Know Your Family Cardiac History — for Your Child’s Sake and Your Own

Most of us know that heart disease is a leading cause of death among adults — and that obesity, smoking, poor exercise, and unhealthy eating habits increase the risk. However, fewer people realize that some serious heart conditions have genetic causes, and that these inherited conditions can put the lives of young adults, adolescents and even children at risk.

“Many children with heart conditions have no symptoms,” explains Marie Gleason, MD, a pediatric cardiologist at Children’s Hospital of Philadelphia (CHOP). “If we are able to diagnose the problem before symptoms appear, the child’s prospects are better.

"We can monitor the heart as the child grows and take preventive steps to reduce the risk of serious health effects," Dr. Gleason says. "Knowing about a history of heart problems in the family can be key to that early detection.”

Know your family's cardiac history

You and your children may be at heightened risk for certain forms of heart disease if you have a parent, grandparent or other close family member who:

• Died before the age of 50
• Was treated for a blocked artery
• Required a defibrillator
• Had high cholesterol levels
• Had an aortic aneurysm
• Had heart muscle or heart rhythm problems

“When a child comes to us with symptoms of a heart condition, one of the first things we want to find out is if there is a history of heart problems in the family,” says Dr. Gleason. “It’s surprising how many people don’t know, or don’t have the details of what caused a parent’s early death or the reasons for a relative’s heart surgery. Those details are critical information for the health of both parents and children.”

Dr. Gleason strongly urges parents to find out the cause of a family member’s cardiac illness or early death. Was there an autopsy and what did it show? If it revealed a heart muscle problem, find out the name of the condition. If no physical problems were found, that may be a clue to a heart rhythm problem.

In the same way, find out the details if a family member has been treated for a “heart problem,” including the name of the condition and medications in use.

“It’s not just for your child’s sake,” says Dr. Gleason. “You may be at risk, too. It’s in everyone’s interest to be fully informed.”

What to do if you discover a heart problem in your family

If you find out about a heart problem in your family, the first step is to share what you know with your child’s pediatrician and your doctor. A physician can explain if the problem might have a genetic component, or if it was likely caused by lifestyle factors such as smoking or diet.

Inheritable heart conditions include:

• Heart muscle problems, including hypertrophic cardiomyopathy
• Heart rhythm problems, including Long QT syndrome
• Problems with very high lipid (cholesterol) levels, including familial hypercholesterolemia
• Connective tissue abnormalities resulting in aortic aneurysms, including Marfan syndrome

Which family member is affected is important, too. Most serious inherited cardiovascular conditions transmit as autosomal dominant traits, which means they are passed on directly from a parent and don’t skip generations. If your parent has hypertrophic cardiomyopathy, for example, a type of heart muscle problem, you have a 50% chance of inheriting it. If you have the condition, each of your children has a 50% chance of inheriting it from you. If you don’t inherit the condition from your parent, you won’t pass it on to your children. So the heart problems of cousins or aunts and uncles are less concerning as inheritable risks than problems in the direct line of parentage.

Most heart problems in adults are acquired, not inherited. So don’t panic about your child’s health if a parent or grandparent had a heart condition in old age. But if you find out about heart problems in family members at younger ages, do your homework to find out the details — and share that information with your child’s pediatrician. They can help you decide if a formal cardiac consultation is indicated for your child.