Common Conditions: When to See the Cardiologist

Each year, 1 out of every 120 babies in the United States is born with congenital heart disease. Although CHD is the most common birth defect, the majority of children don't experience significant heart problems. However, there are some very common symptoms that often cause parents to worry. Here are the three most common issues that may or may not be warning signs of heart disease in children.

Heart murmurs

When you listen to the heartbeat, the “lub-dub” sound is the closing of the valves that let the blood into and out of the heart pumping chambers. A heart murmur is an extra sound in addition to the two valve closure sounds, and is caused by turbulent (faster) blood flow.

In most cases, the turbulent blood flow is normal, meaning the heart murmur is “innocent” and won't require any intervention. Heart murmurs are quite common, and can occur in 1 out of 4 children during their growing years. However, some abnormal blood flow sounds suggest a structural problem or heart defect, which would require further evaluation by a cardiologist.

Your child’s pediatrician can evaluate many characteristics of the heart murmur to determine whether it is normal or abnormal, and whether or not additional evaluation by a pediatric cardiologist is required. If your child is referred to a specialist, common screening tests include an electrocardiogram (ECG) to look at the heart rhythm and see if there are any abnormal electrical patterns, and in some cases an echocardiogram, which is a targeted ultrasound of the heart to look for structural abnormalities.

Chest pains and palpitations

Understandably, when a child complains of chest pain, most parents worry that there is something wrong with the heart. However, chest pains and palpitations are common in growing children. Most chest pain comes from stretching or irritation of the muscles and bones in the chest. Most palpitations either represent the child’s normal heart going slightly faster than usual, or occasionally some extra heart beats from the upper or lower chambers of the heart.

Most of these pose no danger to your child. That doesn’t mean that you should ignore these symptoms. Make an appointment with your child's pediatrician. Your family doctor will be able to determine whether or not your child should visit a pediatric cardiologist for further evaluation and testing such as an electrocardiogram. Some of the factors that determine whether or not chest pains indicate an underlying problem are how frequently they occur, if they happen during exercise, and if there is a family history of heart disease.

Syncope

Syncope is a medical term for fainting or passing out. When a child loses consciousness, it can be very frightening to family members and friends. Additionally, injuries can occur when someone faints.

While the majority of children and young adults who pass out don’t have a heart problem, all episodes of fainting must be addressed by a physician. Your child’s pediatrician will want to know the specifics of when and where the fainting happened, if your child had eaten that day, if there was any illness, and if the child felt abnormal before passing out. Most doctors will order an ECG as a baseline in anyone who faints. You should make an appointment with a pediatric cardiologist if there is a family history of fainting, pacemakers or structural heart disease, if your child has palpitations or chest pains during the fainting spells, or if your child is passing out frequently during physical activity.

The Cardiac Center at CHOP

The Children's Hospital of Philadelphia is a proven leader in cardiac care and heart surgery. Specialists at the Cardiac Center are experts at diagnosing and treating every congenital heart condition.