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Vaccines are medicines that are administered by mouth or by an injection into the muscles or skin with the aim of stimulating the production of defenses (antibodies) that avoid suffering an infectious disease. The protection that is obtained with vaccines must be free of important side effects and its protective effect must be maintained for long periods of time. To get the body to produce a protective immune response, the vaccine must contain parts of the viruses or bacteria that we want to protect ourselves from.

Compulsory vaccinations for everyone, including cardiac patients:

o Antihepatitis B.
o Anti diphtheria, tetanus and whooping cough.
or
o Joint vaccine against Haemophilus influenzae type b.
o Anti measles, rubella and mumps.

Recommended vaccinations in all children, including heart patients:

o Antirotavirus between 2 to 6 months. Rotavirus is the main cause of gastroenteritis in the pediatric age. This virus causes general discomfort with tiredness, vomiting and diarrhea. Special care should be taken in children with heart disease who take diuretics, since they are at higher risk of dehydration.
o Chickenpox infection can be serious in children with heart disease, so vaccination is recommended.

Recommended vaccines in children with heart disease:

o Flu (Influenza). Vaccination against the common seasonal influenza virus is indicated annually in cardiac children older than 6 months of age and also in healthy siblings older than 6 months and adults (parents, relatives, caregivers) who live with cardiac patients, given the risk for them if they get the flu infection.
o Syncytial antivirus (RSV) administering palivizumab (protective antibodies) to children under 24 months (2 years) from October to March (winter) in complex, uncorrected heart disease and / or significant hemodynamic dysfunction and / or associated risk factors (see below). It is economically very expensive and is administered in public hospitals. The respiratory syncytial virus (RSV) is one of the main causes of respiratory tract infection (bronchiolitis), very common in children younger than 2 years of age and that in children with congenital heart defects can trigger a more serious picture than usual, with the need for admission to the Hospital and even to Intensive Care Units, due to cardiac decompensation.

Situations in which syncytial virus prophylaxis is indicated:

o Congenital heart disease, anatomically or hemodynamically significant. Thus, those with heart failure, low weight due to heart failure, significant cyanosis and / or the need for intense cardiological treatment.
o Pulmonary hypertension: Moderate or severe pulmonary hypertension.
Cardiomyopathies requiring medical treatment
o Children with severe, recurrent arrhythmias, who have or have had hemodynamic repercussions and who require chronic medication
oChildren with heart transplant or listed on the same.
oWith risk factors. such as Down Syndrome, 22q11 Deletion or Immunodeficiency.

General advice in the administration of vaccines:

o Vaccines should not be administered about 20-30 days before and after operations, since if they provoke a feverish reaction they can cause diagnostic and therapeutic confusion.
o Its administration should also be delayed if the child has an acute febrile illness, especially if it is a respiratory infection, until he is free of symptoms. Minor infections without fever are no reason to delay vaccinations.
o Live attenuated virus vaccines (measles / rubella / mumps) should not be administered for at least three months after receiving blood transfusions or blood products (as is customary in the postoperative period of cardiac surgeries). It is important to respect this time since vaccination after receiving blood transfusions and blood products (platelets, plasma) may be accompanied by a decrease in the production of antibodies, with the consequent loss of vaccine efficacy.
o If the administration of vaccines is delayed, or in the event of prolonged hospitalization times, as can occur in children with congenital heart defects, in whom vaccines are not administered for long periods of time, the pediatrician has an Accelerated Vaccine Schedule so that the child gradually receives the missing vaccines.
oIn special cases and whenever the child’s cardiologist or pediatrician deems it appropriate, it may be advisable to prevent syncytial virus infection, not take children to daycare, avoid crowds (crowded shopping centers and closed spaces) and take extreme hygiene measures. , mainly frequent hand washing and careful cleaning of toys, pacifiers and bottles, where the virus can remain. However, this measure should be advised with caution since it significantly alters the family organization.

Post-operative heart (surgery) or post-interventionist (catheterization) patients require regular monitoring.

OPERATED PATIENTS WITH COMPLEX CONGENITAL HEART DISEASE ARE NOT HIGHLY DEFINITIVE

The patent foramen ovale in children does not require cardiovascular monitoring.

The patent ductus arteriosus closed by surgery will occasionally require some revision. There are reports of late presentation of subaortic stenosis.

Patients in whom procedures were performed to close the interatrial, interventricular, tetralogy of Fallot communication (among others) require evaluation of short residual circuits as well as long-term arrhythmias.

Patients with palliative procedures (systemic pulmonary fistulas, bidirectional or total cavopulmonary shunts) will require periodic monitoring (electrocardiogram, chest x-ray, echocardiogram, tomography) to assess whether they are candidates for any subsequent surgical or interventional (catheterization) procedure.

Patients undergoing ablation procedures (arrhythmias) and / or pacemakers require regular monitoring.

Heart disease is not a leading cause of death for children and teens, but it is the leading cause of death for adults in the United States. What’s more, every 37 seconds someone in the United States dies of some form of cardiovascular disease.

Certain factors have been found to play a role in your chances of getting heart disease. These are called risk factors. Some risk factors can be altered, treated or modified and others cannot.

Most risk factors that affect children can be controlled in childhood, which reduces cardiovascular risk later. Other risk factors are typically passed down from one generation to the next (they run in families) or are the result of another disease or disorder. These risk factors can typically be controlled. Congenital heart defects (birth heart defects) cannot be changed, but there are now better studies and treatments for children with these types of heart problems.

Children and teens can reduce their risk of heart disease by altering or controlling risk factors that can increase their chances of heart disease later.

• High blood pressure (high blood pressure)
• High cholesterol
• Smoking
• Obesity
• Physical inactivity

It is worth mentioning that some of these risk factors can be altered, treated or modified and others cannot. But it is important to understand that prevention is the best way to avoid a heart problem later on. By starting to control as many risk factors as possible in childhood, you can reduce your risk of heart disease in adulthood.

High blood pressure

It is a serious illness in childhood, especially if it is not detected. Make sure your child’s blood pressure is checked during his annual checkup.

What is high blood pressure?

The heart pumps blood through a network of arteries, veins, and capillaries. Moving blood pushes against the walls of the arteries, and that force is measured as blood pressure.

High blood pressure is caused by a narrowing of very small arteries called “arterioles.” Arterioles regulate blood flow in the body. By narrowing (or contracting) these arterioles, the heart has to work harder to pump the blood through a smaller space, and the pressure inside the blood vessels increases.

What is the cause of high blood pressure in children?

High blood pressure (hypertension) in children is not a congenital heart disease, but there may be an inherited link. For this reason, when there is a family history of hypertension, it is necessary to monitor children’s blood pressure very carefully.

Most cases of high blood pressure in children are typically due to another disease, such as kidney or heart disease. This is called secondary hypertension. Less often, children have what is called “primary (or essential) hypertension.” This means that the true cause of high blood pressure is unknown.

how is the arterial pressure measured?

The doctor will measure your child’s blood pressure using a device called a sphygmomanometer.

Blood pressure readings measure both parts of pressure: systolic pressure and diastolic pressure. Systolic pressure is the force of blood flow through an artery as the heart beats. Diastolic pressure is the force of blood flow within the blood vessels when the heart rests between beats.

A blood pressure reading measures both systolic and diastolic strength, with the systolic noted first. The figures indicate the pressure in units of millimeters of mercury (mm Hg), that is, the height at which the pressure within the arteries could raise a column of mercury.

The doctor will take your child’s age, gender, and height into account to determine age-specific systolic and diastolic blood pressures for that age, gender, and height. Doctors use this method because it allows them to take into account different levels of growth when determining blood pressure. It also allows them to obtain the most accurate blood pressure classification based on the child’s body size.

How is hypertension in children treated?

In most cases, it is possible to control hypertension in children if changes in their lifestyle are implemented.

• Help your child maintain a healthy body weight. Overweight children generally have higher blood pressure.
• Increase your level of physical activity.
• Limit your salt intake.
• Warn him of the risks of cigarette smoking. The nicotine in cigarettes narrows blood vessels, making it more difficult for blood to flow through them.

If a diet and exercise plan does not lower your child’s blood pressure, medications may be prescribed.

Advances in the knowledge, diagnosis and treatment of heart problems from birth (congenital heart defects) has led, in recent decades, to an improvement in the physical condition of people with congenital heart defects, allowing them to perform more amount and intensity of physical activity than in the past, including participation in sports activities.

Ordinary physical activity: is that produced by any movement of muscle groups during normal life (for example, climbing stairs at school).

Physical exercise: all physical activity with repetitive nature regulated to improve or maintain good physical shape. It is always advisable, but it must be individualized in some patients.

Sport: it is a competitive physical exercise. It is an added burden to the body due to its possible stressful nature and the risk of ignoring dangerous symptoms such as dyspnea or pain.

Parents of children, adolescents, and adults with congenital heart defects need to know what kinds of recreational activities or sports they can do within reliable safety margins, based on the heart disease they have or had (in the case of that were already operated)?

Although it is a difficult question to answer due to the difficulties in quantifying the effort of the heart during exercise, which depends on the one hand on the type of sport or recreational activity, and on the other hand on the congenital heart disease in question.

For this, it is necessary to focus on the three successive aspects, in order to finally be able to provide an adequate recommendation:

1. Complete assessment of the cardiovascular situation.
2. Classification of sports and recreational activities in levels of difficulty.