About the Preventive Cardiovascular Program

Some children and adolescents are at increased risk of developing cardiovascular disease, such as heart attack and stroke in adulthood. The Preventive Cardiovascular Program at Children's Hospital of Philadelphia (CHOP) helps identify, monitor and treat these children. We work closely with your child's primary healthcare team to personalize care and ensure the best outcomes possible.

Who is the program for?

There are many risk factors and medical conditions in childhood that may lead to early onset cardiovascular disease. These include, but are not limited to:

• Abnormal lipids (high cholesterol, low HDL cholesterol, high triglycerides)
• High blood pressure (hypertension)
• Family history of a member suffering an early heart attack or stroke before the age of 60
• Elevated lipoprotein (a) level
• Severe obesity (BMI > 99th percentile)
• Type 1 diabetes or type 2 diabetes
• Chronic inflammatory or autoimmune diseases (Lupus erythematosus, Takaysu’s arteritis)
• Sickle cell disease
• Congenital or acquired heart disease, such as aortic coarctation, Kawasaki disease with current or regressed aneurysms, and coronary anomalies
• Solid organ transplant (heart, kidney, liver or lung)
• Extreme premature birth or low birth weight
• Twin-twin transfusion syndrome
• Chronic kidney diseases
• Turner syndrome and Williams syndrome
• Inflammatory bowel disease (IBD)

Comprehensive, patient-centered care

CHOP's Preventive Cardiology Program is unique in that it provides many different services that can be tailored to each patient. The program partners closely with your child’s established care team of primary care providers and specialists to ensure that we work together to optimize the treatment plan.

The program encompasses specific clinics that may be best suited to your child, including:

• Cardiovascular Risk Assessment Clinic
• Lipid Heart Clinic
• Hypertension Clinic

During the scheduling process, we will direct your child to the appropriate clinic based on their medical history and the reason the doctor referred your child. It is possible your child may be evaluated at more than one clinic at separate visits.

Our services

Our Preventive Cardiovascular Program offers a full spectrum of services and tests designed to evaluate and monitor your child's individual unique needs.

Lipid testing and evaluation

There are four primary blood tests used to evaluate your child's cholesterol and triglyceride levels. These include:

• Total cholesterol: Testing can be performed at any time of day and fasting is not required. Too much cholesterol is directly linked to heart and vascular disease.
• High density lipoprotein (HDL): Testing should be performed after a 12-hour fast. Often called "good cholesterol," the higher your HDL level, the better.
• Low density lipoprotein (LDL): Testing should be performed after a 12-hour fast. Often called "bad cholesterol", the higher your LDL is, the greater your risk of developing heart and vascular disease. The primary goal of most cholesterol medications is to lower LDL.
• Triglycerides (TG): Testing should be performed after a 12-hour fast. High levels of triglycerides are often found in patients who have diabetes or are obese, and are linked to a greater risk of heart and vascular disease.

Genetic testing for inherited lipid disorders

This saliva test will determine if your child carries certain inherited genes that place them at increased risk of cardiovascular disease. The saliva uses DNA, which is an individual's unique genetic code, to look for certain changes in sections of genetic material that are known to lead to elevated cholesterol and increased risk of future cardiovascular disease.

24-hour ambulatory blood pressure monitoring

During this test, a blood pressure cuff will be placed on your child’s arm for 24 hours and will automatically inflate and deflate at set intervals to evaluate your child for high blood pressure (hypertension) in different settings, activity levels and during sleep.

Exercise stress testing

While your child is exercising on a stationary bicycle or treadmill, we evaluate your child’s heart rhythm and blood pressure. Learn more about exercise stress testing.

Echocardiogram

During this procedure, ultrasound-guided sound waves create a two-dimensional moving image of your child’s heart structure and function. Learn more about echocardiography.

Electrocardiogram (ECG or EKG)

During an electrocardiogram (sometimes called an ECG or EKG), we measure the electrical activity of your child's heart by attaching electrodes (small patches) to your child's chest, arms and legs and connecting them to an ECG machine. Learn more about electrocardiography.

Vascular ultrasound imaging

During this procedure, ultrasound-guided sound waves measure the thickness of blood vessels in your child's neck (carotid arteries). If the arteries are thicker than expected, it may suggest early signs of atherosclerosis or plaque formation which may be due to untreated risk factors. 

Healthy Lifestyle Program

In addition to medical treatment recommendations, our program offers personalized dietary and physical activity planning with trained dieticians and exercise physiologists to design a healthy lifestyle approach that your child and family can adopt and sustain into adulthood.