Friday, May 20, 2011

Some Signs and Symptoms of Cardiac Issues in Children and Teens

Consistent with Daniel's likely wish that I should try to educate those who are left here on Earth, with regard to potential arrhythmic or other cardiac insufficiency syndromes, I am going to discuss potential signs and symptoms which may be associated with cardiac issues in young people.
Prior to Daniel's complete cardiac arrest, now two and a half years ago, I did not notice clear symptoms of anything I thought required medical attention. I still cannot tell you with certainty that he was completely symptomless, or whether I loved him so much that I attributed any symptoms at all to his known allergies, or simply loved him so much that I could not notice or accept something potentially dangerous. I often mull this over in my head. Sometimes I am sure I noticed nothing, and then other times, especially late at night, I wonder if there was something, and then I misunderstood his reluctance to do something or to come in from play to use the computer etc. Perhaps there was more than I realized, but of course, parents who have lost children may second guess their recollections for the rest of their lives here on Earth.
Factually, a child with one of the heart rhythm disturbances (Long QT Syndrome, Wolff-Parkinson-White Syndrome, Brugada Syndrome) can in fact, be completely asymptomatic until the actual event which can take their lives. For much of their lives, they are asymptomatic. They may enjoy sports, feel energetic, and be more healthy than their siblings. Some of the symptoms that CAN occur though in arrhythmic disorders are: Heart palpitations (feeling ones heart beat, sometimes in a "jumping fashion". Sometimes a child with these issues they may say that their "heart is beating very fast". Sometimes there is shortness of breath on exertion, a sensation of asthma, a palpably irregular pulse, but only sometimes. Children with arrhythmic disorders may faint. A few may actually have seizures, and may be treated as neurologic patients, when in fact they have an episodically occuring cardiac arrhythmia, or disruption of heart rhythm. Their periodic disruption in rhythm periodically may be dramatically dropping blood supply to the brain in such a marked manner, that a seizure occurs in response to this. A child who has a rapid heart rate when startled or lightly disciplined, should also be checked. Since there is an increase in events at puberty when hormones may impact those with rhythm disturbances, any child who faints at or nearing puberty should be given an EKG and seen by a cardiologist to rule out arrhythmic disorders.
Other children who experience a sudden cardiac death may not have an arrhythmic disorder plain and simply. Some of them have heart damage from unrecognized or incompletely treated streptococcus infection. These children may have damage to their valves. Still others, following an influenza, have the viral infection invade the conduction system in their hearts, and ultimately shut it down. When an infectious disorder afflicts the heart, these children should show symptoms. They should be excessively tired, unwilling to walk stairs, complete chores, or to complete tasks that they would normally enjoy. They may be reluctant to participate in a physical education class. Children do die of the flu, and if your child seems to have a protracted recovery, or seems to be sicker than his siblings with the flu, perhaps he should be rechecked by his doctor. (For more information google "Cardiomyopathy in children").
Children may also have congenital heart defects which can also be fairly mild, and may not be diagnosed at birth. Any child who has frequent colds, a wet cough, occasional asthmatic symptoms, or who squats periodically because it "is comfortable" may be experiencing the results of a cardiac defect of some type.
Children with varietal cardiac problems can be overweight from lack of exercise as they may not feel well enough to participate, or be markedly underweight because they eat insufficiently.
Sadly, some of these listed at the top of this post are newly described disorders, first described in the 1990s. Not every physician is alert to them. Depending upon the residency completion date of your physician, he or she, may not know of all of these disorders.
Use your knowledge AND your intuition to take your child for evaluation if you believe that this is necessary. You ARE the expert on your child.

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