Yes, children can get heart disease. It’s more common than most parents realize. Heart defects affect nearly 1% of all births in the United States, roughly 40,000 babies per year, and other forms of heart disease can develop at any point during childhood. Pediatric heart disease falls into two broad categories: conditions a child is born with (congenital) and conditions that develop later (acquired).
Congenital Heart Defects
Congenital heart defects are structural problems with the heart that form during pregnancy, before a baby is born. They are the most common type of birth defect. The most frequently diagnosed is a ventricular septal defect, essentially a hole in the wall between the heart’s two lower chambers. Some defects are mild and close on their own. Others are serious enough to require surgery in the first days or weeks of life.
The good news is that surgical outcomes have improved dramatically. Across all types of congenital heart surgery in children, the overall in-hospital survival rate is about 97.7%. For simpler defects like holes in the heart wall, survival exceeds 99%. Even for the most complex mixed defects, survival rates have climbed from roughly 75% in the mid-2000s to over 97% in recent years.
Warning Signs in Babies
Serious congenital heart defects are usually caught within the first few days or months of life. Signs to watch for include a pale gray or blue color on the lips, tongue, or fingernails. Rapid breathing is another red flag, especially during feedings. Babies with heart problems often struggle to eat because the effort of sucking and swallowing triggers shortness of breath, which leads to poor weight gain over time. If a baby consistently tires out during feedings or isn’t gaining weight as expected, that warrants attention.
Heart Disease That Develops Later
Children can also develop heart problems after birth. These acquired conditions are triggered by infections, immune responses, or lifestyle factors rather than structural defects present from day one.
Kawasaki Disease
Kawasaki disease is an inflammatory condition that primarily affects children under five. It causes inflammation of blood vessels throughout the body, and its most dangerous complication is damage to the coronary arteries that supply blood to the heart. The disease shows up as a persistent high fever alongside a constellation of other symptoms: a rash, red eyes without discharge, swelling in the hands and feet, and a distinctive “strawberry tongue” with red, cracked lips. It remains a clinical diagnosis, meaning there’s no single lab test for it. Doctors typically confirm it when a child has at least four of these features along with fever lasting four or more days. Early treatment is important to reduce the risk of lasting coronary artery damage.
Myocarditis
Myocarditis is inflammation of the heart muscle itself, and in children it’s most often caused by a viral infection. The usual culprits include enteroviruses, adenoviruses, parvovirus B19, and Epstein-Barr virus. Symptoms can look deceptively like the flu at first: fatigue, chest pain, and shortness of breath. The reassuring part is that with early detection and appropriate care, more than 90% of children fully recover with minimal long-term effects. The overall survival rate sits at about 93%, though outcomes vary depending on the child’s age and overall health.
Rheumatic Heart Disease
Rheumatic heart disease is a preventable condition that starts with something as ordinary as strep throat. When a strep infection goes untreated, the body’s immune system can overreact about three weeks later, attacking not just the bacteria but the body’s own tissues, including the heart, joints, skin, and brain. This is called acute rheumatic fever. If a child has repeated episodes of rheumatic fever, the heart valves can become progressively scarred and stiff, eventually leading to rheumatic heart disease. This is far less common in countries where strep throat is routinely treated with antibiotics, but it remains a major problem in parts of the developing world. The takeaway for parents: strep throat in children should always be properly treated.
Heart Rhythm Problems in Children
Children can also develop arrhythmias, which are problems with the electrical signals that control the heartbeat. The most common type in kids is supraventricular tachycardia (SVT), where the heart suddenly beats much faster than normal. In infants, heart rates during an SVT episode can reach 200 to 300 beats per minute. About half of newborns and infants with SVT develop signs of heart failure from the strain of such high rates. Older children with SVT typically notice palpitations, chest pain, or sudden paleness and sweating.
Long QT syndrome is a less common but more dangerous inherited condition that affects the heart’s electrical system. It can cause fainting spells, seizure-like episodes (which are sometimes misdiagnosed as epilepsy), and in the worst cases, sudden cardiac arrest. Because it’s genetic, a family history of unexplained fainting, seizures, or sudden death before age 50 is an important clue.
Obesity, High Blood Pressure, and Cholesterol
The type of heart disease most people associate with adults, the kind driven by high blood pressure and clogged arteries, is increasingly showing up in younger populations. In children with obesity, the rate of high blood pressure is approximately 19%, compared with just 2.4% in children at a healthy weight. Overall, childhood hypertension has roughly doubled over the past two decades.
These aren’t problems that cause a heart attack in a ten-year-old. But they set the stage. A child who develops high blood pressure or abnormal cholesterol levels is on a trajectory toward earlier cardiovascular disease in adulthood. Current guidelines from the American Academy of Pediatrics recommend universal cholesterol screening for all children between ages 9 and 11, and again between 17 and 21. Children over age two who have a family history of lipid disorders or premature heart disease may be screened earlier with a fasting blood test.
Heart Risks in Young Athletes
Sudden cardiac arrest in young athletes is rare but devastating, and it almost always traces back to an undiagnosed heart condition. The single most common cause is hypertrophic cardiomyopathy, a condition where the heart muscle is abnormally thick, which accounts for about 36% of sudden cardiac deaths in young athletes. Other leading causes include abnormal coronary artery anatomy, arrhythmogenic right ventricular cardiomyopathy, and long QT syndrome.
The American Heart Association recommends a 14-point cardiovascular screening checklist before sports participation. It includes questions about family history of premature death or heart disease before age 50, personal history of fainting during exercise, unexplained chest pain, and a physical exam checking for heart murmurs and other signs. This screening won’t catch every case, but it identifies many children who need further evaluation before competing.
A family history of hypertrophic cardiomyopathy, long QT syndrome, Marfan syndrome, or any sudden unexplained death in a young relative is particularly important to share with your child’s doctor, especially before they start organized sports.