Learn About Your Heart...
Made Simple

By Nicolas Shammas, MD

A new, comprehensive sourcebook for
heart and vascular disease patients

Cardiovascular Health Topics

Statistics about Heart and Blood Vessel Diseases in the United States
Structure and Function of the Heart and Blood Vessels
Diseases of the Blood Vessels of the Heart
Surgical Therapies for the Cardiovascular Patient
Peripheral Vascular Disease
Diseases of the Blood Vessels of the Head and Neck
Strokes: How to Survive Them and How to Prevent Them
Valvular Heart Disease
Heart Rhythms: How to Recognize Them and Treat Them
Congestive Heart Failure
11. Understanding Cardiomyopathy, or Weak Heart Muscle
12. Children and Heart Disease
13. Diseases of the Pericardium
14. Systemic Illnesses, Infections and Drugs that Affect the Heart
15. Erectile Dysfunction: a Vascular Disease
16. Cardiovascular Disease Prevention
17. Heart Healthy Nutritional Tips
18. Cardiac Rehabilitation
19. Medications for Cardiovascular Disorders
20. Heart Tests You Need to Know
21. Learn What to Do in a Medical Emergency
22. How to Choose Your Doctor and Hospital
23. Medical Research and How You Can Get Involved
24. Taking the Next Step — A Few Community Resources to Help You Live More Healthfully
25. How Much Did You Learn from This Book: Take a Simple Test

Your children's cholesterol levels can be related to their father's level. If a parent has high cholesterol, chances are that his chil dren will have elevated values as well. Children with elevated blood cholesterol levels tend to have higher levels as they enter adulthood. Elevated cholesterol levels are a risk factor for heart disease. Heart disease is the number 1 killer of both men and women in the United States. This is why your doctor needs to measure your children's cholesterol levels.

Many factors influence your blood cholesterol, including your family's genes or family history. However, there are risk factors that you can control, such as activity level and eating patterns, both of which affect the blood cholesterol level. The amount of saturated fat and cholesterol in your diet and the cholesterol produced by your liver are echoed in the total cholesterol level. Being overweight can be associated with an increase in the total cholesterol level. Thus, regular aerobic activity 5 times a week not only will help control weight but also will reduce the fatty deposits of plaque in artery walls of children and adults, which leads to coronary artery disease. Striking evidence exists that fatty buildups in coronary arteries (atherosclerosis) begin in childhood, as early as the first decade of life, when there is evidence of elevated cholesterol values.

As parents, we need to live a healthy lifestyle and encourage our children to do the same. It is easier to learn healthy behavior as a child than as an adult. This should be a family affair—one that will address many of the risk factors for heart disease and stroke.

The American Heart Association has made the following recommendations for selective screening of young children:

  1. Screen children whose parents or grandparents at 55 years of age or less were diagnosed with cardiovascular disease, such as stroke, or were found to have coronary atherosclerosis

  2. Screen the offspring of a parent who has elevated cholesterol

  3. Screen children whose family history is unknown or who have other risk factors that can affect the cholesterol level, such as obesity, a sedentary life style, and smoking.

Follow-up and treatment depend on the child's age, cholesterol values, and family history of early cardiovascular disease. A total cholesterol level of 200 mg/dL or greater and LDL cholesterol of 130 mg/dL or greater are considered high in children. If diet and exercise interventions are not successful in a child over 10 years of age with a worrisome family history, the cardiologist will discuss the indications of initiating drug therapy with the child's parents.

My baby turns blue when he cries. Sometimes his hands and feet appear cool and purple. Does this mean he has a heart problem?

Blueness around the hands and feet is a very common finding in babies and is completely normal. The medical term used to describe this blueness is acrocyanosis. When translated from its Greek roots, this word means extremities (acro) + cyanosis (blue). This is an effect of the immature vascular tone of the infant, which improves or resolves with age. The blood vessels in the hands and feet are constricting. As a result, the blood flow to these areas slows, allowing more oxygen to be removed from the hemoglobin (the oxygen-carrying protein in the blood) by the surrounding tissues. It is a harmless condition seen in newborns or infants when they are crying or even holding their breath. It is normal for your baby's hands and feet to be cool, especially when he is undressed, such as while bathing.

Cyanosis or true "blueness" indicates that a significant amount of the hemoglobin is not carrying enough oxygen. Cyanosis is divided into 2 types: peripheral, involving the extremities, such as the arms and legs, as described above, and central, typically involving the area around the mouth. Central cyanosis often reflects decreased oxygen carrying in the body due to lung or heart disease. Persistent cyanosis or blueness often indicates obstruction of blood flow to the lungs or an abnormal connection of the heart arteries. If your child appears blue throughout the day and limited in his ability to feed, discuss it with your doctor. This form of blueness may not be normal and should be evaluated by pulse oximetry,a noninvasive and painless test that immediately measures the oxygen level in the blood and is readily available in your doctor's office. If the test is normal, the diagnosis of the benign condition of peripheral cyanosis can be made.

My 10-year-old son is very self-conscious that he is overweight. At a recent physical exam, our physician told us that his blood pressure was also elevated. How concerned should we be about this?

Obesity in children is a major US health concern and presently is referred to as a national epidemic. Currently 1 in 5 children and adolescents in the United States are classified as overweight or at risk for being overweight—contrast this to 1 in 20 children in 1965!

Obesity is defined as a BMI, or body mass index, greater than the 95th percentile. The American Academy of Pediatrics recommends that physicians determine each child's BMI annually. By tracking a child's BMI, not only can physicians diagnose childhood obesity, they also can note significant changes in a child's BMI and perhaps prevent a diagnosis of obesity.

In response to the alarming trend of childhood obesity, the American Medical Association (AMA) issued a statement in June 2005 and presented several new directives to help fight childhood obesity and to promote healthier lifestyles in schools across the country. The AMA published the following statement: "To help curb these statistics, the AMA will develop a school health advocacy agenda that includes funding for school-based health programs, physical education and exercise (with stricter limits on declining participation), alternative polices for vending machines to promote healthy diets, and standards for healthier school lunches. The directives also encourage physicians to collaborate with communities to help develop health programs in schools."

Childhood obesity is directly related to many health conditions. These include hypertension (high blood pressure), hyperlipidemia (elevated cholesterol values), type 2 diabetes, and degenerative joint disease. High blood pressure is seen in 20–30% of overweight children. Sixty percent of overweight children age 5–10 years have at least 1 risk factor of future cardiovascular disease, such as increased blood pressure, elevated cholesterol, and diabetes. Obstructive sleep apnea and other potentially life-threatening breathing difficulties can occur in obese children. Obesity also increases your child's risk for orthopedic problems, such as hip disorders.

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