Medically Reviewed by David J. Steflik, MD

Each year, congenital heart disease (CHD) affects nearly 1% of births (approximately 40,000) in the United States. While CHD is the most common type of birth defect, the majority of children do not experience any significant heart problems. There are, however, some common conditions that can cause parents and grandparents alike to be concerned or worried.

SYNCOPE

Syncope (pronounced SYN-cuh-pee) is the medical term for passing out. When a child loses consciousness, it can be very frightening for the family. For most children and adolescents, fainting does not indicate a serious medical condition, but it should not be ignored.

Before fainting, a child may feel dizzy, see spots or dark vision, hear ringing or muffled sounds, feel nauseated, feel hot or cold, notice a change in heart rate and become pale. It is important to note these premonitory symptoms to discuss with the child’s doctor.

Causes of syncope can range from dehydration and to certain medications. Serious medical conditions such as heart defects or heart problems can also cause syncope. These can include arrhythmias – abnormal electrical signals that control the heartbeat – or structural abnormalities in the heart such as problems with the heart’s valves, chambers, or vessels.

If your grandchild experiences fainting, he or she should be evaluated by a pediatrician. The physician will want to know the details surrounding the episode – where and when it happened as well as if your grandchild was ill or felt abnormal before fainting. If multiple episodes occur, each one should be evaluated by a pediatrician.

Your grandchild may be referred to a pediatric cardiologist if there is a family history of fainting, pacemakers or structural heart disease; if they have palpitations or chest pains during the fainting spells or if the spells occur during activity. If the child has multiple episodes they should also be evaluated by a pediatric cardiologist.

Parents and grandparents alike are naturally concerned if a child faints, but most children who faint do not have underlying heart problems.

CHEST PAIN
Naturally, when a child complains of chest pain, the immediate reaction is to worry that something is wrong with their heart. However, chest pain and palpitations are common in growing children.

Chest pain is often a result of inflammation of the muscles and bones in the chest. Palpitations usually indicate a child’s heart is beating slightly faster than usual, or perhaps some extra heart beats.

As with syncope, most complaints of chest pain or palpitations in children pose no danger. However, these symptoms should be evaluated by a pediatrician.

The physician can then determine if a child needs to visit a pediatric cardiologist for further testing. Often, this decision is based on the frequency and intensity of the child’s chest pains, if chest pain is triggered by activity or exercise, and if there is a family history of heart disease.

HEART MURMURS
Many children have a murmur, but the term ‘heart murmur’ does not mean a disease or pathology: the word refers to a sound heard with a stethoscope. There are several different types of murmurs. The most common type – often referred to as a ‘functional’ or ‘innocent’ murmur – is actually a normal extra sound. On the other hand, ‘pathologic’ heart murmurs are related to problems, like a defective heart valve or a hole between the heart chambers.

If a child’s pediatrician or primary care physician detects a murmur, they may refer the child to a pediatric cardiologist. From there, the specialist examines the child to determine if more testing is needed. Additional testing may include an echocardiogram, an ultrasound used to visualize the walls, chambers, and valves of the heart. Some pediatric heart conditions are mild and can even fix themselves while some are very serious, needing medicine, surgery, and sometimes heart transplantation.

Keep in mind that murmurs are often found incidentally – during a routine examination or a sports physical. As a grandparent, try not to panic. It is okay to be concerned, but this is where further testing is beneficial.

Contact Dr. Steflik at McLeod Pediatric Cardiology at (843) 777-7300. McLeod Pediatric Cardiology is located in McLeod Medical Park East at 101 William H. Johnson Street, Suite 400.