Symptoms of CHD in babies, toddlers, preteens, and teens

Congenital heart disease, or CHD, involves heart defects and conditions that babies are born with. Sometimes CHD can be detected prenatally, but it is often diagnosed after birth and can present at any age. 

There are some common symptoms of CHD that may indicate that a child’s heart should be evaluated by a pediatric cardiologist. Andrew Dodgen, MD(opens in a new tab), shared some of the symptoms that cardiologists look for when evaluating a patient for possible CHD.

Persistent fast breathing is one of the more common signs of heart disease in babies. Although a baby’s breathing can vary throughout the day, including brief periods of rapid breathing alternating with followed by short pauses that quickly return to normal (known as “periodic breathing”), babies with CHD can breathe fast for several hours at a time, even without being upset or otherwise stressed.

 Sometimes turning blue, especially in the hands or feet, can just be a vascular phenomenon, but a cardiologist will want to evaluate a baby whose gums and tongue turn blue. 

“Murmurs are among the most common indications for referral to a pediatric cardiologist,” Dr. Dodgen said. “However, some forms of heart disease may present without a murmur and in such cases, it is important to evaluate for other signs and symptoms suggestive of heart disease. In particular, the way an infant feeds can provide clues to the presence of underlying heart disease and pediatric cardiologists typically ask lots of questions about volume, frequency and length of feeds. If parents feel that there is a problem with the way their child feeds, it is worth discussing with the child’s primary care provider to see if a pediatric cardiology evaluation is indicated”

Toddlers and Young Children

• Poor energy level, tiring easily
• Gums and tongue turning blue, or a blue tinge to the skin
• Poor growth/weight gain
• Chest pain
• Rapid heartbeat or breathing
• Passing out
• Losing their breath during activities sooner than their peers

“When considering whether a toddler has underlying heart disease, certain challenges exist related to their inability express themselves clearly in most cases,” said Dr. Dodgen. “Toddlers have a limited vocabulary which makes it difficult for them to describe what they may be feeling sometimes. This is why pediatric cardiologists rely on parents and caregivers to identify and report any changes, such as a decrease in the child’s energy or activity level, that might warrant further investigation. After all, nobody knows a child better than their parents and, as a result, parents can often pick up on subtle changes that others might not recognize.”

Other symptoms that warrant further investigation include complaints of chest pain when running and playing, worrying about their heart when exercising and saying that they feel their heart “beeping,” which could be a sign of an irregular heart rhythm. 

Preteens/Teens

• Problems with growth/development
• Fainting/passing out
• Gums and tongue turning blue, or a blue tinge to the skin
• Chest pain, especially with exercise
• Rapid heartbeat or breathing
• Losing their breath during activities sooner than their peers
• Palpitations, or hearts beating abnormally or skipping a beat
• Dizziness with exercise

Preteens and teens should be evaluated for CHD if they complain of issues such as a persistent fast heartbeat during exertion or exercise, shortness of breath or extreme fatigue. 

“When taking care of teenagers, it is important to understand the unique psychosocial implications of potential heart disease in this population. For example, I always remind teenaged athletes of the importance of reporting exertional cardiovascular symptoms and offer my personal promise to get them evaluated as quickly as possible to avoid any significant disruption to their practice of game schedule. I would not want a patient to hide a symptom for fear of being restricted or having to miss events,” said Dr. Dodgen.

Dr. Dodgen recommends discussing any concern you may have regarding your child’s cardiovascular health with your pediatric cardiologist. “One of the rules that I live by as a pediatric cardiologist is that if a parent is concerned, I am concerned. A wise pediatrician understands that parents have a unique insight into their child’s health and partners with them to insure their child receives the best care possible,” said Dr. Dodgen.

This is not a comprehensive list of all signs and symptoms. Please contact your child’s doctor if your child experiences any symptoms that concern you.

Andrew Dodgen, MD, sees patients at Children’s Cardiology’s Columbus clinic.

Related:

City Call Program Links Community Hospital and Children’s Heart Center 

NIH: http://www.nhlbi.nih.gov/health/health-topics/topics/chd 

CDC: http://www.cdc.gov/ncbddd 

For more information about Children’s Healthcare of Atlanta Cardiology and our pediatric cardiology specialists, click here.