Many heart conditions can look like more common childhood illnesses such as bronchitis and infections, say Dr Kevin Maher and colleagues.
They studied B-type natriuretic peptide (BNP) as a possible marker for heart disease in children, measuring BNP in 33 children newly diagnosed with acquired or congenital heart disease and in 70 children with infections or breathing illnesses.
The children with heart disease were aged from 2 days to 17.5 years and had symptoms such as tiredness, poor feeding, shortness of breath, swollen legs, weakness and poor vision. Unfortunately, they had first been diagnosed with a viral illness, nephrotic syndrome, bowel disease, an infection or lung disease, and two of them died before their heart disease was diagnosed.
The children without heart disease were aged 3 days to 72 months and had fever, cough, shortness of breath, congestion, tiredness, vomiting or diarrhoea, wheezing, abdominal pain or flu symptoms; none was found to have heart disease.
Average BNP was 3,290 pg/ml in the heart disease group against 17.4 pg/ml in the others, giving the test a sensitivity of 100% and a specificity of 98%.
The team warned that BNP can be raised in newborns without heart disease, and that children with mild or early heart disease may have lower levels, so a normal BNP doesn't rule out heart disease. Still, BNP is a useful aid in the emergency diagnosis of heart disease in children. The study was published in Pediatrics in 2008.
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