A heart murmur is an extra sound that your doctor can hear when listening to the heart. Although being told that your child has a heart murmur can be scary, murmurs can also be normal. Murmurs can also be due to a heart defect like a hole in the heart or a valve abnormality. Listening carefully to the heart, performing an EKG and in some cases an echocardiogram (an ultrasound of the heart), will help tell the difference. If a murmur is found to be due to a structural heart problem, the pediatric cardiologist can determine if any treatment is needed.
These are abnormalities in the structure of the heart that are present at birth. Sometimes these are detected in babies, but other times they are not diagnosed until a child is older. Many heart defects are mild and do not need treatment. Others are more significant, and require medication or interventional procedures like surgery. Pediatric heart surgery is not available in Central Oregon, so if a child needs heart surgery, they are referred to a children’s hospital with special expertise in pediatric heart surgery and postoperative care.
Many heart conditions can have a genetic component. These can include disorders of the heart muscle (cardiomyopathies), heart rhythm problems (like long QT syndrome), congenital heart defects (like bicuspid aortic valve), or connective tissue problems (like Marfan syndrome). Also, children with genetic syndromes like Turner syndrome, Down syndrome, and others are at increased risk for heart defects and therefore should be screened. Screening for many such heart conditions can be accomplished using testing like echocardiography, EKG, and genetic testing.
Chest pain is very common in children, but in most cases is not dangerous. Your child’s primary care provider can determine when further heart evaluation is needed, for example if chest pain is happening with exercise, or if it is associated with other symptoms like fainting, shortness of breath, or a racing heart.
Fainting is also very common in children, and is usually not dangerous unless it causes injury. Although fainting can be related to a heart problem such as an electrical disturbance, in most cases it is due to changes in blood pressure or heart rate, such as in postural orthostatic tachycardia syndrome
(POTS) or vasovagal syncope (the “common” faint). Usually, this type of fainting can be treated with dietary or lifestyle changes, although medication is also available.
Abnormalities in the heart’s electrical system can cause feelings of a racing or irregular heartbeat. Sometimes, they can also cause fainting or other symptoms. Some heart rhythm abnormalities are benign, while others need treatment with medications or specialized procedures. Because heart rhythm symptoms are not necessarily present when a person goes to the doctor, monitors called ambulatory monitors can be used at home to find a diagnosis.
Children with a heart abnormality or a family history of heart problems can be at increased risk when participating in certain types of competitive sports or undergoing anesthesia for surgery. We can help determine what is safe for your child.
There are many possible causes for hypertension in children. These include being overweight, genetics, kidney disorders, and less commonly a congenital heart defect. Children who have had hypertension for a long time can also develop changes in their heart muscle which help tell us that it is time for treatment to lower the blood pressure. Some children with hypertension are seen in the Preventive Clinic, where a dietician discusses lifestyle changes that may be helpful.