Spotting cardiovascular issues can be tricky with children. Experts explain what to look for and ways to protect their heart health long-term.
When it comes to raising kids, there’s a lot to keep track of: dentist appointments, recitals, wellness visits, soccer practice ― the list goes on and is never organized in your brain of what’s most important first.
And then there are the things that are on the list whether you’re aware of them or not ― like your child’s heart health. You know that you want, and maybe even assume, that your child’s heart is tiptop shape, but how do you know if it’s not?
Thankfully, you don’t have to do this alone, explained Dr. Sharon E. O’Brien, director of pediatric cardiology at Boston University School of Medicine. “One of the reasons pregnant women have a fetal screen ultrasound is to detect congenital heart disease,” she said. Depending on the type of ultrasound and sensitivity of the test, these screenings can detect anywhere from 65% to 95% of congenital heart disease.
But not all heart disease starts in utero. O’Brien said these are known as acquired heart issues, and don’t develop until early childhood or beyond. Here are some of the red flags that your child may be dealing with heart issues. Plus, some advice on what you can do to help keep your kid’s heart healthy, so they don’t have a problem down the road during adulthood.
Excessive sweating and poor weight gain
If you find your child sweating profusely regardless of the weather, that could be a warning sign for a heart issue. It’s especially important to pay attention to newborns doing this, said Dr. Achiau Ludormirsky, a pediatric cardiologist at Hassenfeld Children’s Hospital at NYU Langone.
“If there is excessive sweating, where you have to change their clothes every two to three hours, that’s something to be concerned about,” he said.
Ludormirsky added that slow weight gain because of poor feeding may also signal a problem, particularly if they fall asleep on the breast or bottle shortly after they start eating, preventing them from getting the calories they need.
“You may also notice the baby huffing and puffing for a long time after eating, which is clinically referred to as tachypnea ― a high respiratory rate,” he said.
All these symptoms, along with a rapid heart rate (known as tachycardia) may mean your child has intracardiac shunting ― abnormal pathways for blood flow that put the heart in volume and pressure overload.
“While your newborn will be monitored after birth, if you get home and notice they have blue lips or extremities, this can be cyanotic heart disease which results in low blood oxygen level and should be mentioned to a pediatrician,” Ludormirsky added.
Chest pain (and other funny feelings)
The same complaint that fires off warning bells for adults when it comes to their heart can also be worrisome when children start to complain about it, too. Just keep in mind, however, that kids may express this pain differently than adults.
“For younger kids, it can be hard to distinguish what’s going on,” O’Brien said. “It’s normal for heart rates to change based on what we’re doing, such as sleeping versus running, but sometimes heartbeats can be abnormally fast when they don’t need to be.”
Be mindful of chest “pain” that could be actual pain or palpitations, along with other symptoms like exercise intolerance, not being able to keep up with their friends, and being tired all the time (i.e., a child that always must be carried through the grocery store when peers their age walk without difficulty).
“If your child has experienced fainting, that’s a big red flag that needs immediate evaluation,” O’Brien said.
In addition to chest pain, notice if any corresponding symptoms come up in young kids, such as fever or rash. “This could be Kawasaki disease, which can cause inflammation in the coronary arteries and requires treatment,” O’Brien said.
Sometimes the sign that heart issues may be a problem for your child can be found on paper through their family history.
“In some cases, there is a family gene of hypercholesterolemia,” Ludormirsky said. “This is high cholesterol of 600 or more. In these cases, it’s always best to get the child set up with a cardiologist to help prevent early coronary heart disease.”
If you’ve had a family member have a heart attack at an early age, require a pacemaker, or any other cardiac issues, O’Brien said it’s best to mention that to your pediatrician so they are aware and can assess accordingly.
How to prevent heart disease in kids
When specialists discuss and evaluate heart disease in kids, there are two main buckets: congenital issues and acquired. But there is a third group ― preventative, said Dr. Carissa Baker-Smith, director of the pediatric preventive cardiology program at Nemours Children’s Health in Wilmington, Delaware, and an American Heart Association volunteer expert.
“When we talk about heart disease and adulthood ― things like high blood pressure, heart attack and stroke ― we often assume they only happen as adults. Yet these conditions can begin in early childhood if we’re not taking the proper preventative measures,” she said.
Here are a few ways Baker-Smith said you can protect your child’s heart health and spot warning signs early on:
- Recognize when a child’s weight for their height is not normal. Stay on top of your child’s wellness visits, as your pediatrician will log their growth chart. A body mass index greater than 85% is considered overweight and 95% is clinically classified as obesity.
- Joyful movement is important. Even when the weather gods are against you ― get your kids moving around the house. Anything goes ― a game of Twister, helping you clean, making silly TikTok videos, whatever has them off the couch and moving.
- Meal balance is key. Try to get as many fruits and vegetables into their diet as possible. When fresh isn’t an option, frozen is a healthy substitute. (Skip canned fruits and veggies though, as they contain a lot of salt and sugar.)
- Practice portion control. An easy way to do this is to serve kids meals on a salad plate. They don’t need to be (and shouldn’t be) eating the same amount of food adults are yet.
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