Pediatric heart conditions: Expert answers to common questions

Meet our pediatric cardiology specialist

Dr. Erica Bonura is a board-certified pediatric cardiologist practicing general cardiology and working in the Heart Failure Clinic at SSM Health Cardinal Glennon Children's Hospital. Dr. Bonura came to SSM Health Cardinal Glennon for a cardiology fellowship following medical school in Wisconsin and a residency at the Mayo Clinic in Minnesota. After a second fellowship in heart transplantation at St. Louis Children’s Hospital, Dr. Bonura joined the cardiology team at SSM Health Cardinal Glennon last summer. She works with young patients who suffer from a wide range of heart conditions, from shortness of breath to the care and monitoring of heart transplant patients.

To see a pediatric cardiology specialist at SSM Health Cardinal Glennon Children's Hospital, complete the request an appointment form.

How common is it for a child to have a heart condition?

Congenital heart disease affects approximately 1% of children born each year. Others will develop a condition later in childhood, for example one in 100,000 children develop a cardiomyopathy each year. Overall congenital and acquired heart disease in children is rare but it but it can have a big impact on the families who care for these children.

What other problems are seen in children with a congenital heart defect? Does heredity play a role?

Children with congenital heart disease (CHD) may require more frequent medical care including clinic visits, hospitalizations, procedures, medications, and surgery to treat their condition. Given how important the heart is to keep the body healthy, heart disease can have an impact on many different aspects of a child’s health. Sometimes children will also have an underlying genetic syndrome that is associated with CHD such as Down Syndrome or Noonan Syndrome. Even without a specific syndrome or genetic mutation, the risk for CHD can run in families. In families with a first degree relative who has CHD, there is triple the risk that a child will be born with CHD. Most children will undergo genetic testing as part of their evaluation after birth, but many times a specific cause isn’t found.

Is it possible to outgrow a heart condition?

Heart conditions can affect children differently, ranging from minor heart valve problems or small holes in the heart that cause no symptoms to more severe heart disease that requires surgery shortly after a child is born. As children grow up, the severity of their heart disease can change. Many times small holes between the ventricles will close on their own and children will not require ongoing cardiology follow up. Most children with congenital heart disease will be seen by a cardiologist throughout their lives. There is a growing specialty within cardiology specifically focused on caring for adults who were born with congenital heart disease. It’s known as adult congenital heart disease, or ACHD.

We hear about heart failure in adults. Can kids have it too? How is it treated?

Heart failure is much more common in adults, but it can affect children too. Heart failure happens when the heart is unable to do its job of making sure oxygen-rich blood gets delivered to all parts of the body. This can be due to a variety of causes including congenital heart disease. Some children will develop a problem within the heart muscle that causes it to have trouble squeezing or relaxing normally. This is called a cardiomyopathy. There are many different types of cardiomyopathy, some are temporary and others worsen over time. Heart failure is treated with medications, but some patients will go on to need more advanced support such as IV medications or mechanical support devices like a Ventricular Assist Device (VAD). Some children may eventually need a heart transplant to treat their heart failure. There is a specific team within cardiology who helps care for children who develop heart failure.

If my child’s heart sounds fine at a doctor’s visit, is it safe to assume he/she is healthy? When should I be concerned?

If your child is active and growing well with no symptoms, and has a normal evaluation by their primary care provider, it is very unlikely that they have undiagnosed heart disease. Thankfully, congenital and acquired heart disease is rare in children. You should notify your primary care provider if you notice your child complaining of chest pain with exercise, shortness of breath, heart racing or skipping beats, passing out, or new difficulty keeping up with other children. Sometimes children with heart failure will also have problems with nausea, vomiting, and diarrhea. In infants, difficulty breathing or sweating with feeds and challenges with gaining weight are also reasons to talk with your primary care provider.

If you have concerns about your child’s heart health, fill out our request an appointment form to see a pediatric cardiology specialist at SSM Health Cardinal Glennon Children's Hospital.