If you have any questions, please e-mail us at wcchn@albertahealthservices.ca.
"My son turns pretty blue when he's at his swimming class, in the cool water. He gets the shivers really bad too, but insists on staying in the water. Is this okay for him or should I be taking him out? Is it too much strain on his heart and circulatory system?"
Depending on the underlying heart condition, usually it is ok to stay in the water.
"I know that my heart child has to have an antibiotic whenever he has dental work done, to prevent bacterial endocarditis caused by the bacteria on his teeth. Is flossing safe for a child with a heart condition or does it expose too much of the open gum line to the bacteria? Also, if a heart patient is bitten by an animal (breaking the skin) does that require antibiotics to prevent the spread of the animal's oral bacteria? Lastly, if my child does happen to get bacterial endocarditis what are the symptoms and how will I know if he has it?"
Flossing is safe for a child with a heart condition. Depending on the animal and the animal's health, the child may or may not require antiobiotics to prevent the spread of the animal's oral bacteria. The symptoms of bacterial endocarditis are low grade fever and vaguely unwell. They are usually not very sick. Check with the physician to find out if your child has bacterial endocarditis.
"Why is blood particularly important in cardiac patients?"
(taken from the Cincinnati Children's Hospital Website)
Hemoglobin in red blood cells is the molecule responsible for transporting oxygen through the bloodstream from the lungs to all the tissues of the body. A normal hemoglobin (or hematocrit) level is important for maintaining the ability to deliver enough oxygen to meet the body's needs. A low hemoglobin level (anemia) forces the heart to generate a higher output to achieve adequate oxygen delivery. This may not always be possible, especially in the presence of cardiac anomalies or dysfunction.
There are components of blood which are crucial in the complex clotting mechanisms. It is particularly important that this system works properly at the time of surgery to prevent bleeding complications.
"How do you keep your baby safe from germs?"
(taken from iParenting Media)
Well, there's no 100 percent fail-proof method, but here are a few tips to help you eliminate as many germs as possible.
Hand wash. Hand wash. Hand wash. It is recommended that you wash your hands for three minutes, using an antibacterial soap and water.
Another way to "de-germ' is to clean household surfaces with a mixture of bleach and water. It is recommended that you mix 2 teaspoons of liquid bleach per gallon of water to clean counters, toys and other surfaces. Bleach and water will kill 99.9 percent of household germs.
Parents also should teach their children what is appropriate to share. It's OK to share toys, but not cups, bottles, pacifiers, or anything else that would commonly be in the mouth.
In addition, parents should handle foods appropriately, not letting children touch raw poultry, beef, or uncooked eggs, and keep foods that are supposed to be cold refrigerated at all times.
Also, parents should keep their children away from cigarette smoke. Exposure to cigarette smoke has been linked to bronchities, asthma, pneumonia, and chronic ear infections in small children and infants.
But remember, children have to be children and allowed to play and have fun. There is no way to completely sterilize any room.
Blue Spells and Your Child
(taken from the VCHC website)
Children with some types of heart problems occasionally have what is called a "blue spell" because the child's skin turns bluish. These spells can be frightening for both children and their parents. The following explains why blue spells happen and what to do if your child has one.
"What happens in a blue spell?"
During a blue spell children may:
- Suddenly feel uncomfortable.
- Begin to breathe faster and deeper.
- Turn blue, especially around the mouth and face.
- Sometimes faint.
- A spell usually lasts no longer than one minute.
"What causes blue spells?"
The most common cause of blue spells is contraction or narrowing of the area below the lung artery. This narrowing lowers the amount of blood going to the lungs. The children most often affected by blue spells are those with tetralogy of Fallot (a form of congenital heart disease). However, blue spells may also occur in children with other forms of heart disease in which blood flow to the lung is reduced.
"What should you do if your child has a blue spell?"
If your child has a blue spell, do not panic. To help your child, follow these steps:
For infants:
- Place your infant on his or her back.
- Bring the baby's knees up to touch the chest.
- Cuddle your baby to confort him or her.
- Remain calm.
For older children:
- Place your child on his or her side, bringing the knees up to the chest.
- Some children will automatically squat during a blue spell. This is their way of bringing their knees to the chest on their own.
- Make sure you can see the child's face to watch for color changes and check the degree of alertness and length of spell.
"When should I call the doctor?"
If this is your child's first blue spell, notify your child's pediatrician or cardiologist.
If your child has blue spells more often than he or she normally does, notify your child's pediatrician or cardiologist.
If a blue spell lasts longer than one minute, take your child to the nearest emergency department.
The source of the statement is unknown. Unfortunately, it is very misleading. The incidence of 'allergic bronchial asthma' in patients with congenital disease is no higher in congenital heart disease vs general population. It is a misconception that 'a lot of kids with pulmonary atresia have reactive airway disease...usually a result of numerous surgeries'. If this is true, then one would see more frequent reactive airways in any patients undergoing any cardiac surgery, and not just in pulmonary atresia. There is no association with 'the nature of their congenital heart disease'. Conceivably, wheezing can result from 'cardiac asthma' (as opposed to 'bronchial asthma'), which may occur in patients with congestive heart failure.
Cardiac ashtma from pulmonary edema can result in wheezing and responds to antifailure therapy. Heart failure does not occur in TOF, pulmonary atresia. Both cardiac and brochial asthma respond to Xanthine type of drugs (theophylline, aminohpylline). Patients with absent pulmonary valve may have respiratory distress and wheezing, a result of the large pulmonary artery compressing the bronchi.
Allergic asthma is not more common in congenital heart disease. In reading and interpreting what is on the internet, one has to be very careful in distinguishing between respiratory distress from wheezing, and wheezing from cardiac vs brochial asthma.
Did You Know? - "Heart Failure"
Did you know that almost five million Americans have heart failure? Did you know that over 500,000 cases of heart failure are diagnosed each year in the United States? Indeed, many individuals do not even know they have the condition, or are unaware of the signs, symptoms, and therapies of what was formally known as congestive heart failure (CHF).
Contrary to its name, congestive heart failure does not necessarily indicate that the heart has completely failed/stopped, which is the case when someone has gone into cardiac arrest. It means that the heart is operating at a decreased efficiency level and, therefore, is working harder to try to make up for the shortcoming in function. For example, the heart may pump more frequently to compensate for its weakened pumping ability. the longer the heart overworks itself to compensate for its shortcomings, the more its pumping ability is damaged and the more likely that serious pumping failure will result. This typically results in such classic symptoms as shortness of breath and other breathing difficulties, fatigue, frequent coughing, and swelling in the ankles or feet (edema).
While CHF cannot be cured, it can be managed so that the risks of hospitalizations and more severe disease are minimized. This includes identificatino of lifestyle risk factors and available medical and surgical treatment options (e.g., diuretics, ACE inhibitors, beta blockers, cardiotonics, pacemakers, angioplasty, coronary artery bypass, transplantation).
"When a cardiac child is sick, does the cardiologist need to be informed? How does a parent know when they should be?"
Young patients with heart disease get the same common illnesses (colds, ear infections, etc.) as health children. Blue children, those with heart failure, or after transplantation, are at a higher risk of becoming very sick with a common illness; or a relatively simple illness may produce complication (like pneumonia from a flu). When a child with a significant heart disease becomes sick, his/her medications may have to be re-adjusted. Many heart medications interfere with medications used for other illnesses.
Thus the recommendations are:
1. A child with a minor heart defect or a repaired heart defect on virtually no medications can be looked after by a general practitioner or pediatrician.
2. A child with a significant heart defect, especially blue children and those with heart failure, should be seen by a pediatrician or practitioner who know the child well and feels comfortable treating him/her.
3. Significant illnesses in children with significant heart problems should at least be reported to the cardiologist; many of these illnesses may affect the heart function and an evaluation by a cardiologist is necessary.
