Take child fainting to heart

If your child faints, they should always be seen a healthcare professional to rule out underlying health issues.

Did you know that a child fainting may be a sign of a heart rhythm disorder? Heart rhythm disorders (arrhythmias) occur in adults, but few are aware that it is a significant problem among many South African children as well.

Greater awareness needed of heart rhythm disorders

Children may be born with a heart disorder that causes electrical and functional problems in the heart and, may remain unaware into adulthood that they have a potentially dangerous health problem. “There needs to be much greater awareness of heart rhythm disorders and congenital heart disease, which is a common birth defect occurring in children and can cause problems with the efficient functioning of the heart,” says Dr Adele Greyling, a paediatric cardiologist.

Dr Greyling says that many children with congenital heart defects go undiagnosed and take these conditions into adulthood. She says that untreated congenital heart defects and arrhythmias may be detrimental to health and in some cases even result in heart failure.

Inherited heart defects affect about four in 1 000 babies

“It has been estimated that about four out of every 1 000 babies are born with inherited heart defects, which provides some idea of the extent of the challenge posed by this condition within the Eastern Cape and nationally,” adds Dr Greyling. “We need to equip people with the necessary knowledge to be able to identify inherited heart problems and heart rhythm disorders, and to know when and where to obtain help.”

The signs and symptoms

Symptoms of a heart rhythm disorder include:

  • fainting
  • heart palpitations
  • dizziness
  • light-headedness
  • discomfort in the chest
  • general weakness

Good to know: A child with an inherited heart rhythm disorder may fail to thrive. “It has been suggested that some 55 children out of every 100 000 suffer from heart rhythm disorders internationally, and our incidence here in South Africa is likely to echo this. The most common of these are supraventricular tachycardias, which is an electrical problem in the upper chambers of the heart,” notes Dr Greyling, who is accredited as an electrophysiologist by the Cardiac Arrhythmia Society of South Africa.

What are the causes?

“Heart damage and rhythm disorders may be caused by a number of factors including certain infections and rheumatic heart disease, but heart rhythm problems are particularly common among those born with a complex congenital, or inherited heart defect. “A child may, for example, be born with an inherited defect such as a hole in the heart that may cause the heart to function improperly, or with an extra electrical pathway in their heart that might cause heart rhythm disturbances,” she explains.

The condition can be treated

“Tragically, although many of these inherited heart defects can be relatively easily corrected with a minimally invasive catheter procedure, even in the very youngest of babies, the condition often goes undetected for years. “We are finding that in the Eastern Cape, as well as nationally, there is a growing population of patients with inherited heart conditions surviving to adulthood due to improved surgical care, which poses unique challenges and a higher incidence of arrhythmias.”

Dr Greyling, who also practises in the state sector in addition to Netcare Greenacres Hospital, says that while the catheters and devices such as pacemakers often need to be smaller for children, the principles and physiology of treating heart rhythm disorders in children are similar to those in adults. Therefore, cardiologists who have specialised in electrophysiology for adults can and do treat children with rhythm disorders, and likewise Dr Greyling, as a paediatric cardiologist who has super-specialised in heart rhythm disorders, also sometimes treats adults with inherited heart defects and arrhythmia.

Dr Greyling and her team perform interventions to repair structural heart defects, electrophysiology procedures such as cardiac ablations, which involve correcting electrical heart problems and structural abnormalities, and also implant pacemakers and defibrillators.

According to Dr Greyling, each patient is completely different and treatment depends entirely on the nature of their specific problem. Having experience in congenital heart disease is thus most useful when dealing with heart rhythm disorders in patients with inherited heart disease.

South Africa needs more specialists

Asked if the fields of paediatric cardiology and heart rhythm disorders receive sufficient attention in South Africa, she said that the short answer was “no.”

“We do not have enough paediatric cardiologists, adult cardiologists, or electrophysiologists, let alone paediatric and congenital electrophysiologists for the patient burden. Many towns in South Africa have no cardiologists at all.”