Common infections bad for children’s heart

Researchers have grappled with whether exposure to common infections contributes to heart disease. In this report by Sade Oguntola, experts say reducing childhood infection, either through immunisation or by treating and preventing infection, may be protective against heart attack later in life.

Every child gets sick from time to time. Most children who have repeated infections don’t have any serious problems and grow up to be healthy adults. Now, researchers say efforts at protecting children from infections also reduces their likelihood of having a heart attack in adulthood.

In a new study, researchers suggest that infections in childhood such as typhoid fever, measles and chicken pox may increase their chances of experiencing a heart attack in later life.

According to the findings presented at the Acute Cardiovascular Care conference at Vienna in 2015, these infections may lead to premature acute coronary syndromes (ACS), a term that was used to describe various heart conditions including a heart attack.

What heart attack means

A heart attack occurs when the blood supply to the heart is cut off. During this time, cells in the heart muscle that do not get enough oxygen through the blood begin to die. The more time that passes without a restored blood flow, the greater the damage to the heart.

Symptoms of heart attack include chest pain; discomfort in arms, back or neck; shortness of breath and nausea.

Common problem that triggers a heart attack

There are strong evidences that infections in childhood can increase the risk of heart disease. “There are infections in childhood, particularly viruses, that can cause heart diseases. Virus can cause damage to the heart, including other organs of the body. Such damage, in some instances, might manifest later in future,” said Dr Oluwatoyin Ogunkunle, a consultant Paediatric Cardiologist at the University College Hospital (UCH), Ibadan, Oyo State.

In children, rheumatic heart disease, Dr Ogunkunle said could also occur as a result of a bacterium that causes throat infection.

According to her, “The body tries to resist or combat this throat infection by producing antibodies. It is these antibodies that cause the damage to the heart and other parts of the body such as the joints and even parts of the brain.

“Now, those that develop rheumatic fever with involvement of the heart, may now progress to have rheumatic heart disease because there is a permanent damage to the heart muscles and its valve. This is a problem that would have been stemmed if people treat throat infections properly and promptly.”

Dr Ogunkunle listed other infections that could damage the heart to include Kawasaki disease and diphtheria infection that can be prevented through child vaccination.

Mother’s role in preventing heart disease

According to her, “all infections whether in the mother or the child should be treated promptly and appropriately so that even if such could cause a damage to the heart, this would be averted,”

Moreover, she added that infections such as Rubella or German measles and cytomegalovirus in the first three months of pregnancy can also cause an unborn baby to develop a heart problem.

Dr Ogunkunle, however, declared that sometimes the signs of a heart problem may not manifest immediately, but that most heart diseases can be treated if they were detected early.

A damaged or weak heart, say from an infection in childhood, Dr Okechukwu Ogah, a consultant cardiologist, UCH, Ibadan, said may only start to show its signs as the child grows in age and the heart increasing need to do more work in order to feed the body.

He declared that infections such as measles, typhoid fever and chicken pox in rare cases can cause damage to the heart muscles, adding “such a damaged heart will manifest immediately.”

According to Dr Ogah, “if you have a severe typhoid fever that affects the heart, the organ can fail. This is not necessarily saying that having typhoid fever at age five can be linked to a heart attack say at age 70, it is not likely.

“If you are thinking of a childhood heart problem that will manifest in adulthood, the best is rheumatic heart disease. Usually, the symptoms of rheumatic heart disease show up 10 to 20 years after the original illness.”

What triggers heart attacks is changing with time

Infectious diseases, including typhoid fever, measles, chicken pox, bronchitis, tuberculosis and dengue fever are common in children living in low and medium income countries, including Indonesia, where the study was conducted.

It was a population-based case-control study involving 153 patients with ACS before the age of 56 years and 153 age- and sex-matched controls with no history of ACS.

Results showed that study subjects who experienced infection in childhood and adolescence had a three-fold higher likelihood of experiencing ACS in later life. Of course, they had taken into consideration common risk factors for heart problems.

Basically, certain traits, conditions, or habits raise the risk for heart attack. These include dietary pattern, physical inactivity, smoking status, family history of heart disease, diabetes, sudden cardiac death, and known history of hypertension and diabetes.

They hypothesised that infections experienced in childhood and adolescence might adversely affect the circulation of blood in the blood vessels of the heart muscle as well the blood vessels themselves, which is the pivotal event in most heart attacks and strokes.

Atherosclerosis, the hardening and narrowing of the blood vessels that carry oxygen rich blood to the heart, is a disease that is silent, but often deadly, since it can cause an individual to suddenly have a heart attack or stroke.

The study concluded “Our findings may apply to other countries in South-East Asia where infectious disease is still prevalent. Here governments and policymakers should have a combined strategy for tackling infectious diseases and cardiovascular disease. Early-life infection may be a relatively unknown contributing factor in ACS occurrence.”

Doctors now pay serious attention to the possibility that germs in one part of the body can cause an array of problems if they get to other parts of the body.  In fact, there is a growing body of evidence in people linking gum disease to cardiovascular disease such as stroke and heart disease.