Children also need care and prevention for heart health even though they are less prone to heart disease than adults. As part of its cardiology activities, Humanitas Medical Care is particularly interested in pediatric prevention. This is why an outpatient clinic has been set up in the center of Via Domodossola in Milan to carry out first-level screening of cardiac defects that may affect children from the age of 3 years onwards; this is done through careful clinical supervision that includes the objective examination, an electrocardiogram and the color doppler echocardiogram. To find out more about the activity of the clinic, we interviewed Dr. Silvana Gramenzi, specialist in Cardiology at Humanitas Medical Care Milan, via Domodossola.
A service aimed at for children aged 3 and up
The surgery in Via Domodossola is aimed at children over the age of 3 and is specialized in the detection of simple congenital heart diseases, which are most often asymptomatic. In the vast majority of cases, complex congenital heart disease is symptomatic and is diagnosed within the first year of life. There are also arrhythmogenic heart diseases, sometimes linked to genetic defects, which can be detected or suspected by the electrocardiogram.
“In pediatric age the main problem is to be able to detect the presence of both congenital and acquired heart diseases, as well as heart rhythm disorders – explains Dr. Gramenzi. The purpose of this pediatric cardiology clinic is to offer a first level screening to assess the presence or absence of heart defects.
Acquired heart diseases, in particular rheumatic heart disease linked to a streptococcal infection, are fortunately less frequent than in the past, as hygiene and health conditions have improved significantly. Other infectious heart diseases, such as pericarditis (inflammation affecting the pericardium) and myocarditis (inflammation of the heart muscle) can occur in childhood, but being strongly symptomatic they are related to hospital facilities.
How does the pediatric cardiology examination work?
The services offered by the pediatric cardiology clinic of HMC in via Domodossola include clinical examination, electrocardiogram and echocardiogram color doppler. If other types of examinations are needed, for example the 24-hour dynamic electrocardiogram (Holter ECG) or if heart diseases worthy of further investigation or invasive therapies were found, the child would obviously be referred to second-level clinics in complex structures such as that of Humanitas of Rozzano.
Generally, it is the basic pediatrician who, finding a heart murmur or an irregular heart rhythm, recommends a cardiac examination to rule out any anomalies.
“Generally, children are referred to the cardiology clinic by the pediatrician after a heart murmur has been detected. Other symptoms for which the cardiac evaluation is required are strong heartbeat or chest pains, especially during physical exercise – said the specialist. The cardiac examination consists of a clinical examination, auscultation of the child’s heart, to understand whether the murmur may be pathological or is simply ‘innocent’, i.e. not related to structural changes and the execution of the electrocardiogram.
“If there is any doubt – added Dr. Gramenzi -, a color Doppler echocardiogram is also performed, a very useful test because it allows the assessment of cardiac structures, valves, intracardiac flows as well as recognizing any structural and functional abnormalities.
Particular attention to the patient
Younger children under the age of 5 may be scared, afraid of the doctor and the environment and may have crying crises or defensive attitudes. The doctors at Humanitas are therefore very patient and want to win the trust of the children, allowing them to be in the mother’s arms, both during the visit and during the execution of the instrumental examinations.
