HOW IS YOUR CHILD’S HEART HEALTH? 
Heart Healthy Advice from Children's Healthcare of Atlanta
A newborn’s heart may be small, about the size of a strawberry, but it is powerful—most of the time. How powerful, energetic and healthy is your child’s heart? If you have not asked yourself that question, you should.
Cardiologists at the Children's Healthcare of Atlanta Sibley Heart Center help thousands of newborns, children and teenagers with heart defects each year. Robert M. Campbell, M.D., Chief Medical Officer at the Children’s Sibley Heart Center and Director of Sibley Heart Center Cardiology, often receives the questions below from parents of patients who visit his office. The Sibley Heart Center Cardiologists offer the following advice about heart health for children:
What should I do if my child has chest pain?
Chest pain is one of the more common reasons for referral to a pediatric cardiologist office. However, chest pain in pediatric patients is rarely caused by a cardiac abnormality. The most common causes of pediatric chest pain are: chest wall musculoskeletal pain, stress/anxiety pain or idiopathic “growing pains”. Chest wall pains are usually characterized by tenderness in one specific point, pain that is relatively sharp or stabbing in nature, or pain that is made worst with deep breathing or pressure over the area of tenderness. The chest pain may last for seconds to minutes and may be associated with certain activities. Stress or anxiety related chest pain is more difficult to characterize but may be very chronic in nature and is not generally associated with other specific objective abnormalities on exam.
Growing pains simply means that thorough evaluation found no specific cause for the pains. This does not mean that the child is not experiencing chest pain, but rather that no dangerous or worrisome cause has been detected. Simple reassurance to the patient and the family is indicated. Patients with persistent chest pain should undergo evaluation by a pediatric cardiologist. Chest pain associated with other exercise-related symptoms, such as shortness of breath, nausea, dizziness and/or fainting requires immediate attention.
What do I do if my child feels palpitations or an irregular heart beat?
Many children and adolescents will report the sensation of fluttering of the chest or irregular heart beats. An irregular heartbeat does not necessarily indicate that there is a dangerous abnormality present. There are many benign causes of an irregular heartbeat.
Evaluation often includes resting EKG and then home EKG monitoring to determine the heart rate and rhythm during the symptomatic events. Frequent causes of irregular heartbeat of children include early beats in the upper chambers (atrial premature beats) or lower (chambers (ventricular premature beats) of the heart. These often are benign but may warrant further evaluation. Other patients may have abnormal fast heart rates from the upper chambers of the heart (supraventricular tachycardia, or SVT). These patients may need daily medications or other more definite cardiac catheterization procedures.
It is recommended that adults exercise 20 minutes, 3 times a week to help maintain good heart health. Is this the same recommendation for children?
No. The American Heart Association recommends that all children age two years and older should participate in at least 30 minutes of enjoyable, moderate-intensity activities every day. They should also perform at least 30 minutes of vigorous physical activities at least three to four days each week to achieve and maintain a good level of heart and lung fitness. If there is not a full 30-minute activity break for the child the vigorous activity can be done in two 15-minute bouts or three 10-minute bouts. Remember these times are minimums; the benefits of physical activity generally increase with increased time spent being active and with intensity. It is important to note that children need more vigorous activity than adults.
It is clear that healthy physical activity is a learned behavior, so physically active parents are more likely to have physically active children. While it is important to have physical education in school and organized sports and recreational activities, this may account for only a minimal amount of time. Participation in a competitive sport with one practice and one game per week falls short of the minimal recommended physical activity.
For weight maintenance along normal growth curves or even weight loss, it is important to remember that physical activity is the “calories used” side of the equation and perhaps is more important than caloric limitation. Older kids and adolescents might be encouraged to increase physical activity by using a simple electronic pedometer (cost about $20) with a goal of achieving at least 10,000 steps per day.