Pediatric Cardiology

What is Pediatric Cardiology?

Pediatric cardiology is the branch of science that deals with the heart problems of all children up to the age of 18, starting from the time the baby spends in the womb. In this process, heart diseases in children may be congenital or may appear later. The pediatric cardiology department deals with the treatment of not only children up to the age of 18, but also adults with congenital heart disease.

Areas of interest for pediatric cardiology:

•Diagnosis, treatment and follow-up of congenital heart diseases

•Diagnosis, treatment and follow-up of acquired heart diseases

•Diagnosis, treatment and monitoring of rhythm and conduction disorders (ECG, 24-hour rhythm holter recording, stress test, electrophysiological studies)

•Pre-sports assessment

•Fetal echocardiography

•Evaluation of signs and complaints such as chest pain, murmur, palpitation, fainting

Which Diseases Does the Pediatric Cardiovascular Surgery Unit Treat?

Some of the heart diseases in children have no symptoms or the symptoms are mild, while some may have a severe course. These symptoms may occur in the baby as bruising, feeding difficulties, tiredness while breastfeeding, rapid breathing, shortness of breath, inability to gain weight or frequent lower respiratory tract infections. Older children apply to our clinic with complaints such as fatigue, palpitations, chest pain and fainting, or high blood pressure, or to be evaluated for sports ability.

During the course of many childhood diseases, the circulatory system and the heart are also affected. These diseases are congenital diseases, rheumatic diseases, infectious diseases, diseases of liver, kidney and other systems.

In parallel with the new developments in medicine, many diseases that were previously treated with surgery can be treated during the catheter angiography procedure without requiring surgery.

Heart diseases seen in children are grouped under 3 main titles.

Congenital Diseases

The most common heart diseases among children are congenital diseases. Since babies complete their heart development within the first 3 months in the mother's womb, some diseases can be diagnosed after this period. With the developing technology, it is possible to diagnose diseases and treat diseases immediately after the birth of the baby.

The rate of childbearing with congenital heart disease is 8 per thousand. With this rate, between 10 thousand and 15 thousand babies are born with congenital heart disease every year in Turkey. If the mother or father has a congenital heart disease, this rate may increase to 16 percent. In some cases, treatment is not possible in the womb, but they can be detected between the 16-20th weeks of pregnancy with advanced imaging devices.

Heart diseases that occur in babies can be diagnosed in the womb, as well as in the period up to the first age of the child. Symptoms of congenital heart disease; shortness of breath, difficulty breathing, underdevelopment of muscles and limbs, growth retardation, chest pain, fainting, slow growth, heart murmur, tendency to pneumonia and feeling dizzy. Parents who notice these symptoms in their child should consult a pediatric cardiologist as soon as possible. With early diagnosis in children, it is possible to progress more quickly in treatment and prevent possible deaths.

The causes of some congenital heart diseases are not clearly known. However, environmental factors, genetic predisposition, the mother's use of illegal drugs and alcohol during pregnancy, viral infections, exposure of the mother to radiation during pregnancy, kin marriage, malnutrition in the mother and the mother's lifestyle can cause the baby to be born with heart disease.

The most common congenital heart disease is a hole in the heart. Holes may occur between the atria or ventricles of the heart, as well as anomalies (deviation) in the vessels coming out of the heart and coming to the heart, developmental disorders of the ventricles or atria, anomalies in the coronary vessels, anomalies causing stenosis or insufficiency in the heart valves are among the congenital heart diseases.

Rheumatic Diseases

Rheumatic diseases, which are most common in children between the ages of 5 and 15, are also known as cardiac rheumatism. This disease, which is caused by a throat infection caused by a bacterium called group A streptococcus, has a very high risk of developing heart rheumatism if it is not treated.

This disease, also called acute rheumatic fever, can manifest itself approximately 2-3 weeks after a throat infection. The most important effect of acute rheumatic fever, which starts to show symptoms with swelling, redness and fever in joints such as knees, feet and hands, is the heart. Acute rheumatic fever causes stenosis or insufficiency due to deformities of the heart valves. Skin problems are also observed in this disease, although rarely. In some children, mood changes, behavioral disorders, involuntary movements in the hands, face, legs and arms can also be seen.

Early diagnosis is also very important in rheumatic diseases. These diseases can be treated with cortisone, penicillin and antibiotics in the early period. However, sometimes the disease is permanent. For this reason, children who have a throat infection should be under the control of a doctor and the necessary tests should be examined for the presence of bacteria causing this disease.

Rhythm and Conduction Disorders

It is a rhythm disorder where the heart works slower, faster or irregularly with a pause. Rhythm and conduction disorders, which can be one of the congenital heart diseases in children, can also occur for different reasons after heart surgery. Illegal drug use, hyperthyroidism or hypothyroidism, anemia, low blood sugar, consumption of caffeinated foods and beverages, infections that can affect the heart, or genetic arrhythmia can also cause rhythm and conduction disorders in children.

The most important symptom of rhythm disorders in children is palpitation. Rhythm disturbances can also cause complaints such as difficulty in breathing, chest pain, fatigue, sweating, fainting after exertion. In babies, there are points that mothers should pay special attention to. If there are symptoms such as a change in the baby's skin color, rapid breathing, getting tired quickly when breastfeeding and weakness, mothers should check their baby's heartbeat during these attacks.

Pre-Sports Cardiological Evaluation

It is possible to determine the risk of sudden death in children with the follow-up of children who will do sports. At young ages, the disease called “hypertrophic cardiomyopathy” with thickening of the heart muscle can lead to fainting and sudden death. The early diagnosis of many genetic diseases such as "Long QT syndrome", which causes sudden death, can be made with simple tests.

With the ultrasonographic imaging method called fetal echocardiography, heart diseases of the baby in the mother's womb can be detected in the early period and some of them can be intervened while in the womb.

It is possible to determine the risk of sudden death in children with the follow-up of children who will do sports. It is stated that the incidence of the disease called “hypertrophic cardiomyopathy”, which is the most common cause of sudden death in young ages, is around 1 in 1000. It is known that the frequency of “long QT syndrome”, another genetic disease that causes sudden death, in the population is approximately 1 in 2500. The early diagnosis of these diseases can be made with simple tests.

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