Patient education: Heart block in children (The Basics)

What is heart block in children? — Heart block is a condition that affects the heartbeat. Heart block in children can be mild or serious. Mild types of heart block can cause a child's heart to beat more slowly than normal or to skip beats. More serious types can cause a child's heart rate to be dangerously low. Without emergency treatment, serious heart block can be fatal.

What causes heart block in children? — Normally, the heart has a built-in electrical system that makes it beat. Heart block happens when there is a slowing or blockage of the electrical signal from the upper part of the heart to the lower part that pumps the blood (figure 1). This can cause the heart rate to be slower than normal. Heart block can be caused by:

●A problem with the heart that happened before the child was born – These heart problems are called "congenital heart defects." Congenital means a condition a person is born with.

●An autoimmune disease called "neonatal lupus" – This can happen when a mother has a certain type of antibodies (proteins in the blood) that are passed on to the baby.

●Surgery for another congenital heart defect

●Other heart problems, diseases, or injuries

What are the symptoms of heart block? — The symptoms depend on the type of heart block your child has. There are 3 types of heart block:

●First degree – This is the mildest type of heart block. Often, children with this type have no symptoms.

●Second degree – This type is more serious than first degree. Children with second degree heart block might or might not have symptoms. Symptoms can include:

•Fainting

•Feeling dizzy

•Feeling tired

●Third degree (also called "complete" heart block) – This is the most serious type of heart block. It can cause the same symptoms as second degree, but they will be more severe. Third degree heart block can be life-threatening.

Will my child need tests? — Yes. Your child will have 1 or more of these tests:

●An electrocardiogram (ECG) – This test measures the electrical activity in the heart.

●A Holter monitor – This is a small, portable machine the child wears that records all the heart's electrical activity over 1 or 2 days.

●An echocardiogram – This test uses sound waves to create a picture of the heart as it beats. It might be used if your child has a history of passing out, or if the ECG or Holter monitor testing are abnormal. It checks to see if there are any structural heart problems (congenital heart defects) and it tests how well the heart is pumping.

How is heart block treated? — The treatment depends on the type of heart block your child has and their symptoms. Often, children who have first degree heart block do not need treatment. But children who have third degree heart block and some who have second degree heart block need a pacemaker. A pacemaker is a device that goes under the skin near the heart. It sends electrical signals to the heart that help it beat normally.

More on this topic

Patient education: ECG and stress test (The Basics)
Patient education: Pacemakers (The Basics)