Broadly speaking, there are two kinds of heart disease. Those a child is born with and those that a child acquires as they go through life. 

Congenital heart disease (CHD), which occurs in almost 1 in every 100 newborn babies, takes many forms. The commonly used term, “hole in the heart”, under-estimates the severity of the more complex abnormalities.  Almost 60% of babies with CHD will require heart surgery during their young life and a third will need life saving surgery in the first three months.  

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Acquired heart disease in adults in wealthier nations is commonly what is called “coronary heart disease”.  The sort of lifestyle diseases associated with poor diet, overweight and obesity, lack of regular exercise and tobacco smoke.  These poor habits of course start in children.  The other type of acquired diseases are infections and in sub-Saharan Africa the commonest of these is Rheumatic Heart Disease (RHD).  This is a disease of poverty which starts with sore throat caused by a common bacteria known as streptococcus (or strep throat). If not treated with penicillin, this can cause rheumatic fever which damages the heart valves resulting in rheumatic heart disease.  

 

Children are most commonly affected between the age of 5 and 15 years.  The heart valves seldom recover from this attack, they leak with varying degrees of severity and usually require surgery with repair of replacement of the valve later in life.