Enlarged Heart in Children

By Batul Nafisa Baxamusa

Enlarged heart in children is not a disease in itself, but a very rare symptom of other underlying medical conditions. This article will cover all the information you need to know more on its causes.

Cardiomegaly is the medical term for enlarged heart in children. It refers to the enlarged heart size seen on an X-ray, a sign that shows the heart is an overworked organ. It is usually a symptom of some underlying disease or something that alters the functioning of the heart. Adults can develop cardiomegaly due to stress on the working of the body, pregnancy or a heart disease like weakening of the muscles of the heart, coronary artery disease, heart valve problems or abnormal heart rhythms.

What is an Enlarged Heart?

Enlarged heart or cardiomegaly as mentioned is not a disease in itself. It is a condition where one observes enlargement of the heart on a chest X-ray. It is related to the disease of the heart muscles, that is, myocardium. There are different types of cardiomyopathies. These include primary that involves ailments of the heart. Secondary that involves some other disease or toxins that affect other organs as well as heart. Let us see what causes cardiomegaly in children.

Causes of Enlarged Heart in Children

High stress levels on the heart causes it to enlarge as the chambers grow and allow more blood to be processed. Thus, depending on the nature of enlargement, the heart is stretched more than its limit. A swelling in the heart in children may also lead to death. Cardiomegaly is also called hypertrophic heart. When the left ventricle of the heart gets enlarged, it is called left ventricular hypertrophy. The causes of an enlarged heart like ventricular hypertrophy is due to some disease or condition that causes extra stress on the left ventricle. The left ventricle is the main chamber for pumping in the heart.

One of the causes can also be due to cardiomyopathy. In cardiomyopathy, the heart is prevented from pumping enough blood. This causes deficiency of blood requirement within the body, leading to a condition called congestive heart failure. There can be an increase in blood pressure in the lungs and it can lead to a condition called pulmonary hypertension.

At times pericarditis can also lead to this condition. The sac surrounding the heart, that is, pericardium gets irritated and starts swelling. The child will complain of a sharp pain in the left side or the center of the chest. Fever, dry cough, shortness of breath and fatigue are common signs. Pericarditis may last for a few weeks or may become a chronic condition that lasts as long as 6 months or beyond. Other than that, myocarditis, that is inflammation of the heart wall can also lead to cardiomegaly. It is generally due to a reaction to certain chemicals, infection, medications as well as radiation.

The main causes due to cardiomyopathy is viral infection. It is generally an overreaction of the immune system to a viral infection. This virus is commonly found to be the Coxsackievirus B (CVB). Bacterial infection, like endocarditis can also lead to enlargement of the heart in children. This condition is generally treated with the help of aggressive antibiotic medications.

Many times, it may be due to congenital heart diseases, nutritional deficiency, fast heart rhythms or even due to chemotherapy for treating cancers in children. Cardiomyopathy can also be due to genetic disease or have no known cause.

Types of Cardiomyopathy Causing Enlarged Heart

There are a few types of cardiomyopathy that causes dilation of the heart. The following are some of the causes:

Dilated or Congestive Cardiomyopathy

The most common type of cardiomyopathy that causes the heart to enlarge and stretch that makes it weak and pump blood inefficiently. This disease may also cause other conditions like irregular heart rhythms leading to arrhythmia or dysrhythmia, increased chances of developing blood clots and congestive heart failure. Many infections, especially viral infections may also cause an inflammation of the heart muscles or myocarditis that causes cardiomyopathy. Chemotherapy that is given for treating cancers also leads to dilated cardiomyopathy. Many times, 20% of the children suffering from this condition have someone in the family with cardiomyopathy, making it a type of hereditary disease.

As explained earlier, the blood flow to the various parts of the body is decreased in cardiomyopathy. Thus, the body begins to conserve nutrients in the essential organs like brain, kidneys, etc. by lowering the supply of these essentials nutrients to skin and muscles. There are many symptoms of dilated cardiomyopathy that are commonly seen in children. However, not all children exhibit these symptoms. The symptoms due to dilated cardiomyopathy include:

Ashen skin color or pale color

Sweaty skin

Rapid heart rate

Increased rate of breathing

Shortness of breath

Fatigue

Irritability

Chest pain

Slow growth

Vomiting

Abdominal pain

The treatment of dilated cardiomyopathy is based on the child's age and overall health of the child. The progress of the disease and the tolerance to specific therapies, medications and procedures by the child also plays an important role. The doctor may try to help the heartbeat more effectively and decrease the stress on the heart with the help of certain medications. He may also prescribe drugs that prevent clots, inflammation and irregular heartbeats. The enlarged heart in children due to dilated cardiomyopathy may improve with improvement in the viral infection. However, it may also worsen and transplantation of the heart may be considered.

Hypertrophic Cardiomyopathy

Hypertrophic cardiomyopathy; also known by other medical terms like hypertrophic obstructive cardiomyopathy (HOCM), asymmetric septal hypertrophy (ASH), or idiopathic hypertrophic subaortic stenosis (IHSS), is a rare disease. In this condition, the muscular mass of left ventricles become larger than normal or the septum between the two ventricles is enlarged. This causes obstruction in the flow of blood from the left ventricle, leading to abnormalities.

One of the mitral valve separating the left atrium and left ventricle may get affected by the thickened septal wall. This leads to a leaking mitral valve. Thus, the blood moves backward from the left ventricle into the left atrium instead of flowing in the forward direction into the body. The causes of enlarged heart due to hypertrophic cardiomyopathy is mostly due to hereditary conditions. The symptoms due to hypertrophic cardiomyopathy are:

Dizziness

Pain in chest

Abnormal heart rhythms

Fainting spells

The course of treatment and medications given to treat this condition due to hypertrophic cardiomyopathy are similar to dilated cardiomyopathy. The treatment of hypertrophic cardiomyopathy may also include surgery. The surgical procedures may involve placing an artificial pace maker, removal of a part of the enlarged muscle or heart transplantation.

If you observe anything out of the unusual with your child's health, consult a doctor immediately. It is very important to trust your parental instincts and take immediate action to ease it. Your child's doctor knows what's best for your child. Follow medical advice and take some utmost care of your child and his/her heart health.

Heart Valve Disease - Symptoms and Possible Causes

by Saul Peterson

The heart is one of the strongest muscles in the human body. It is divided into two halves, called the atrium and the ventricle chambers and between these two chambers are a set of valves that insure that the blood flows in only one direction. Occasionally however, these valves become damaged and as a result the person could suffer from some sort of heart valve disease. If left untreated this disease could lead to heart failure and even death.

Signs and Symptoms

It is truly difficult to determine if a set of symptoms are a sign of heart valve disease, since many of them are so mild and can be attributed to a number of different conditions including asthma, heartburn, heart attack, or sometimes even pregnancy. The best thing to do is to have a running conversation with your medical professional concerning your thoughts and physical symptoms. Based on that complete picture, he or she should be able to diagnose your situation professionally. Heart valve disease is a serious condition, and should never be self-diagnosed although there are a few common symptoms of heart valve disease that if you notice on a regular basis you should watch out for. If you experience dizzy spells or faintness brought on by physical activity, shortness of breath, or chest pain while doing physical activity it is certainly something to bring up to your doctor as soon as possible.

Possible Causes of Heart Valve Disease

Often heart valve disease is caused by a malformation of the valves that separate the two chambers of the heart. These deformities can include narrowed valves, and leaking valves.

Narrowed valves that can lead to valve heart disease can be caused by a number of things, some unpreventable, others that can be prevented. One cause of this condition is congenital abnormality, a condition that is often seen since birth. Another cause, one that can be prevented through diet exercise and perhaps medications is degeneration of the valve through atherosclerosis, or hardening of the blood vessels. In addition heart valve disease can also be caused by damage from rheumatic fever or extensive calcification that sometimes occurs in old age.

Leaking valves that can lead to heart valve disease can be caused by a number of additional factors. These include such things as a bacterial infection, or other inflammation of the valve, excessive floppiness of the valve leaflets, or even enlargement of the heart or the aorta. Any or all of these things can be the cause for leaking valves, and therefore heart valve disease.

Although heart valve disease is not, in every case a matter of life and death, it can sometimes lead to major complications within the heart, which is something that nobody would ever want. The best course of action, as always in any medical situation, is to talk to your doctor and be honest with him or her. Together you should be able to recognize a potential case of heart valve disease and make the necessary lifestyle changes.

Complete Information on Fallot Tetralogy

by Alicia Stock

Tetralogy of fallot is a congenital heart defect. This heart defect is mostly find in children. Congenital heart defects change the normal flow of blood through the heart. This rare and complex heart defect occurs in about 5 out every 10,000 babies. It affects boys and girls equally. Tetralogy of Fallot occurs due to improper development of the heart in the first eight weeks of fetal growth. Some congenital heart defects may have a genetic link. One genetic link that has been associated with tetralogy of fallot is a deletion, or tiny missing piece, of chromosone 22q11. The condition is known as the 22q11 deletion, and blood tests are available to detect it.

Environmental exposures, such as maternal abuse of alcohol during pregnancy leading to fetal alcohol syndrome (FAS), are Connected to Tetralogy of Fallot. Mothers who take medications to control seizures and mothers with phenylketonuria (PKU) also are more likely to have a baby with Tetralogy of fallot. Tetralogy of fallot results in low oxygenation of blood due to mixing of oxygenated and deoxygenated blood in the left ventricle through the VSD and preferential flow of both oxygenated and deoxygenated blood from the ventricles through the aorta because of obstruction to flow through the pulmonary valve.

Corrective surgery is usually performed at about six months. The goal of surgery is to repair the defects so the heart can work as normally as possible. Almost 70 per cent of babies with Fallot's tetralogy will need complex heart surgery Heart surgery and anaesthetic techniques have changed dramatically in recent years. The first surgery may be done to help increase blood flow to the lungs, and a surgery to correct the problem is done at a later time. Corrective surgery is done to widen part of the narrowed pulmonary tract and close the ventricular septal defect.

Congestive Heart Failure

By Rita Putatunda

Congestive heart failure is a condition, wherein, the heart loses its capacity to pump enough blood, which leads to retention of fluid in the body.

Congestive heart failure (CHF), which is also referred to as congestive cardiac failure (CCF) or simply heart failure, is a medical problem, wherein, the heart loses its ability to fill with or pump adequate amount of blood to the various parts of the body as well as the organs, which causes fluid retention in the body. This condition occurs due to various factors, such as:

The narrowing of the arteries supplying the heart muscle with blood, known as coronary artery disease Myocardial infarction, in which, there is a scar tissue that hinders the normal working of the heart Impairment of the heart valve because of rheumatic fever in the past, or other reasons

Congenital defects of the heart

High blood pressure

Cardiomyopathy, which is a disorder of the heart muscle or myocardium, generally of unknown causes Endocarditis, which is an inflammation of the heart valves and the endocardium Myocarditis, which is the inflammation of the muscular tissue of the heart, or myocardium

The impaired heart continues to work, but not as efficiently as it does normally. Those who are affected with this condition, lose their ability to exert themselves as they tire faster and experience shortness of breath.

Effects

As there is a slow down in the blood flow from the heart, the blood that returns to the heart via the veins, begins backing up, resulting in the tissues becoming congested. Often, this results in edema, or swelling, usually in the ankles and legs, although it can also affect other areas of the body as well as organs. For instance, the impaired heart muscles may be incapable of supplying the kidneys with enough blood, causing them to lose the ability to excrete water and sodium, which in turn, causes increased fluid retention in the body. There is also a buildup of fluid in the lungs, known as pulmonary edema, which results in shortness of breath, hence, diminishing the individual's exercise capacity. Likewise, fluids may get accumulated in the liver, because of which, it loses its ability to get rid of toxins from the body as well as make essential proteins. Fluid retention also affects the intestines, which makes them lose their ability to absorb nutrients as well as medications efficiently. If left untreated, eventually, congestive heart failure can affect almost every organ in the body.

As a matter of fact, it is one of the leading causes of people above the age of 65 getting hospitalized. There is a 10 percent mortality rate annually, even with the best of treatment methods. In addition, the condition often goes undiagnosed because of difficulties in the diagnosis, especially at its initial stages or when it occurs in its mild form.

Signs and Symptoms

One of the earliest indications is fatigue, accompanied by the affected person's diminished capacity to exercise. In fact, most people don't even realize this reduction, with them usually compensating subconsciously by reducing their activities in order to adapt to this limitation. 

Sometimes, the affected person may wake up at night gasping for breath. Some even have to sleep sitting in an upright position. The excessive fluid in the body also results in an increase in urination, especially at night. When the fluids accumulate in the intestines and liver, it may result in a decrease in the appetite, pain in the abdomen, and nausea.

Treatment Options

The treatment usually includes, adequate rest, a balanced diet, modification in daily activities, and drugs like, angiotensin-converting enzyme, or ACE inhibitors, beta blockers, vasodilators, digitalis, and diuretics.

Vasodilators and ACE inhibitors help to expand the blood vessels as well as decrease the resistance of the blood flow in them. This enables the easier flow of blood, easing the working of the heart, thus making it more efficient. Digitalis is a powerful heart stimulant. Beta blockers improve the pumping of the left ventricle. And, diuretics help in eliminating the excess fluid and salt from the body.

Sometimes, when a specific cause is identified, treating that or correcting it can alleviate this disorder. For instance, sometimes treating high blood pressure can ease CHF, or if an abnormal heart valve is found to be the cause, surgically replacing it can ease the condition.

A more drastic step, like a heart transplant, has to be taken in case of the heart becoming so damaged that repairing it becomes impossible.

Human Heart - How Your Heart Works

Treatment For Patent Ductus Arteriosus Prevents Further Complications of PDA

By Alana Olson

Accordingly, almost all of the newborn babies have openings in the ductus arteriosus. This is normal because the ductus arteriosus closes itself along with the baby's growth. The closing takes a very short period of time, around few weeks or months after the baby was born. This is the reason why the symptoms of this birth defect may only be noticeable after a certain period of time. When after weeks and months and your baby starts to show the symptoms of PDA, it is best that you take your baby to the doctor immediately for the diagnosis of PDA and for treatments for patent ductus arteriosus.

Babies with this condition are not really required to undergo treatments for patent ductus srteriosus because the ductus arteriosus of any person closes by itself. However, to babies and children with relatively larger openings in the ducuts arteriosus, a medical treatment or to some cases surgical operation may be needed.

While there are telltales that treatments for patent ductus arteriosus are not really needed, there are still main reasons to do it. One reason is for patients with large openings in ductus arteriosus, blood is directed to the lungs and this is a major cause of heart enlargement not in the present but at a later time and when this happens, treatments may be more complicated. Another reason why a treatment is necessary is that the spread of infection, a major cause of endocarditis is prevented.

Medically, there are three treatments for PDA. One is the medication which requires the use of indomethacin. It is not really recommended to patients who are very young and are still infants but there are some cases when doctors require this. Taking this drug, the wall muscles are constricted to close the opening of the ductus areriosus. Another treatment is the need for trans-catheter procedure. In this method, a small tube or the catheter is inserted in the groin area of the body and this small tube is used to obstruct the passageway in the ductus arteriosus. This method is always used to treat babies with small openings in the ductus arteriosus. The last treatment which is optional is the medical surgery. This treatment is required to patients whose ductus arteriosus does not close by itself and that these patients show a very long term symptoms of the birth defect. This is the process of repairing the PDA opening.

Although the above treatments for PDA may sound complicated, you have to be open to the possibilities and chances for recovery. The complications PDA bring are even more complicated so start while the symptoms are not yet severe. Consult your baby's pediatrician and ask for the treatment options your baby needs.

Teratogy of Fallot - The Most Common Cyanotic Heart Disease in Children

By Funom Makama

Tetratogy of Fallot is the most common cyanotic heart disease in children. The anatomic definition includes four defects:

1. Ventricular septal defect,

2. Pulmonic stenosis

3. an aorta that overrides the ventricular septal defect

4. Right ventricular hypertrophy

The first three defects are congenital, and the fourth is acquired as a result of the increased pressure within the right ventricle.

Embryonic development

The development of the defects in tetralogy of Fallot is the result of abnormal embryologic development of the ventricular septum, which results in infundibular hypertrophy, and in the division of the truncus arteriosus, which results in a smaller pulmonary artery and a larger aorta.