Well, fortunately, it's not very common. Typically, we quote about eight to ten children per 1000 will be born with some sort of heart defect.

Maggie McKay (Host): And what are some of the most common congenital heart defects in babies?

Dr. Robert English: Like I said, we see all sorts of different things from simple holes in the heart that will fix themselves and never require any sort of surgery to really complicated defects that involve multiple problems, multiple holes, multiple valve abnormalities. Sometimes the child might be missing an entire chamber of their heart. I would say the most common thing that we see is a simple hole between the lower two chambers of the heart and we call that VSD, which stands for ventricular septal defect.

Maggie McKay (Host): And what are some of the most common heart diseases that children develop after birth?

Dr. Robert English: Fortunately, that's even less common. And the most common acquired heart problems that we see are problems with the coronary arteries. These are the arteries that supply the heart muscle itself with blood. There is a disease out there called Kawasaki's disease that can cause aneurysms of the coronary arteries to develop. That's probably the most common acquired heart disease, but we also see situations where a viral infection might weaken the heart muscle or cause inflammation of the sac that surrounds the heart leading to fluid buildup around the heart. This is called pericarditis. And then we even see children who have been diagnosed with cancer and who have received chemotherapy that can sometimes weaken the heart muscle as well.

Maggie McKay (Host): What's the difference in the age of children who have heart problems? Like do teenagers have the same problems as say a toddler or different?

Dr. Robert English: That's a good question. So, a child can come to our attention with a defect that they were born with really at any age. And some people even live into adulthood not realizing that, for instance, they have a hole between the upper two chambers of their heart. Typically, the more serious things are obvious in the newborn period. The child might have a murmur or they might be blue or one of the more common symptoms is just that they have trouble feeding because they're constantly breathing hard. And, when a baby eats, they have to hold their breath. And if they're short of breath already, then they can't feed very well because they can't hold their breath to feed.

In older kids, typically, they'll come to our attention because their primary care doctor heard a heart murmur or maybe they passed out or had some difficulty breathing. Sometimes kids will come to our attention because they have difficulty exercising or playing sports. We have children who feel like they should be able to run for longer than they could otherwise and we evaluate them and find out that there's something wrong. But that's pretty unusual that that happens.

Maggie McKay (Host): Well, that's encouraging, If parents suspect their child has an underlying heart condition, where should they start? What doctor should they call first?

Dr. Robert English: Well, I think that it's important to make sure that the primary care doctor is aware of their concerns. Sometimes these concerns stem from past experiences that parents have had or have heard of a case of a child having a heart problem, and so then they worry. But they start with their primary care doctor and just tell them specifically what it is that they're concerned about. And then the primary care doctor will take that information and determine whether or not they need to come and see us and then, of course, we'll evaluate and have a listen and do some testing if we need to.

Maggie McKay (Host): Do heart defects require lifelong care or is there a cure?

Dr. Robert English: Most of the time with most heart defects, if they don't fix themselves, we can fix them and there's no long-term issues. But it's not too uncommon that a defect that a child is born with does require lifetime care. And we can usually fix the problem, but it doesn't mean we can forget the problem. And so sometimes, we'll need to follow them up and just make sure that they're not having any residual issues and we'll typically follow them all the way through childhood and into early adulthood at least.

Maggie McKay (Host): Anything related to the heart, especially when it comes to children can be scary. What advice or good news can you share with parents who are going through something similar? How do you put their mind at ease?

Dr. Robert English: Well, first of all, I don't know that I can ever truly put their minds at ease. as the father of a former patient at Wolfson children's hospital, I've been on their side. So I understand how scary it can be. at the same time, we have a great inexperienced team of specialists who want the child and the parents to feel as comfortable in a safe as possible.

We do this, day in and day out every day. Everybody on the team is very dedicated to ensuring the best outcome and really all eyes are on the child the entire time during these procedures. we take care of our patients as if they're our own kids. And typically for the procedures that I do, in the cardiac catheterization laboratory, the risk of any really serious complications is much less than 100.

Maggie McKay (Host): Oh, well, that's good news too. See, there's a lot of good news in here, doctor.

Dr. Robert English: Yeah, yeah.

Maggie McKay (Host): I mean, I'm sure it's scary, no matter what, but still. Anything else you'd like to say in closing?

Dr. Robert English: The one thing that I would say that frequently parents are really nervous about is when their child has chest pain. And it's important for parents to remember that chest pain is almost never caused by a heart problem in a child. And so when we see these kids to be evaluated, it's really important for the parent to be able to sort of recreate the circumstances when the chest pain happened. You know, was it at rest or was it with activity? Was it before or after eating a meal? What time of day it was. And knowing all those little details can usually lead us to the right answer, but it's almost never their hearts. So parents need to understand that we will find out what's causing it, but it's not typically anything serious.

Maggie McKay (Host): Okay. Thank you so much, Dr. English. All this information is invaluable. We really appreciate your time.

Dr. Robert English: Absolutely. It's my pleasure.

Maggie McKay (Host): The Pediatric Cardiology Cardiac Intensive Care and Heart Surgery Teams with Wolfson Children's C. Herman and Mary Virginia Terry Heart Institute treat a full range of pediatric cardiac conditions from defects present at birth to heart rhythm disorders. To learn more, call (904) 697-4300, that's (904) 697-4300, or visit wolfsonchildrens.com/heart. Thank you for listening to Baptist Health Radio. I'm your host, Maggie McKay. Be well.