How has COVID-19 impacted heart health in children and teens?
Early studies and publications suggest that young athletes who have had COVID-19 may be at a higher risk of damage or inflammation to the heart that isn’t immediately apparent. Cardiac issues in young people with COVID-19 have been almost unheard of, but there has been a subset of children who have developed a secondary infection from the virus called multisystem inflammatory syndrome in children, or MIS-C. The vast majority of these kids do have some level of cardiac inflammation – almost a whole separate disease. No one really understands it yet, so these kids need very close observation to make sure they recover, whether they are an athlete or not. This can determine if there should be any restrictions on activities.
How is Children’s Health advancing noninvasive technology to diagnose and manage children with congenital and acquired heart disease?
We are continually working on better ways to monitor the sickest kids in the hospital by gathering a large amount of data on these patients. It is a daunting task but one that is worthwhile. We review the lab and imaging studies, but we also study all the information being generated in real-time, so we can work through algorithms where we can determine when a child isn’t doing well and be able to intervene sooner.
How do I know if my child has a cardiac issue?
The most important thing to know is your family’s history of heart disease, or if a close family member died of a sudden death that was connected to heart failure. A lot of conditions we see have an inherited component to them. It takes some thought on the part of the family and physician to delve into that to see if there is a family history of heart disease. A child can be born with an undetected anomaly of the coronary artery and can have a heart attack, just like an adult can. In fact, the second most common cause of death in athletes is coronary abnormality. It’s considered a silent disease because the person is doing fine until the circumstance is happening. Any chest pain that takes place during exertion warrants an evaluation. Pay close attention to warning signs. Young athletes get pushed pretty hard, which is the nature of sports, but if your child has unusual fatigue that is new, becomes easily out of breath, or mentions a frequent racing heart, these are warning signs. It doesn’t mean they have heart disease, but it should be checked. And anyone who faints during exertion needs to be checked, as this is also a significant marker.
What can I do to make sure my child’s risk for a cardiac event is as low as possible at school or on the field?
Things have been on standby, in general, when it comes to returning to sports. It goes back to making sure kids are healthy when they participate in sports. In addition to knowing your family’s history of heart disease, pay close attention to warning signs. We have a panel of tests we can do for children who are attempting to return to sports after having COVID-19, but the most important thing we can do is be prepared. It is clear that if we intervene right away, the chance of surviving a cardiac incident is higher. Every sporting event should have an AED easily accessible for coaches and athletic trainers, and everyone should be trained to use it. Every school or athletic organization should have an emergency plan that is periodically rehearsed, whether kids are walking down the hallway or playing basketball. You can save a lot of people by being ready, because you can’t screen every child for everything.
William A. Scott, M.D., M.S., is director of cardiac electrophysiology at Children’s Health and professor of pediatrics at UT Southwestern. His specific area of expertise is cardiac electrophysiology (arrhythmias), and he has a special interest in the prevention of sudden cardiac death. He established a comprehensive program for the management of children with arrhythmias upon his arrival in 1990 and continues to direct that program. Dr. Scott’s research interests are directed at advancing noninvasive technology to diagnose and manage children with congenital and acquired heart disease. He has authored many peer-reviewed publications and book chapters. Dr. Scott helped oversee a collaborative grant from the State of Texas to evaluate the feasibility of screening school-age children for unrecognized heart disease.