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PEDIATRIC SERVICES

Diagnosis & Treatment

Cardiomyopathy in Children

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How is Cardiomyopathy in Children Diagnosed?

Diagnosis

Symptoms for cardiomyopathy may be misdiagnosed as another condition like asthma, an infection, or a gastrointestinal issue. The condition may be discovered when your child has a chest X-ray for another problem, which could reveal an enlarged heart, possibly indicating inflammation.

Your child’s pediatrician may request further tests to determine the source of the heart abnormalities and rule out cardiomyopathy. They may order the following tests:

  • Blood tests – Blood will be tested to check kidney and liver function. Thyroid dysfunction could indicate cardiovascular disease or risk. In addition, a certain blood test measures a protein level in the heart which rises during heart failure.
  • Chest X-rays – An X-ray of the heart can reveal an enlarged heart and fluid built up in the lungs
  • Echocardiogram – Sound waves are used to create an image of the heart. Doctors can view the function of the heart’s two pumping chambers and also the four valves of the heart to aid in diagnosing the child’s condition.
  • Electrocardiogram (ECG or EKG) – An ECG measures the heart’s electrical signals. It is a noninvasive test that attaches electrodes to the skin. These electrodes can detect irregular heartbeats or show injury to the heart.
  • Holter monitor or Ziopatch – A monitor that can be worn on the chest as a sticker or a set of leads that can track the electrical activity of the heart for up to several days. This can help detect irregular heartbeats or arrhythmias of the heart.
  • Cardiac catheterization – A thin tube (catheter) is inserted into a blood vessel through the blood vessels in the neck or groin. Pressure and tightness of the heart chambers, and also blood vessels to and from the heart and lungs, can be measured with this process. Dye is sometimes injected to make the blood vessels more visible on the X-rays. This test can also show if there is any blockage in the blood vessels. A small piece of heart tissue may be taken for biopsy in a laboratory.
  • Cardiac magnetic resonance imaging (MRI) – An MRI uses magnetic fields and radio waves to create vivid images of the heart. Certain sequences of an MRI can also assess the quality of the heart muscle and detect things like inflammation and scarring.
  • Treadmill stress test – The patient’s heart rhythm, blood pressure, and breathing are measured while they walk and/or jog on the treadmill. This test determines whether exercise brings on an irregular heart rhythm.
  • Genetic testing or screening – Cardiomyopathy is sometimes inherited. Ask your doctor if genetic testing is an option to explore.

How is Cardiomyopathy in Children Treated?

Treatments

Pediatric cardiologists usually choose medication as the first course of treatment to improve heart function. However, in some cases, surgeries and special devices may be necessary. Treatment for cardiomyopathy in children has three objectives: managing the signs and symptoms, preventing worsening symptoms, and reducing complications.

Medication

Medications to treat cardiomyopathy are designed to:

  • Improve the ability of the heart to pump blood
  • Increase blood flow
  • Reduce blood pressure
  • Slow down the heart rate
  • Eliminate excess fluid from the body
  • Prevent blood clots

Surgical Options

Devices are available to improve the heart’s function and relieve many symptoms. These devices include:

  • Pacemaker – A pacemaker is a small device surgically implanted below the skin in either the chest or abdomen which allows electrical impulses to control arrhythmias
  • Implantable cardioverter-defibrillator (ICD) – This device is used in cases where the heart has an irregular beat; electrical impulses are delivered to the heart to “jump-start” the heart back into a regular rhythm. An ICD is not meant to treat cardiomyopathy. Instead, it regulates the heartbeat. An irregular heartbeat is a serious complication of cardiomyopathy.
  • Ventricular assist device (VAD) – A VAD takes over the function of one or both of the heart’s pumping chambers. This procedure is usually recommended if prior, less invasive treatments were unsuccessful. It is used for long-term and short-term treatment while waiting for a heart transplant.

Surgeries used to treat cardiomyopathy are:

  • Septal myectomy – Open heart surgery that’s commonly used to treat hypertrophic cardiomyopathy. This procedure removes the thickened section of the heart’s muscle wall, which improves the flow of blood through the heart.
  • Heart transplant – This procedure is performed when all other attempts to correct the cardiomyopathy in a patient, including medications, have failed. A heart transplant is usually reserved for people with end-stage heart failure.

Other therapies

Some of the non-surgical procedures used to treat cardiomyopathy may include:

  • Radiofrequency ablation – Small tubes (catheters) equipped with electrodes attached to the tips are guided through the blood vessels to the damaged heart tissue. By emitting an electrical charge, the section of the heart tissue causing the irregular heart rhythm is destroyed, allowing blood to flow freely again.

The goal of treating childhood cardiomyopathy is to manage current symptoms and prevent the disease from progressing. Treatment for cardiomyopathy depends on the type and severity of the condition.

FAQs

FAQs

You can develop cardiomyopathy as an adult, though this rare condition tends to be genetic, affecting people during childhood. In adults, cardiomyopathy is usually the result of damaged heart muscle after a heart attack or another condition or behavior factor, like excessive alcohol consumption.

Cardiomyopathy in children can vary in terms of severity. Even though cardiomyopathy is a chronic disorder, children can generally lead normal lives by following some extra considerations. If your child has cardiomyopathy, they may need to take daily medications and visit the pediatric cardiologist a few times during the year. They should also limit their participation in contact sports and sports requiring extensive physical exertion. Your child’s school should be made aware of any accommodations they might require.

According to the North American Pediatric Cardiomyopathy Registry, one in 100,000 children in the United States are affected with cardiomyopathy every year.

The prognosis varies and is dependent on the type of cardiomyopathy as well as its severity. Your pediatric cardiologist will use an array of testing to help determine prognosis.

Get Care

Trust NewYork-Presbyterian for Childhood Cardiomyopathy Treatment

Schedule an appointment today with one of our expert pediatric cardiologists. Understanding the causes and symptoms of cardiomyopathy in children is the first step in treating this condition. Schedule a consultation with one of our specialists today.