WARNING: Parents urged to watch out for 'red flag' symptoms of heart disease in kids

A leading paediatric cardiologist has warned Irish parents about “red flags” to look out for in children’s cardiac health.

Speaking to Dr Afif El Khuffash on The Baby Tribe podcast, paediatric cardiologist Professor Orla Franklin gave advice to parents of children and teenagers about common symptoms experienced by this cohort that may indicate heart disease.

She says: “The most common one we see in boys is chest pain. Chest pain and growing teenagers is super common. Cardiac chest pain (angina) is very rare, even in children that we know have heart disease. As kids grow and stretch, what you find is that sometimes children and teenagers will develop short, sharp central chest pain that's not provoked by exercise. It's really sharp and then it's gone. It's gone as soon as it comes.

"There's excellent data now from multiple surveys involving tens of thousands of kids that these boys will be fine. But of course, the kids who come in are often super sporty, super active. They come from families who are very invested in maintaining their children's long term cardiac health. And so we see them, we see them, we do the screening and we make sure that there's nothing else going on. And we know from all of our own data, and from the worldwide literature that there's something else going on in less than 2% of these kids.

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"The girls, and also to a lesser extent, the boys tend to experience problems with fainting. So we know as you go through puberty, 1 in 6 teenagers will faint. We know the peak ages for fainting is around 15. We see a lot of kids like this again, to screen for heart disease and make sure it's not there, which by and large it isn't. By and large, the complex stuff that we see in kids, they're born with, for children with symptoms of fainting, chest pain, they're by and large a healthy group.”

When asked about other red flags to watch out for, Professor Franklin explained: “We don't like any events relating to swimming or cold water immersion. We don't like it when we hear that a child was running and then they dropped. Most kids run, feel a bit unwell, look white in the face, get to the edge of the pitch and then they drop. That's a more benign phenomenon. We can be worried if we hear that this occurs in the context of a family history.

"The dynamic is changing a little bit. There used to be a lot of issues in relation to exercise, but now we realise that some of that is adrenaline release. And so now, for example, there are certain arrhythmias that are well described in boys playing video games, tragically and suddenly, a boy who has been invested and excited about a video game may drop, may have a sinkable event, anything like that. We need to see this child. We need to go through this with a fine tooth comb and try to find those kids and preserve their health."

Professor Franklin also speaks about the worry parents have about sudden death in children: “Every single parent in Ireland is completely worried, and rightly so, about the risk of sudden death. It's something that we all really worry about. We've all stood at the side lines watching our kids get very flushed in the face, or come off a pitch looking white because they've given it their all and we think could there be something happening here?

"And, you know, finding those kids who have that risk because of heart muscle disease, because of inherited rhythm problems, that's something in the teenage group that we are super invested in doing. There's very good screening available for that. Should you have any red flags at all in your history where you think you might need to come in and for us to have a second look, we will look and hopefully our objective will be to get you back on the pitch. That's where we want you to be. We want to do the testing, reassure you and get you back out there with confidence.”

In this interview, Professor Franklin also shares her journey to becoming a paediatric cardiologist. Her stories from the corridors of prestigious hospitals to the realities of healthcare in Ireland show the importance of early intervention in children's cardiovascular health and the societal factors children’s hearts.

This episode provides a unique perspective on prevalent heart conditions, recent advances in paediatric cardiology, and the challenges of dealing with congenital heart defects.

You can listen here.