Keeping Our Children Heart Healthy: Could My Child Have Heart Disease? PDF Print E-mail
Written by Dr. Ramin Manshadi MD   
Friday, 29 March 2013 14:57

Heart disease is the number one cause of mortality in United States for both men and women. According to the American Heart Association, at least 60,800,000 people in this country suffer from some form of heart disease.

Heart disease still ranks higher in mortality even If one combines all cancer death together.  When is the best time to prevent and treat heart disease?  Fifty percent of time, the first sign of a heart attack is sudden cardiac death. The best time to treat would be before we even develop fat build up in our arteries. Parents have to be educated so that they can help prevent heart disease in their children and to start doing so at a very young age. Autopsies that were done on Korean War veterans with an average age of 21 has shown significant fat build up within their arteries even at this age.

Researchers from Centers for Disease Control (CDC) looked at the data from National Health and Nutrition Examination Survey (NHANES) over the past decade. The emphasis was to assess how many adolescents were at risk for future heart disease. They assessed at the main risk factors such as high blood pressure, High LDL cholesterol, and diabetes. Some of these findings were disturbing: one in four adolescents has diabetes up by 10 percent from the prior decade. 25% have more than two risk factors for heart disease, 20% have high blood pressure, and 33% were overweight and obese of which Mexican American boys and girls and African American girls are disproportionately affected.  Over the past three decades, the prevalence of obesity in children 6 to 11 years of age has increased from 4% to more than 20%. Obesity which is defined a BMI (Body Mass Index) of more than 30, has shown to increase the incidence of diabetes, cardiovascular disease, asthma, cancer, degenerative joint disease and many others.

Can children have heart attacks? If we are talking about classical heart attacks that can be caused by fat buildup, then the answer is no. In general, it is very unlikely to have anyone to have a heart attack below the age of 25 unless it is induced by using illegal drugs such as Cocaine, Amphetamines, or they are harboring some form congenital heart disease.  The pathophysiology leading to heart attacks are different in children compared to adults.

Most adults will eventually end up having significant heart disease as they accumulate risk factors namely hypertension, diabetes, smoking, obesity, and high cholesterol. This is called acquired heart disease.  On the other hand children who end up having heart attacks could be more because of anomalous coronary arteries (normally arteries are supposed to provide oxygen to the heart) rather than having significant fat buildup.  For example, the arteries could be traversing the heart muscle rather than running on top of the muscle. This can lead to physical compression of the artery especially during physical exertion. On occasion, the coronary artery can originate from the wrong side and travel in a direction that can be compressed with two large arteries and cause a sudden heart attack in children. These conditions are called congenital heart disease meaning before birth.  Congenital heart defects are the most common birth defects, affecting 1 in every 100 infants. On the other hand, heart disease developing after birth is called acquired heart disease. In children, these are Hypertrophic Cardiomyopathy, Dilated Cardiomyopathy, Myocarditis, Endocarditis, Kawasaki Disease, Rheumatic Fever and Pericarditis.

Doctors have to take all symptoms serious even if it is coming from a child that one would not think that they have any reason to be at risk for a heart attack. Children can present with chest pain, shortness of breath, or (fainting) syncope. One should not look past these symptoms and try to identify a structural heart disease in these children. Since most structural heart disease in children can be worsened by exercise, it is strongly recommended that they should be well screened and evaluated for any heart condition before they participate in any sport.  Healthy eating and lifestyle should be one of the main focus at the level of childhood ages. Some examples would be to drink low fat milk, eat multiple portions of fruits and vegetables, exercise regularly, and staying away from sweets.

What are some interventions that should be done to curb these acquired risks for heart disease in young children and adolescents? Parents to be educated and should know their children's Body Mass Index, their blood pressure, do screening blood tests at ages of 9-11 and again at ages 17-21, if the child is obese to check for diabetes, get their kids moving and exercising at least for 60 minutes more than 5 times a week, feed their children with a lots of fruits, vegetables, lean protein and whole grains.

Heat disease continues to be deadly; we need to check for heart disease aggressively not only for adults but also children. It is important that parents, teachers, educators, children, and medical providers to be well educated in hearth health and in prevention of heart disease.



Dr. Manshadi MD, FACC, FSCAI, FAHA, FACP is among the top American cardiologists. He is the author of The Wisdom of Heart Health.  The physician is an Interventional Cardiologist who treats patients from prevention to intervention. He is a CMA (California Medical Association) member since 2001. He is a Board-Certified physician with the American Board of Interventional Cardiology, American Board of Cardiology. He combines private practice with Academic Medicine. Presently, he serves as Associate Clinical Professor at UC Davis Medical Center and as Clinical Professor at University of the Pacific among other positions. In addition, he is the Chair of Media Relations for American College of Cardiology, California Chapter. The multi-faceted physician is licensed and certified in nuclear medicine, a subspecialty of radiology. In this regard, he is a member of the American Board of Nuclear Cardiology. It is noteworthy to mention that in his practice, he likes to use innovative tests. If you want to know more about Dr. Manshadi, you can click here: Dr. Ramin Manshadi-Cardiologist. Dr. Manshadi is our health columnist and  is available to answer your questions. You can e-mail him at This e-mail address is being protected from spambots. You need JavaScript enabled to view it and the address of his official website is