Resources
The following educational resources contain information on heart diseases, childhood cancers, nutrition for heart diseases, delicious recipies, information on the effects of loneliness, mental health, home, curb appeal and the effects of kids playing sports.
Heart Conditions
Pediatric Cardiomyopathy
Pediatric cardiomyopathy is a rare heart condition that affects infants and children. Specifically, cardiomyopathy means disease of the heart muscle (myocardium). Several different types of cardiomyopathy exist and the specific symptoms vary from case to case. In some cases, no symptoms may be present (asymptomatic); in many cases, cardiomyopathy is a progressive condition that may result in an impaired ability of the heart to pump blood; fatigue; heart block; irregular heartbeats (tachycardia); and, potentially, heart failure and sudden cardiac death.
Cardiomyopathy may be termed ischemic or nonischemic. Ischemic cardiomyopathy refers to cases that occur due to a lack of blood flow and oxygen (ischemia) to the heart. Such cases often result from hardening of the arteries (coronary artery disease). Nonischemic cardiomyopathy refers to cases that occur due to structural damage or malfunction of the heart muscle. Nearly all cases of pediatric cardiomyopathy are nonischemic. This report deals with nonischemic pediatric cardiomyopathy.
Cardiomyopathy may also be termed primary or secondary. Primary cardiomyopathy refers to cases where cardiomyopathy occurs by itself or for unknown reasons (idiopathic). Secondary cardiomyopathy refers to cases where the disease occurs secondary to a known cause such as heart muscle inflammation (myocarditis) caused by viral or bacterial infections; exposure to certain toxins such as heavy metals or excessive alcohol use; or certain disorders that affect the heart and/or additional organs systems.
According to the Pediatric Cardiomyopathy Registry, approximately 79 percent of pediatric cardiomyopathy cases occur for unknown reasons (idiopathic).
Nonischemic cardiomyopathy may be further divided into four subtypes based upon the specific changes within the heart. These subtypes are: dilated, hypertrophic, restrictive and arrhythmogenic right ventricular dysplasia.
Cardiomyopathy is a disease of the heart muscle. It affects people of all ages and is mostly inherited. It is not curable but can usually be treated successfully, with most of those affected going on to lead a long and full life.
There are several different types of cardiomyopathy three main types of cardiomyopathy – hypertrophic, dilated and arrhythmogenic right ventricular.
Early diagnosis
Increased awareness of the condition in recent years and recognition of subtle symptoms has helped early diagnosis and therefore early management. Without doubt, this can change the outcome of the condition and help to prevent complications. With the knowledge that the disease can be inherited, family screening has also contributed a great deal to early diagnosis. With knowledge of an existing or potential problem, lifestyle modifications and medication can be applied on time. Young people can be given appropriate advice when undergoing preventative screening and this is much better than treating an already severe condition.
Understanding the Condition
Understanding about the mechanisms and progression of heart dysfunction has significantly increased in the last few years. Studies have shown a number of mechanisms are activated when the heart function starts to go down and doctors are now trying to use these mechanisms in a beneficial way for the patient. In the context of a weak heart, the body’s reaction triggers compensatory mechanisms that can be helpful short term but damaging in the long term. Although it was previously thought that a weak heart needs medication that will make it beat more strongly, contemporary cardiology has been able to apply treatment that interferes with the more basic mechanisms.
An example of this is medication that prevents the heart condition from deteriorating further by keeping the heart rate and function mildly suppressed and under reasonable control. This is because studies have shown that the more you activate the failing heart, the worse it becomes in the long run. Whereas the more you protect the heart from its own compensatory reaction, the safer it is for the heart in the long term. So the philosophy in the management of heart dysfunction has changed over the years and is focusing on the prognosis and prevention of complications alongside the immediate reduction of symptoms
Congenital Heart Disease
Congenital heart disease is a category of heart disease that includes abnormalities in cardiovascular structures that occur before birth. These defects occur while the fetus is developing in the uterus and may affect approximately 1 in 100 children.
Congenital heart defects may produce symptoms at birth, during childhood, or not until adulthood. Other congenital defects may cause no symptoms.
What Causes Congenital Heart Disease?
The cause of congenital heart disease is unknown. However, there are some factors that are associated with an increased chance of having congenital heart disease. These risk factors include:
- Genetic or chromosomal abnormalities in the child, such as Down syndrome
- Taking certain medications or alcohol or drug abuse during pregnancy
- Maternal viral infection, such as rubella (German measles) in the first trimester of pregnancy
- The risk of having a child with congenital heart disease may double if a parent or a sibling has a congenital heart defect
What Types of Congenital Heart Problems Are There?
The most common congenital heart problems include:
- Heart valve defects. These can result in a narrowing or stenosis of the valves, or a complete closure that impedes or obstructs forward blood flow. Other valve defects include leaky valves that don’t close properly, thereby allowing blood to leak backwards.
- Defects in the walls between the atria and ventricles of the heart (atrial and ventricular septal defects).
- Holes or passageways between the heart’s different chambers may allow abnormal mixing of oxygenated and unoxygenated blood between the right and left sides of the heart.
- Heart muscle abnormalities that can lead to heart failure
There are several different types of CHD’s.
- Genetic or chromosomal abnormalities in the child, such as Down syndrome
- Taking certain medications or alcohol or drug abuse during pregnancy
- Maternal viral infection, such as rubella (German measles) in the first trimester of pregnancy
- The risk of having a child with congenital heart disease may double if a parent or a sibling has a congenital heart defect
Atrial Septal Defect
A congenital defect in the interatrial septum of the heart.
Atrioventricular Septal Defect
A heart defect, where there are holes between the right and left chambers of the heart, and the valves, which control the way blood flows in the chambers, may not be formed correctly.
Coarctation of the Aorta (“Coarctation of the Aorta.”)
The aorta is the largest organ of the body, and its function is to move oxygen-rich blood to the entire body to provide it with oxygen. Coarctation occurs in any part of the aorta, but it usually occurs in the ductus arteriosus artery.
Depending on how much the aorta is narrowed, symptoms of this will be shown once someone enters adulthood.
Dextro-Transposition of the Great Arteries (d-TGA)
d-TGA is a birth defect where the two main arteries of the heart, the pulmonary and aorta artery, are switched in position.
Hypoplastic Left Heart Syndrome
A malformation of the heart in which the left side is underdeveloped, resulting in insufficient blood flow.
Pulmonary Atresia
This occurs when the valve that controls the blood flow from the heart to the lungs does not form at all.
Tetralogy of Fallot
It is characterized by pulmonary stenosis, an opening in the interventricular septum, malposition of the aorta over both ventricles, and hypertrophy over the right ventricle.
Tricuspid Atresia
Tricuspid is the valve that controls blood flow from the right atrium, the upper right chamber of the heart, to the right ventricle, the lower right chamber of the heart.
Total Anomalous Pulmonary Venous Return (TAPVR)
Oxygen-rich blood does not return to the left atrium from the lungs. Instead, oxygen-rich blood returns to the right side of the heart, where there are oxygen-poor cells. The oxygen-rich and oxygen-poor cells combine, so the baby gets less oxygen than it actually needs
Most babies usually have a hole between their right and left atrium to survive with this defect
Truncus Arteriosus
This defect occurs when the blood vessel coming out of the babies’ heart does not separate during its development. As a result, there is still a connection between the aorta and the pulmonary artery.
There are different types of Truncus, but the most common one is a hole between the bottom two chambers of the heart ventricles (ventricular septal defect).
Most babies usually have a hole between their right and left atrium to survive with this defect
Ventricular Septal Defect
This occurs during pregnancy, and it happens when the wall between the left and right ventricles does not develop, leaving a hole in the heart.
In this process, the blood flows from the left ventricle to the ventricular septal defect then to the right ventricle. This extra step forces the heart and the lungs to work harder, and this can result in higher blood pressure, irregular heart rhythms, or stroke.
What Are the Symptoms of Congenital Heart Disease in Adults?
Congentital heart disease may be diagnosed before birth, right after birth, during childhood, or not until adulthood. It is possible to have a defect and no symptoms at all. In adults, if symptoms are present, they may include:
- Shortness of breath
- Limited ability to exercise
Congenital Heart Defects in Children
There are several congenital heart defects that are detected and treated early in infancy. Most of them are abnormal connections among the veins, as well as other arteries of the heart (aortic and pulmonary). These abnormal connections can allow unoxygenated blood to flow to the body instead of to the lungs, or allow oxygenated blood to flow to the lungs instead of to the body. They may also cause heart failure. Some examples of congenital heart disease in infants and children include:
- Patent ductus arteriosus (when blood bypasses the lungs, preventing oxygen from circulating throughout the body)
- Tetralogy of Fallot (four different heart defects that occur together)
- Transposition of the great vessels (blood from the left side of the heart and right side of the heart intermix because the large artery connections are incorrect)
- Coarctation of the aorta (a pinched aorta)
- Heart valve problems
- Shortness of breath
- Limited ability to exercise
What are the Symptoms of Congenital Heart Disease in Infants and Children?
The symptoms of congenital heart disease in infants and children include:
- Cyanosis (a bluish tint to the skin, fingernails, and lips)
- Fast breathing and poor feeding
- Poor weight gain
- Recurrent lung infections
- Inability to exercise
- Patent ductus arteriosus (when blood bypasses the lungs, preventing oxygen from circulating throughout the body)
- Tetralogy of Fallot (four different heart defects that occur together)
- Transposition of the great vessels (blood from the left side of the heart and right side of the heart intermix because the large artery connections are incorrect)
- Coarctation of the aorta (a pinched aorta)
- Heart valve problems
- Shortness of breath
- Limited ability to exercise
How Are Congenital Heart Defects in Children Treated?
Some congenital heart defects will require surgery or an interventional procedure to repair the problem.
Children with congenital heart disease may also need treatment with medication to improve heart function.
Children and adults with congenital heart disease should be treated by a cardiologist who specializes in congenital heart disease. Some types of disease may require a team approach as the child grows into an adult.
Atrial Fibrillation
Atrial fibrillation (say “A-tree-uhl fih-bruh-LAY-shun”) is an irregular heart rhythm (arrhythmia) that starts in the upper parts (atria) of the heart. Atrial fibrillation is the most common type of persistent irregular heartbeat (arrhythmia).
Normally, the heart beats in a strong, steady rhythm. In atrial fibrillation, a problem with the heart’s electrical system causes the atria to quiver, or fibrillate. The quivering upsets the normal rhythm between the atria and the lower parts (ventricles) of the heart. The lower parts may beat fast and without a regular rhythm.
Atrial fibrillation is dangerous because it greatly increases the risk of stroke. If the heart doesn’t beat strongly, blood can collect, or pool, in the atria. Pooled blood is more likely to form clots. If the heart pumps a clot into the bloodstream, the clot can travel to the brain and block blood flow, causing a stroke. Atrial fibrillation can also lead to heart failure.
What causes atrial fibrillation?
Conditions that damage or strain the heart commonly cause atrial fibrillation.
These include:
- High blood pressure
- Coronary artery disease (CAD)
- Heart attack
- Heart valve disease, especially diseases of the mitral valve
What are the symptoms?
Symptoms may include:
- Feeling dizzy or lightheaded
- Feeling out of breath
- Feeling weak and tired
- A feeling that the heart is fluttering, racing, or pounding (palpitations)
- A feeling that the heart is beating unevenly
- Chest pain (angina)
Third-Degree Atrioventricular Block
When DJ was 17 months old a horrible virus caused a Third-Degree Atrioventricular Block.
What is a Third-Degree Atrioventricular Block?
It’s a medical condition where the SA node (the hearts natural pacemaker; sets the heart rate) cannot do its job of sending impulses to propagate the ventricles (start the pump of blood throughout the body). The body does have a backup plan for if the SA node fails, the AV node is considered the secondary pacemaker. The AV node is only 40-60 beats per minute and the SA node is 60-100 beats per minute, which is a great decrease of blood pressure.
Anything less than 60 beats per minute causes bradycardia which will become a serious problem if the heart doesn’t pump enough oxygen rich blood to the body. A Third-Degree Atrioventricular block is when the AV is also blocked, and its classified as a complete heart block in many cases, where bradycardia is a common symptom.
What are the treatments?
In some less severe cases the heart block can go away on its own if the factor causing it are treated, such as changing medications or taking medications to increase heart rate (short term solution). The cure is a permanent pacemaker, which is what DJ got surgery for after the virus in his heart caused the third-degree atrioventricular block when he was 17 months old. The pacing may not be successful if the underlying diseases causing the heart block don’t receive treatment. Unfortunately, what caused DJs heart block was an underlying virus that was never seen before, or since. The virus was dormmate for 16 years after his surgery, until it woke up and destroyed his heart in a matter of weeks by causing cardiomyopathy (hard for the heart to deliver blood to the body) which lead to his passing.
How to tell if you have one (symptoms):
- Light headedness
- Dizziness
- Fainting
- Fatigue
- Chest Pain
- Bradycardia (slow heartbeat)
- Shortness of breath
Seek medical attention if experiencing any of these symptoms, especially if having past heart problems or family history of third-degree atrioventricular block.
What causes a third-degree atrioventricular block?
A third-degree AV block can be caused by damage to the heart from surgery, damage to the heart muscle from a heart attack, heart disease that results in muscle damage, heart valve disease, some medications, rheumatic fever (results if strep throat is not treated properly) and sarcoidosis (growth of tiny collections of inflammatory cells in different parts of the body). Some babies are born with a heart block and it may also be genetic factors. In DJs case it was a virus he contracted at 17 months old.