Monroe Carell Jr. Children's Hospital at Vanderbilt
Monroe Carell Jr. Children's Hospital at Vanderbilt
Monroe Carell Jr. Children's Hospital at Vanderbilt
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Monroe Carell Jr.
Children's Hospital
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Nashville, TN 37232

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Acquired Heart Disease


Hypertrophic Cardiomyopathy

Hypertrophic Cardiomyopathy (HCM) is a disorder of the heart muscle in which the muscle cells grow too large. The heart becomes enlarged and blood flow both into and out of the heart chambers is impaired.

Ultrasound testing (echocardiography) can be useful in identifying who has HCM. However, HCM may occur at any age, so a negative test in a young person does not exclude the possibility of developing the problem in later life. For that reason, your cardiologist may advise periodic testing if you are believed to be at risk of developing HCM.


Myocarditis is an inflammatory condition of the muscle of the heart that is frequently viral in nature, but many times the exact cause of the inflammation is unknown. It can cause severe dysfunction of the heart with heart failure, requiring intensive care treatment and sometimes transplantation. With proper treatment, many cases can be associated with complete resolution. Others may result in a persistent myocardial problem that requires long-term medical therapy. Vanderbilt Pediatric Cardiology has experience in evaluation, treatment, and long-term follow-up of patients with this condition.


A sack called the pericardium normally surrounds the heart. There is usually a small amount of fluid between the heart and the pericardium. This fluid protects and lubricates the heart.

Pericarditis occurs when there is more fluid than normal in this space. The extra fluid is usually caused by a viral infection or a form of arthritis.

Chest pain, shortness of breath, and fever are common symptoms of pericarditis. Treatment may include a medication to reduce the inflammation (swelling). In severe cases, it may be necessary to drain the fluid.

Kawasaki Disease

Kawasaki disease is an illness characterized by days of high fever, swelling of the lymph nodes (glands), rashes (mostly hands, feet, diaper area, lips and mouth), and redness of the eyes, along with irritability. Kawasaki’s usually affects children between the ages of six months and four years. The cause is not known.

Kawasaki can cause swellings or aneurysms of the large arteries of the heart (coronary arteries). Sometimes medicine can prevent the aneurysms. Many aneurysms get better with time. Most children return to their normal state of health after Kawasaki disease.


The endocardium is the thin tissue layer that lines the chambers of the heart and covers the heart valves. Infectious endocarditis results when a germ grows on the endocardium, usually of the valves, and causes inflammation and destruction of the tissue. Clumps of the organisms, usually bacteria but sometimes a fungus, can not only impair valve function but also may break off (embolize) and travel to other parts of the body such as the kidneys or brain, causing serious damage and infection.

Those at greatest risk of infectious endocarditis, also called bacterial endocarditis, are people with damaged heart valves (congenital, or the result of rheumatic fever) or prosthetic heart valves. The infection may enter the bloodstream during procedures such as routine dental work or diagnostic procedures such as removal of a colon polyp.

The key to endocarditis is prevention. People with problems that put them at risk should usually take an antibiotic before a procedure and sometimes for a brief period following the procedure. Treatment of the condition involves taking one or more antibiotic medications for an extended period of time in hopes of destroying all of the germs and preventing further damage to heart valves. Sometimes, it may be necessary to replace the infected valve.

Marfan's syndrome

Marfan's Syndrome is a disorder of the connective tissue in the body, such as in the eye, skeletal system, and blood vessels. Marfan’s is an inherited disorder. People with Marfan’s syndrome may have one or more of the following manifestations:

  • Unusual height and span of the arms exceeding the height
  • Long fingers and toes (arachnodactyly, or “spider digits”)
  • Deformity of the breastbone (sternum) and spine
  • Excessive flexibility of joints
  • Unusually high palate
  • Dislocation of the eye lens
  • Enlargement of the aorta
  • Leakage of the aortic valve

Diagnoses of Marfan’s are not based on any single feature, nor are there any features that exclude it. Knowledge of a family history is very helpful in identifying whether or not a patient has Marfan’s. Echocardiography is another useful tool for monitoring patients with Marfan’s syndrome.

Rheumatic fever

Rheumatic fever is an uncommon inflammatory disease that can occur after streptococcal infections of the respiratory tract. It can cause valvular problems of the mitral and aortic valve on the left side of the heart and, on rare occasions, congestive heart failure. Although extremely rare in this country, it is common in developing countries. The Vanderbilt group has experience in treating this uncommon condition.

Last Edited: June 30, 2016
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