Can A Teenager Have A Heart Attack?

Heart attacks in teenagers are rare but it is a real danger, especially for those that participate in sports. They can arise from a pediatric heart condition or heart disease. We will overview these conditions in this article covering their causes, symptoms, and risk factors. 

What is a pediatric heart condition?

A child’s body and mental health are completely different from an adult’s due to the developmental changes that happen between the two. Thus, a field of medicine is established called pediatrics that deals with the health and diseases of children. One disease that can occur in children is a heart condition. These can either be congenital or acquired by an individual.

Congenital heart disease

Congenital means that an individual has inherited something from their parents and they are born with it. Therefore, congenita l heart disease means there is a defect to the structure of a child’s heart that they are born with. The structures that can be affected include the valves, chambers, and vessels of the heart. These defects can be simple and don’t need treatment but they can be more serious and require treatment over several years including surgeries. The Mayo Clinic recognises 26 different congenital heart diseases in children. 

Acquired heart disease

While congenital heart diseases refer to conditions that a child is born with, acquired heart diseases refer to conditions that a child can get after birth. This can be due to a variety of reasons such as infection or a condition that affects another part of the body. This type of heart disease includes rheumatic heart disease. 

Heart disease in children and teenagers

Here we will explore some of the heart diseases that can occur in children. We will explore the symptoms and causes that can occur in each.

Heart attack

Heart attack is when the blood flow to the muscles of the heart is  blocked, causing some of the tissue of the heart to die off, and is also known as myocardial infarction. Commonly, this is caused by coronary artery disease in adults but in children, one cause is Kawasaki disease.¹ Heart attacks can occur in children and teenagers but it is extremely rare.² The symptoms that present in children are the same as heart attacks in adults.

Sudden cardiac arrest

A sudden cardiac arrest occurs when the heart is unable to pump blood. There can be several causes for this such as a congenital heart condition. The causes can also be split into two categories: structural or electrical conditions. The occurrence of a sudden cardiac arrest can be fatal and symptoms can include chest pains and sudden collapse with no pulse. In addition, adolescents who undertake sports at an athlete level can be at risk of sudden cardiac arrest.³

Chest pain 

Chest pain is a symptom that can arise from heart conditions in children and teenagers. More commonly chest pains are due to the result of musculoskeletal causes than cardiac so are more than likely benign. However, if the pain occurs on exertion then it could signal that it is of cardiac origin.⁴

Rheumatic heart disease

Rheumatic fever is an infection that can develop if strep infections or scarlet fever is not treated properly. This can develop into rheumatic heart disease as the heart is one of the areas affected by the fever including the joints, skin, and brain. This causes permanent damage to the heart that needs to be treated with surgery. Overall, rheumatic heart disease claims 288,348 lives each year. Its symptoms can include chest pain or discomfort, shortness of breath, swelling of the stomach, hands, or feet, fatigue and rapid or irregular heartbeat. 

Kawasaki disease

This condition is also known as mucocutaneous lymph node syndrome and mainly affects children under 5. Its initial symptoms include a high temperature lasting 5 days as well as possibly: a rash; swollen glands, tongue, hands, or feet; red lips, tongue, throat, or eyes. After a few weeks, these symptoms can become less severe but in some children, it can take longer. These symptoms resemble a bacterial or viral infection but no bacterial or viral agent has been isolated from the disease. In addition, some children can be predisposed to the disease suggesting there is a genetic cause. Overall, this infection can lead to an inflammation of the blood vessels in the heart, potentially causing a heart attack or other heart complications.

Other heart diseases in children and teenagers

There are a variety of other heart diseases  that can affect children and teenagers. These can result in symptoms such as chest pains and lead to further heart complications such as a heart attack. Examples of other heart diseases include long QT syndrome, pulmonarazay atresia, and vascular rings. 

Signs of heart disease in teenagers

The diseases that have been explored above have symptoms related to them. These can range from chest pains to swollen hands or feet. Identification of these symptoms allows the diagnosis of the specific order. Diagnosis will also depend on accompanying tests to assess the heart. However, some general signs can indicate heart disease in a teenager. These signs include:

• Easily becoming short of breath or tired during exercise or activity
• Fainting during exercise or activities
• Swelling of the hands or feet
• Chest pain or heart murmurs  

Risk factors of heart disease in teenagers

There can be risk factors that increase the probability of heart disease in teenagers. This can include high cholesterol, high blood pressure, smoking, obesity, and physical inactivity. This section of the article will explore these risk factors.

High cholesterol

Just like adults, teenagers can have high cholesterol. This is related to low-density lipid protein which is known as the “bad” cholesterol. It can be tested for with a blood test. Studies have shown that teenagers with high cholesterol are at risk of hypertension in adulthood.⁵ 

High blood pressure

Again like adults, teenagers can have high blood pressure. High blood pressure can be diagnosed with a cuff monitor, either manual or digital to give a reading of diastolic and systolic pressure. An example of high blood pressure would be ≥140/≥90 mmHg. This high blood pressure has the same effects in teenagers as in adults and is a risk factor for heart disease. In addition, having high blood pressure as a teenager increases chances of heart disease later in life.

Smoking

Smoking is well known to increase the risk of heart disease in adults and the same rings true for teenagers. A 2008 study showed that teens who smoke have considerably more risk for cardiovascular disease later in life.⁶ In addition, the younger the age at which a person starts smoking, the higher the risk of heart disease later in life. Move hyperlink

Obesity

Obesity rates are on the rise around the world with worldwide obesity rates tripling since 1975. An increase in obesity is not only seen in adults but also seen in teens and studies have shown that obesity in teens increases the risk of heart disease.⁷ It also increases the risk of other conditions such as diabetes. 

Physical inactivity

Lastly, physical inactivity and lack of exercise can increase the risk of heart disease in teenagers as well. This is due to the resulting poor cardio health from inactivity. It can also increase the risk of some of the above-mentioned factors as well such as obesity. 

Can a teenager have a heart attack?

As has been investigated so far in this article, teenagers and children can have heart conditions that are either congenital or acquired which can in some cases lead to a heart attack. It is rare for a teenager to have a heart attack but it is still a possibility. Another possibility is a sudden cardiac arrest which is different from a heart attack. 

Differences between a sudden cardiac arrest and heart attack in teenagers

A sudden cardiac arrest is different from a heart attack. A sudden cardiac arrest is when the heart is no longer able to pump blood around the body. This can be caused due to a structural or electrical defect. In contrast, a heart attack is when the blood supply is cut to the heart, commonly due to coronary artery disease, which causes the tissues of the heart to die off. It should be noted however that a heart attack can bring on a sudden cardiac arrest.

Prevention

A heart attack in a teenager can be prevented or minimised by taking several steps. For congenital heart conditions, these steps should be taken by the mother as these conditions can develop in the womb. Prevention steps for a mother can include:

• Rubella - an infection of rubella during pregnancy can affect the development of the baby’s heart. Measures to prevent this can be taking the rubella vaccine
• Diabetes - Blood sugar levels need to be controlled throughout pregnancy to avoid defects in heart development
• Medications - Certain medications can affect the development of the baby. Famously, thalidomide causes birth defects
• Drinking alcohol during pregnancy - Fetal alcohol syndrome is now well established and can affect the development of the heart. It is advisable to not drink alcohol while pregnant
• Smoking - smoking while pregnant increases the risk of heart defects developing during pregnancy

Prevention for acquired heart conditions depends on the condition. For example, prevention for rheumatic heart disease relies on the proper treatment of the initial step of infection. This prevents the development of rheumatic fever which can lead to the condition.  

Summary

Teenagers can have heart conditions that are either congenital or acquired which can lead to heart attacks. Heart attacks are rare, however. It should also be noted that teenagers who participate in sports at a high level should be monitored for any heart conditions as these individuals are at risk of heart attacks. Another condition known as sudden cardiac arrest is also of concern in teenagers.