It is extremely rare, but a child can have a heart attack, especially if they have a congenital or acquired heart disease or have experienced chest trauma.
A heart attack, which doctors also call acute myocardial infarction, is rare in childhood.
This article explores heart attacks and the potential causes, the warning signs and symptoms to look out for, and diagnosing them.
Although rare, there are several possible causes of a heart attack in childhood, such as:
Congenital heart disease
Congenital heart disease, or congenital heart defects, is an umbrella term for birth-related heart conditions. It affects around
Children with a history of certain congenital heart defects are at higher risk than others for having a heart attack from the blockage of a coronary artery.
Anomalous origin of the left coronary artery
An example of congenital heart disease is the anomalous origin of the left coronary artery. This occurs when the heart and blood vessels are forming. The left coronary artery connects to the pulmonary artery instead of the aorta in the heart.
When the heart does not get enough blood from the coronary arteries, it begins to fail, similar to what occurs during a myocardial infarction or heart attack.
However, this is also a rare occurrence, comprising less than 1% of all congenital heart defects in children.
Acquired heart disease
Acquired heart conditions develop after birth. Below are some examples of conditions a child may develop.
Rheumatic heart disease
This is the most common type of acquired heart disease in children, affecting
Rheumatic fever can be a consequence of untreated strep pharyngitis or strep throat. However, it is uncommon in places where doctors readily treat strep throat with antibiotics.
If doctors do not treat rheumatic fever promptly, long-term heart damage, or rheumatic heart disease, may occur. Rheumatic heart disease
Kasawki disease
Kawasaki disease is another acquired condition that affects
Kawasaki disease affects the coronary arteries due to
The condition also causes fever to develop suddenly. Other symptoms include:
- rash
- irritation and redness in the whites of the eyes
- irritation and inflammation of the mouth, lips, and throat
- swollen lymph glands
- edema, or swelling in the hands and feet
Other
Chest trauma
Research also considers blunt chest trauma, due to injury or an accident, as a rare cause of heart attack in children.
It is important to look for possible signs that children may be experiencing a heart attack or symptoms of another condition for prompt diagnosis and treatment.
If a parent or caregiver notices the following symptoms in their child, they should seek medical attention.
| Newborn symptoms | Older children symptoms |
| feeding problems | fatigue |
| lack of interest in surroundings | lack of appetite |
| irritability | paleness |
| diarrhea | dyspnea |
| sweating | tachypnea |
| vomiting | tachycardia |
| skin paleness | hypotension |
| tachypnea | weak pulse |
| dyspnea | rhythm irregularity |
Overlaps with other conditions
Heart conditions may be
Hypertrophic cardiomyopathy is a condition that causes the heart muscle and heart walls to become thick.
In some cases, the wall becomes so thick that it blocks blood flow out of the heart. Many people do not receive a diagnosis until adulthood, making it far less common, affecting 1 in 200,000 children. However, symptoms of hypertrophic cardiomyopathy can mimic those of a heart attack.
It is important to seek immediate medical attention if a child shows any of the above symptoms.
Unlike adults, chest pain is rarely a symptom of a heart attack in children. Chest pain accounts for around
Common causes of chest pain that do not relate to heart conditions include:
- musculoskeletal causes, such as muscle strain or slipping rib syndrome
- respiratory conditions, such as chronic cough or asthma
- gastrointestinal causes, such as constipation or gastroesophageal reflux disorder
- mental or emotional disorders, such as anxiety or depression
According to the
It is
A healthcare professional can assess a child using one of the
- Chest X-rays can determine if the heart has enlarged.
- Electrocardiograms can assess heart rhythm.
- Echocardiograms can check heart structure and function.
- An exercise stress test can assess heart-lung function.
A more invasive test is a cardiac catheterization study. This involves a doctor inserting a catheter into the heart through one of the blood vessels in an arm or leg. The test aims to check for clogged arteries or an irregular heartbeat.
As the procedure requires an anesthetic, some children may experience side effects from this medication, such as nausea and vomiting. However, this is usually only in the short term. A child will need to stay in bed for the first two hours to reduce the risk of bleeding.
Once a child has had something to eat and drink, passed urine, and mobilized they will be able to go home. The cardiologist will discuss the results with a parent or caregiver.
Treatment
Myocardial infarction is so rare in children, and the causes are so diverse, that doctors have adapted principles of adult treatments for children.
In recent years, alteplase has become the most common fibrinolytic drug in children.
Other treatments may include:
- hospitalization for supportive care
- anticoagulant medications to break up clots, if present
- beta-blockers
Additionally, doctors may recommend a coronary angioplasty, a procedure that widens blocked or narrowed coronary arteries. The hospital survival for adolescents without any underlying heart disease is excellent, and the need for surgical coronary artery intervention is uncommon.
There have been cases of children experiencing heart attacks, but they are rare. What causes them can range from congenital to acquired heart diseases.
It is always best to seek a diagnosis and medical attention if a parent or caregiver notices any warning signs or symptoms that their child is experiencing.