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Acquired heart diseases in children refer to conditions that develop after birth. Are often caused by infections, autoimmune reactions, or other factors affecting the heart’s structure or function. Unlike congenital heart diseases, acquired heart diseases manifest later in childhood and can vary widely in presentation and severity.
Types:
1. Rheumatic Heart Disease (RHD):
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- Caused by untreated streptococcal infections (throat infection) leading to autoimmune reactions affecting the heart valves.
- Common in developing countries with over-crowding and delayed access to treatment
2. Kawasaki Disease:
- An inflammatory condition affecting blood vessels, particularly coronary arteries (arteries which supply heart).
- Exact cause is unknown, but it may involve an immune response to certain infections.
3. Infective Endocarditis:
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- Bacterial infection of the inner lining of the heart chambers and valves.
- Occurs when bacteria enter the bloodstream and attach to damaged heart valves or other heart tissues.
- More common in abnormal hearts or in those with drug abuse
4. Cardiomyopathy:
- Disease of the heart muscle, leading to impaired heart function.
- Can be idiopathic (unknown cause), genetic, viral, or secondary to metabolic disorders.
- Has poor long-term outcome
Symptoms:
Vary depending on the specific disease but may include:
- Fever (common in Kawasaki disease and infective endocarditis).
- Joint swelling/ pain
- Shortness of breath
- Fatigue
- Palpitations
- Swelling in the face, legs, abdomen (edema).
Diagnostic modalities:
- Detailed medical history and physical examination.
- Blood tests to assess for signs of infection or inflammation.
- Echocardiography
- Electrocardiography, ECG and other advanced imaging tests(TEE, MRI) as needed.
Management:
Depends on the underlying cause and severity of the condition:
- Antibiotics: eginfective endocarditis
- Anti-inflammatory medications: As in Kawasaki disease or Rheumatic fever
- Cardiac surgery: Sometimes necessary for repairing or replacing damaged heart valves (as in RHD) or for Heart transplantation in cardiomyopathy
Long-term management may include medications to manage symptoms and prevent recurrence, regular follow-ups with pediatric cardiologists, and lifestyle modifications to promote heart health.
Prognosis:
Prognosis varies based on the specific disease and how early it’s diagnosed and treated. With prompt medical intervention and appropriate management, many children can recover fully or manage their condition effectively. However, some conditions, like severe RHD or advanced cardiomyopathy, may require ongoing care and monitoring throughout life.
