1) What is the right age to get heart-related testing in children?
Not all children need routine heart-related testing. Children should be checked regularly by their pediatrician and if the pediatrician suspects heart disease in the child, they will be referred to a pediatric cardiologist. The pediatric cardiologist will then assess the child in detail and perform an echocardiogram to diagnose the heart defect and begin treatment.
The most common heart defects in children are congenital heart defects, which the child is born with. Major congenital heart defects can be detected during pregnancy itself by fetal echocardiography. After the baby is born, critical heart defects can be diagnosed and treated within hours of birth.
2) What are some telltale signs that a child’s heart health needs attention?
Symptoms and signs such as babies not feeding properly, getting tired while feeding, having poor weight gain and excessive sweating indicate congenital heart disease. Some infants and babies develop a bluish discoloration of their lips, tongue, and nails while crying. Older children may present with recurrent pneumonia, fatigue, and increased dyspnea on exertion.
3) Do you often see children reporting heart problems?
As a pediatric cardiologist, I regularly see children with heart conditions. However, in the general population, only about 8-10 babies in 1000 live births are born with heart disease. So about 1% of all children have congenital heart disease. A small percentage of children have developed heart disease such as Kawasaki disease and rheumatic heart disease and in recent years post covid MIS-C affecting the heart.
4) What are the biggest mistakes or health mistakes that predispose children to heart problems?
Congenital heart defects are developmental abnormalities and are usually not due to health problems or errors during pregnancy. Heart disease in children is not related to lifestyle, unlike in adults. Therefore, children do not develop heart disease through their or their parents’ fault. However, once heart disease has been diagnosed, timely intervention is essential for good outcomes. And for that, the patients should consult a pediatric heart specialist and follow the treatment advice given.
Unfortunately, even today we see children who have been diagnosed with a hole in the heart in childhood and have been advised early surgery, and the parents have not brought the child in for surgery because of their belief that the heart condition will go away on its own. disappear or that the child is too young for heart surgery. And with this delay, the child develops late complications such as pulmonary hypertension and may even become incapacitated.
5) How much should children exercise daily? Is there a breakdown by age? Toddlers, pre-teens, teens etc.
Children should be encouraged to exercise and play outside, and their screen time and TV viewing time should be limited. There is no minimum or maximum number of hours or amount of exercise that is recommended, but 1-2 hours of daily outdoor activity is helpful for teaching and encouraging a healthy lifestyle from an early age. Of course, exercise and outdoor activities should be balanced against schoolwork and studies as the child grows.
Children with heart disease may have limitations on how much they can and should exercise, and this should be discussed with their pediatric heart specialist.
6) What is a heart healthy diet? Are there foods that children should eat daily (or often)?
A heart-healthy diet is the one that equips an individual to fight heart disease. It recommends that a child’s diet have food diversity with foods from different food groups, including fruits, vegetables, whole grains, low-fat dairy products, lean proteins, nuts, legumes, and vegetable oils. Such a diet contributes to maintaining a healthy weight and stable metabolism, while providing all the nutrients to meet a child’s daily requirement according to the RDA (recommended daily allowance). Foods high in calories but low in nutrients, such as cakes, donuts and sugary drinks, foods high in saturated fat, trans fat and high in sodium should be consumed in moderation or avoided.
A child with congenital heart disease has a high metabolism which causes a faster burning of calories and so they should be fed high calorie foods. Regularly feeding high-calorie and nutritious meals helps to meet this increased need. High protein foods such as milk or dairy products, meat, legumes, sprouts and nuts should be included. For older children, it is best to avoid salty, fried, sugary and junk foods.
Foods containing omega 3 fatty acids have a protective effect, so foods such as fish, linseed and linseed oil, walnuts, canola, soybeans and soybean oil, chia seeds. Green leafy vegetables should be regularly included in the diet.
Dr. Supratim Sen-Sr. Consultant (Pediatric Cardiology)
Ms. Roshan Kore – Sr. Dietitian and Nutritionist