Conditions We Treat

Congenital heart disease (CHD)

Congenital heart disease (CHD), the most common kind of heart defect in children, is a broad classification including any problem with the heart’s structure and function that is present at birth. Some CHD can be life threatening from the beginning, while other types may present no early symptoms. Physicians often divide CHD into two groups: The first type, cyanotic CHD, is so named for the bluish skin some newborns may have if their heart fails to deliver enough oxygen to their body. Some examples of cyanotic CHD include Ebstein's anomaly, hypoplastic left heart, pulmonary atresia, tetralogy of Fallot, total anomalous pulmonary venous, transposition of the great vessels, tricuspid atresia and truncus arteriosus. The second type, non-cyanotic CHD, is a catchall category including all other kinds of congenital heart defects, including, for example, aortic stenosis, bicuspid aortic valve, atrial septal defect, endocardial cushion defect, coarctation of the aorta, patent ductus arteriosus, pulmonic stenosis and ventricular septal defect. While most CHD occurs alone, it is sometimes associated with chromosomal and genetic syndromes.

Cardiomyopathy

Cardiomyopathy is a rare condition that affects the heart’s muscle fibers, which are responsible for the essential contractions that constitute a heartbeat. While some children with cardiomyopathy present no symptoms, in others the heart’s inability to pump properly causes fatigue, tachycardia or even heart failure. There are two main classes of cardiomyopathies: primary and secondary.

• Primary cardiomyopathies are caused by genetic mutations that direct heart muscle cells to grow abnormally.
• Secondary cardiomyopathies, however, are caused when normal heart muscle cells are damaged over time by other disorders, such as inadequate oxygen in the blood (hypoxemia), hypertension or infection.

Congestive heart failure (CHF)

Congestive heart failure (CHF), also simply called heart failure, is a condition in which the heart does not pump blood efficiently enough to meet the long-term needs of the body's organs. It is usually progressive and typically reflects an underlying heart condition. Some children’s CHF results from congenital heart disease, but other medical problems can also cause heart failure. For example, enlargement of the heart, heart valve disease, irregular heartbeats, hypertension, and viral infections can all lead to CHF.

Valve disease

Valve disease affects one or more of the heart’s four valves, which together keep blood flowing through the heart in the right direction. When the valves fail to work properly, blood can get backed up in the heart, which may become enlarged, resulting in congestive heart failure. Some children with mild valve disease may present no symptoms except a heart murmur and may never need treatment. On the other end of the spectrum are those with what can be debilitating shortness of breath, fainting, fatigue and irregular heartbeat. Some children require medical treatment or surgery to repair or replace their defective valve or valves. While most valve disease is congenital, it can also be caused by rheumatic fever, hypertension or bacterial infection.

Aortic aneurysm

An aortic aneurysm is the bulging of a section of the aorta, the large artery that carries oxygen-rich blood away from the heart to the rest of the body. Stretching an artery thins and weakens it where it is bulging. A burst aortic aneurysm quickly results in a catastrophic loss of blood. There often are no symptoms associated directly with aortic aneurysms in children; however, aneurisms are sometimes associated with connective tissue defect syndromes such as Marfan syndrome, Loeys-Dietz syndrome and bicuspid aortic valve syndrome. Children diagnosed with these syndromes should be screened for aortic aneurysm.

Pericarditis

Pericarditis is the inflammation or infection of the pericardium, the two-layered membrane that surrounds the heart. In a healthy heart, the space between the inner and outer parts of the pericardium is filled with just a thin layer of fluid. If the pericardium becomes inflamed, however, that fluid may increase in volume. If too much fluid fills the space, it inhibits the heart’s ability to pump efficiently. Pediatric pericarditis can result from heart surgery, but it can also be caused by infection or chest injury. Symptoms may include fever, heart palpitations, fainting, irregular heartbeat, and/or sharp pain in the middle or left chest. Pericarditis can be treated with medication, surgery or the removal of excess pericardial fluid.