Fortunately, heart disease is rare in the pediatric population. The incidence of congenital heart disease is 8-10 cases per 1,000 births, with a double chance if the condition already exists in the family.

Sudden death is again rare, only 0.6-1 per 100,000 athletes per year. If we take into account that, for every sudden death in exercise, there are 100 young deaths from drugs, traffic accidents and suicides worldwide, the question is:

“Why rush our child for specialized tests for something so rare?”

“Because every death of a young and healthy – even apparently – athlete is a tragic event, with incalculable psychological and non-psychological, family and social ramifications, let alone if these deaths can be prevented, when the family is informed and the medical community is vigilant “, answers Mr. Vasilios Tsiribis Adult-Pediatric Cardiologist, Deputy Director Cardiologist Metropolitan Hospital and continues:

“But in order to prevent something, you have to know about it. So, let’s see briefly the causes of Heart Diseases in the Pediatric population”.
The categories of heart disease that concern the pediatric population that have nothing to do with the “wear and tear” diseases that we find in adults and our elderly relatives (heart attack, heart failure, etc.) and that new moms usually worry about inheriting from their children are:

1. Congenital Heart Diseaseswhich are the most frequent, with the most frequent of all at birth, the interventricular communication. They are the diseases (stenosis and insufficiency of valves, cyanotic heart diseases, narrowing of the isthmus, etc.) with which a baby is born and it is good to be diagnosed as quickly as possible, so that their treatment is optimal,

2. Environmental / Genetic conditions related to heart diseases and concerning syndromes and conditions of the mother during pregnancy (diabetes mellitus, smoking, alcohol, infections, HIV, taking drugs) or chromosomal abnormalities, in which the diagnosis is made early (if possible also in utero, or immediately after birth),

3. Acquired Heart Diseaseswhich appear later in the child’s life and concern either diseases with a genetic background (Myocardiopathies of various etiologies – Hypertrophic, Dilated, etc., syndromes such as Marfan, mitral prolapse),

4. Either others arising as a complication from the children’s contact with infectious agents (pericarditis, myocarditis, rheumatic fever, infective endocarditis) and finally

5. Arrhythmological Diseases concerning rhythm disorders (arrhythmias), conduction disorders (AV blocks, WPW syndrome), Inherited Arrhythmic Syndromes (Brugada, Long QT).

So it seems, the detection of heart disease in the pediatric population:

• It begins with the detailed history of the mother’s perinatal period (take of aggravating substances or drugs, maternal illnesses during pregnancy, results of prenatal tests)
• It goes through the recording of the family history of the parents, with special emphasis on cardiomyopathy, sudden death, syncope and implantable defibrillators especially at young ages
• And ends, essentially, with a complete pediatric examination (detection of murmurs, measurement of blood pressure in older children), questioning about noisy symptoms (especially during exercise in older children and feeding in newborns) such as precardial pain, easy fatigue, arrhythmias or fainting episodes .

It is now understood by all of us, that even if Congenital Heart Diseases and conditions due to Environmental / Genetic conditions are ruled out, immediately after birth, a newborn / child / young adult is at risk at any time from Acquired Heart Diseases (usually coincident with viruses – recent example the complications after COVID-19) or occurrence of Arrhythmic diseases.

If we keep in mind that a heart in everyday life, even if it is suffering, may not give symptoms and these may arise during exercise or intense exercise, it is clear that the person and the family must be on the lookout and not ignore warning signs.
Somehow, the annual Pre-Sports Screening of young and non-athletes came about (and rightly so) in order to diagnose, as far as possible, coexisting cardiac conditions that could lead to Sudden Cardiac Death.

So the annual check-up, which starts with the Pediatrician (full history, monitoring the development of the child, detection of suspicious signs – murmurs or symptoms) and ends with the Specialized Cardiologist (ECG, heart triplex and everything else needed – Holter 24h , fatigue test, Stress Echo, Magnetics), is the hope and solution proposed by the Scientific community, for the early diagnosis of rare heart diseases in the Pediatric Population and the reduction or disappearance of Sudden Cardiac Deaths in young athletes.

“The annual follow-up of our children by their doctors and the specialized check-up by a Cardiologist is vital”, concludes Mr. Tsiribis.