HeartDisease

Whattypeofheartconditionsarecommonlydiagnosedin
childrenandhowcanthesymptomsbemanaged?

MedeaBurton
Mrs.Lindinger
SeniorProject
March11,2015

In2008,heartdiseasecausedalmost25%ofdeathsalmostoneineveryfourinthe
UnitedStates.Although,heartdiseasearecommonlyinchildrenandhowtheyriskfactorscan
bemanagedindifferentways.Theheartdiseasethatarecommonlydiagnosedinchildrenare
SingleVentricleDefects,AorticValveStenosis,RheumaticHeartDiseaseetc.Thesymptomscan
bemanagedbycheckingupwiththedoctorandmakingsureyourbodyishealthy.Thekindof
heartdiseasesthatchildrencangetisrheumaticheartdisease,congentialheartdisease
,cardiovascularheartdisease.Alsotheriskfactorsinheartdiseasearehighbloodpressure
smoking,stress,angeretc.Anotherreasonistreatmentsforheartdiseasearestabilizingthe
conditions,controllingsymptomsoverlongtermalsoastressreductionandadietlifestyle
.Heartdiseasecanbecommonlyfoundinchildrenanddiagnosedinchildrenandthereare
differentwaysriskfactorsbemanaged.
MostsuddendeathsinathleteswereattributabletoCVD(56%).Ofthecardiovascular
deathsthatoccurred,29%occurredinblacks,54%inhighschoolstudents,and82%with
physicalexertionduringcompetition/training,andonly11%occurredinfemales.Whiteshasthe
highestratesinHeartDiseasewhichis25.1%,thesecondhighestraceisAfricanAmericans
whichis24.5%.Whatheartdiseaseisalsoknownascardiovasculardiseaseitgenerallyrefersto
conditionsinvolvenarrowedorblockedbloodvesselsthatcanleadtoaheartattack,chestpains
orstroke.Thedemographicsinheartdiseaseisthatwomenandelderlywomencancommonly
getheartdiseasemorethanmales.InchildrenboyswerelikelytohaveCHDsurgeythangirls.
Femaleshaveamorelowriskprocedurestodealwithharderthanboysdo.Howeverthe
adjustedinhospitaldeathsarehigherinfemales,CHDcanbefoundinchildrentheageof10
throughouttheiradulthood(NHLBI,2014,pg.1).Accordingtotext,NHLBIsaysCHDisa

diseaseinwhichawaxysubstancecalledplaquebuildsupinsidethecoronaryarteries.These
arteriessupplyoxygenrichbloodtoyourheartmuscle
ThecausesofheartdiseaseisPlaquebuildupthickensandstiffensarterywalls,which
caninhibitbloodflowthroughyourarteriestoyourorgansandtissues.Atherosclerosisisalso
themostcommoncauseofcardiovasculardisease.Itcanbecausedbycorrectableproblems,
suchasanunhealthydiet,lackofexercise,beingoverweightandsmoking.Alsoheartdisease
canbeginswithdamagetotheliningandinnerlayersofthecoronaryarteries.Plaquemaybegin
tobuildupwherethearteriesaredamaged.Thebuildupofplaqueinthecoronaryarteriesmay
startinchildhood.Overtime,plaquecanhardenedplaquenarrowsthecoronaryarteriesand
reducestheflowofoxygenrichbloodtotheheart.Thiscancausechestpainordiscomfort
calledangina.Iftheplaqueruptures,bloodcellfragmentscalledplateletssticktothesiteofthe
injury.Theymayclumptogethertoformbloodclots.
Bloodclotscanfurthernarrowthecoronaryarteriesandworsenangina.Ifaclotbecomes
largeenough,itcanmostlyorcompletelyblockacoronaryarteryandcauseaheartattack.
Theresultsofheartdiseaseisheartattack,stroke,heartfailure,peripheralvascular
disease.
Signsandsymptomsofheartdiseaseischestpain.shortnessofbreath,Pain,numbness,
weaknessorcoldnessinyourlegsorarmsifthebloodvesselsinthosepartsofyourbodyare
narrowed.Painintheneck,jaw,throat,upperabdomenorback.
ThetreatmentsorthegoaltocureheartdiseaseisRelievesymptoms.Reduceriskfactors
inanefforttoslow,stop,orreversethebuildupofplaque.Lowertheriskofbloodclotsforming.
(Bloodclotscancauseaheartattack.)Widenorbypassplaquecloggedcoronary(heart)arteries.

PreventCHDcomplications.Alsopeoplewithheartdiseasecanchangetheirlifestylesifthe
preventortreatCHDbydoingquitsmokingorbybeingonhealthydiet,bephysicalactive
.maintainahealthyweight,notsufferfromstressordepressionetc.
Before1900,veryfewpeoplediedofheartdisease.Sincethen,heartdiseasehasbecome
thenumberonekillerintheUnitedStates.Theageoftechnologyhasmadelifeeasierandmade
peoplemorepronetoheartdisease.Thecombinationofasedentarylifestyleandarichdietledto
anincreaseincloggedbloodvessels,heartattacks,andstrokes.Heartdiseasebecame
commonplace.Therateofheartdiseaseincreasedsosharplybetweenthe1940and1967thatthe
WorldHealthOrganizationcalledittheworld'smostseriousepidemic.
Medicalscienceimmediatelywenttoworkstudyingthediseaseandsearchingoutits
causesandcures.In1948,athirtyyearstudybeganinFramingham,Massachusetts.Knownas
theFraminghamStudy,theinvestigationinvolved5127peopleaged30to62whoshowedno
signsofheartdisease.Everytwoyears,theparticipantsunderwentacompletephysical
examination.TheStudylastedthirtyyearsandprovidedpricelessprofileinformationfor
predictingheartdisease.HeartdiseaseisthenumberonekillerofmenandwomenintheUnited
Statestoday.In2008,over600,000Americansdiedofthedisease.Hundredsofthousandsmore
sufferedfromanonfatalheartattack.Tosayexactlywhencivilizationfirstbecameawareof
coronaryarterydiseaseorarterynarrowingisdifficult.However,itsknownthatLeonardoda
Vinci(14521519)investigatedcoronaryarteries.WilliamHarvey(15781657)physicianto
KingCharlesIiscreditedwithdiscoveringhowthebloodmoves:fromtherightventricleof
theheartthroughthelungandintotheaorta,thentheperipheralvessels,andbackintothelung.
Later,FriedrichHoffmann(16601742),chiefprofessorofcardiologyattheUniversityofHalle,

notedthatcoronaryheartdiseasestartedinthereducedpassageofthebloodwithinthecoronary
arteries.

OnewaytopreventheartdiseaseinchildrenisHeartdiseaseisamajornationalhealth
concern.ItistheprimarycauseofmortalityintheUnitedStates,claimingmoreAmericanlives
everyyearthanthenextfiveleadingcausesofdeathcombined.
Althoughheartdiseaseistypicallydiagnosedinadulthood,sadly,itsrootsoftenbeginin
childhood.Compellingresearchhasshownthatplaquebeginsbuildingupinthewallsofthe
arteries(knownasarteriosclerosis)veryearlyinlife.Infact,fattybuilduphasbeenidentifiedin
theheartsofchildrenasyoungasfiveyearsold.Heartdiseaseistheresultofalifelongprocess
and,assuch,interventionstrategiestoreduceriskshouldbegininchildhood.
Researchunderscorestheimportanceofadoptingahealthylifestyleasearlyinlifeas
possible.Scientificevidencecollectedinthelastthirtyyearshasgreatlyinformedour
understandingofheartdiseaseanditsassociatedmodifiableriskfactors.The"evidencedbased"
guidancedispensedbygroupslikethe

AmericanHeartAssociation
andthe

NationalCholesterol
EducationProgram
isbasedlargelyonthisresearch.
Muchofthecompellinghistoricaldatarelatedtochildrenandheartdiseasecomesfrom
epidemiologicalstudieswhichfollowagroupofyoungsubjectsforasignificantperiodoftime
(forexample,childhoodthroughadolescencethroughearlyadulthood)toobservewhichhealth
factorscontributetothedevelopmentheartdisease.Thistypeofresearchallowsforalong
followupperiodandtheabilityto"track"varioushealthparametersthroughouttheyears.
Therearedifferenttypesofstudiesthatchildrencangetheartdiseases:

BogalusaHeartStudy:
Perhapsthemostwellknownstudytolookspecificallyatthe
naturalhistoryanddevelopmentof

heartdisease
,researchersbegancollectingdataonyoung
subjectsinBogalusa,Louisianain1973.Morethan16,000subjectshavebeeninvolvedinthis
study,whichhasfollowedsomeparticipantsfromearlylifetoage40.
FraminghamChildren'sStudy:
Initiatedin1985aspartoftheFraminghamHeart
Study,thisMassachusettsbasedstudyexaminesfactorsthatinfluenceeatingandexercise
behaviorsinchildrenthataffectfuture

heartdisease
risk,includingdataonfamilyand
environmentalfactors.Thisisonewaytopreventheartdisease.

Anotherwaytopreventheartdiseaseisbyeatinghealthyandlivingahealthierlifestyle
suchas,Nutritionanddietplayahugeroleinpreventingheartdisease.Accordingto
theMayo
Clinic
,
researchsuggeststhatevenifyouhaveafamilyhistoryorgeneticpredispositionforheart
disease,maintainingagooddietcanreduceyourrisk.Mostresearchhasshownthatadiethigh
inrawfruitsandvegetables,wholegrains,andomega3fattyacids(oftenfoundinfish)helps
preventheartdisease.TheMediterraneanstyledietinparticularisknowntoreducethe
occurrenceofheartdisease.Alongwithincreasedservingsoffruitsandvegetables,wholegrains,
andfishtwiceaweek,theMediterraneanstyledietfocusesontheuseofoliveoil(healthyfat)
andherbs,consumingnuts,andlimitingredmeattooneortwotimesamonth.
Tomaintainahealthydiet,youllalsoneedtoavoidorlimitsomefoodsthatworsen
heartdisease.Thisincludesfoodswithhighamountsofsugarandsalt,alcoholicbeverages,and
foodswithpartiallyhydrogenatedvegetableoil.Dontforgetthatwatchingcaloriesisimportant,
too.Knowhowmanycaloriesperdayyoushouldbegettingandfocusoneatingavarietyof

foodsthatarehighinnutrientsandlowincalories.Heartdiseasemaybetheleadingkillerofmen
andwomen,butthatdoesntmeanyoucantprotectyourself.Inadditiontoexercise,being
carefulaboutwhatyoueatandwhatyoudonteatcanhelpyoulowercholesterol,control
bloodpressureandbloodsugarlevels,andmaintainahealthyweight.Ifyouvealreadybeen
diagnosedwithheartdiseaseorhavehighcholesterolorbloodpressure,aheartsmartdietcan
helpyoubettermanagetheseconditions,loweringyourriskforheartattack.Accordingtothe
text,Fiber'sroleinpreventingheartdiseaseisthoughttostemfromitsabilitytolowerboth
bloodpressureandcholesterol.Italsofillsyouup,whichhelpsyoueatlessandperhapslose
weight(Robinson,2015,pg.1).Improvingyourdietisanimportantsteptowardpreventingheart
disease,butyoumayfeelunsurewheretobegin.Takealookatthebigpicture:youroverall
eatingpatternsaremoreimportantthanobsessingoverindividualfoods.Nosinglefoodcan
makeyoumagicallyhealthy,soyourgoalcanbetoincorporateavarietyofhealthyfoods
cookedinhealthywaysintoyourdiet,andmakethesehabitsyournewlifestyle.Thisisanother
waytopreventheartdiseasecanchildrencanpreventfromhavingheartdiseaseoritandbea
goalforthetreatmentforheartdisease.

AnotherheartdiseasethatchildrencanbediagnosedisRheumaticHeartDisease.
RheumaticHeartDiseaseisveryrarediseasetofindinchildren.
Rheumaticheartdisease
describesagroupofshorttermandlongtermheartdisordersthatcanoccurasaresultof
rheumaticfever.Onecommonresultofrheumaticfeverisheartvalvedamage.Thisdamageto
theheartvalvesmayleadtoavalvedisorder.Rheumaticfeverisaninflammatorydiseasethat
mayaffectmanyconnectivetissuesofthebody,especiallythoseoftheheart,joints,brainor

skin.Itusuallystartsoutasastrepthroatinfection.Anyonecangetacuterheumaticfever,butit
usuallyoccursinchildrenbetweentheagesof5and15years.About60%ofpeoplewith
rheumaticfeverdevelopsomedegreeofsubsequentheartdisease.Accordingtothetext,
The
bodyproducesantibodiestofightthebacteria,butinsteadtheantibodiesattackadifferenttarget
thebody'sowntissues(WebMD,2004,pg.1).
Everypartoftheheart,includingtheoutersac(thepericardium),theinnerlining(the
endocardium)andthevalvesmaybedamagedbyinflammationcausedbyacuterheumaticfever.
However,themostcommonformofrheumaticheartdiseaseaffectstheheartvalves,particularly
themitralvalve.Itmaytakeseveralyearsafteranepisodeofrheumaticfeverforvalvedamage
todeveloporsymptomstoappear.
Antibioticscanpreventstreptococcalinfectionfromdevelopingintorheumaticfever.
Anychildwithapersistentsorethroatshouldhaveathroatculturetocheckforstrepinfection.
Penicillinoranotherantibioticwillusuallypreventstrepthroatfromdevelopingintorheumatic
fever.Forexample,akidcanhaveheartdiseaseattheageof5andthevalvescangetdamaged
oryoumaycannevercurethemormakethemcomebackbetter.Theycouldneverfindacure
tilltoday.Accordingtothetext,
Asmanyas39%ofpatientswithacuterheumaticfevermay
developvaryingdegreesofpancarditiswithassociatedvalveinsufficiency,heartfailure,
pericarditis,andevendeath(Chin,2014,pg.1)
.Overall,alotpeoplehavewiththe39%hasa
acuterheumaticfeverwhichcanberiskfactors.
ThesymptomsforRheumaticHeartDisease
Symptomsofheartvalveproblems,which
areoftentheresultofrheumaticheartdisease,caninclude:chestpain,excessivefatigue,heart
palpitations(whentheheartfluttersormissesbeats),athumpingsensationinthechest,shortness

ofbreath,andswollenankles,wristsorstomach.Additionally,theotherheartdiseaseisSingle
VentricleDefects
Childrenwithasingleventricledefectarebornwithaheartthathasonlyone
ventriclelargeenoughorstrongenoughtopumpeffectively.Inmostcases,childrenwithsingle
ventricleheartdefectsrequireintensivemedicalinterventionsoonafterbirth.Thehearthasfour
chambers.Theupperchambers,calledatria,receivebloodflowingintotheheart.Thelower
chambers,calledventricles,pumpbloodoutoftheheart.Achildwithasingleventricledefectis
bornwithaheartthathasonlyoneventriclethatislargeenoughorstrongenoughtopump
effectively.SingleventricleheartdefectsincludeDoubleoutletleftventricle(DOLV)Some
heterotaxy
defects.Other
congenitalheartdefectssuchasHypoplasticleftSyndrome
,Tricuspid
atresia.Forexample,
Thereisnotricuspidvalveintheheartsobloodcannotflowfromthe

bodyintotheheartinthenormalway.Thebloodisnotbeingproperlyrefilledwithoxygenit
doesnotcompletethenormalcycleofbodyheartlungsheartbody.Overall,bloodcan
stop
flowingwhentherearebloodclotsandcanbeveryserious.Basedonthetext,
Asdescribed
above,achildwithcomplexsingleventriclehasonlyoneworkingventricle(LeRoy,2012,pg.1).

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