Our American heart condition

Within a medical home, primary care providers can identify needs, provide services, and coordinate care for children with heart conditions. Using parent-reported data from the 2016-2017 National Survey of Children's Health, we examined receipt of preventive care in the last 12 months and having a medical home (care that is accessible, continuous, comprehensive, family-centred, coordinated, compassionate, and culturally effective) among US children aged 0-17 years with and without heart conditions. Using the marginal predictions approach to multivariable logistic regression, we examined associations between presence of a heart condition and receipt of preventive care and having a medical home. Among children with heart conditions, we evaluated associations between sociodemographic and health characteristics and receipt of preventive care and having a medical home. Of the 66,971 children included, 2.2% had heart conditions. Receipt of preventive care was reported for more children with heart conditions (91.0%) than without (82.7%) (adjusted prevalence ratio = 1.09, 95% confidence interval: 1.05-1.13). Less than half of children with heart conditions (48.2%) and without (49.5%) had a medical home (adjusted prevalence ratio = 1.02, 95% confidence interval: 0.91-1.14). For children with heart conditions, preventive care was slightly more common among younger children and less common among those with family incomes 200-399% of the federal poverty level. Having a medical home was less common among younger children, non-Hispanic "other" race, and those with ≥2 other health conditions. Most children with heart conditions received preventive care, but less than half had a medical home, with disparities by age, socioeconomic status, race, and concurrent health conditions. These findings highlight opportunities to improve care for children with heart conditions.

Children with heart conditions often use more health care services and specialized care than children without a heart condition (1); however, little is known about the number of U.S. children with heart conditions and their special health care needs. CDC used data from the 2016 National Survey of Children's Health (NSCH) to estimate the prevalence of heart conditions among U.S. children aged 0-17 years, which indicated that 1.3% had a current heart condition and 1.1% had a past heart condition (representing approximately 900,000 and 755,000 children, respectively). Sixty percent and 40% of children with current and past heart conditions, respectively, had one or more special health care needs, compared with 18.7% of children without a heart condition (adjusted prevalence ratios [aPRs]=3.1 and 2.1, respectively). Functional limitations were 6.3 times more common in children with current heart conditions (30.7%) than in those without heart conditions (4.6%). Among children with current heart conditions, males, children with lower family income, and children living in other than a two-parent household had an increased prevalence of special health care needs. These findings highlight the importance of developmental surveillance and screening for children with heart conditions and might inform public health resource planning.

Children with chronic illnesses report being bullied by peers, yet little is known about bullying among children with heart conditions. Using 2018-2020 National Survey of Children's Health data, the prevalence and frequency of being bullied in the past year (never; annually or monthly; weekly or daily) were compared between children aged 6-17 years with and without heart conditions. Among children with heart conditions, associations between demographic and health characteristics and being bullied, and prevalence of diagnosed anxiety or depression by bullying status were examined. Differences were assessed with chi-square tests and multivariable logistic regression using predicted marginals to produce adjusted prevalence ratios and 95% confidence intervals. Weights yielded national estimates. Of 69,428 children, 2.2% had heart conditions. Children with heart conditions, compared to those without, were more likely to be bullied (56.3% and 43.3% respectively; adjusted prevalence ratio [95% confidence interval] = 1.3 [1.2, 1.4]) and bullied more frequently (weekly or daily = 11.2% and 5.3%; p < 0.001). Among children with heart conditions, characteristics associated with greater odds of weekly or daily bullying included ages 9-11 years compared to 15-17 years (3.4 [2.0, 5.7]), other genetic or inherited condition (1.7 [1.0, 3.0]), ever overweight (1.7 [1.0, 2.8]), and a functional limitation (4.8 [2.7, 8.5]). Children with heart conditions who were bullied, compared to never, more commonly had anxiety (40.1%, 25.9%, and 12.8%, respectively) and depression (18.0%, 9.3%, and 4.7%; p < 0.01 for both). Findings highlight the social and psychological needs of children with heart conditions.

Introduction. Cardiovascular complications are the common in patients with Henoch-Schönlein purpura (HSP; IgA-vasculitis). Heart condition is strictly connected with gall bladder (GB) changes. However the heart condition in patients with HSP in dependence of gallbladder status was not studied before. Purpose. To reveal peculiarities of heart structure and function in patients with HSP in dependence of gall bladder condition. Material and methods. We analyzed data from 75 patients with active HSP, which underwent the treatment according to guidelines of Helsinki Declaration. Investigated patients included 57% females and 43% males, middle age – 47.7±4.3 years; middle body mass index (BMI) 27,9 kg/m2. Patients were divided into 6 groups: group 0 – normal intact GB (38.7%); group 1 – sludge, polyposis and cholesterosis of GB (14.7%); group 2 – bent GB body (10.1%); group 3 – GB neck deformations and signs of chronic cholecystitis (18.7%); group 4 – cholelithiasis (10.1%); group 5 – patients with removed GB (7.7%). Digital data was processed with the statistical methods, the quantitative variables are expressed as mean ± standard deviation. Values of р&lt;0.05 were considered statistically significant. Results. Patients with HSP significantly more often had some GB disorders than its intact status (61.3% vs 38.7%, р&lt;0.05). Group 1 with sludge, cholesterosis and polyposis of GB was characterized by the normal values of EchoCG parameters. Patients with bent GB body (group 2) had bigger arrhythmia frequency and heart rate close to the maximal value but the best EchoCG. Group 3 had the most often left axis deviation and quite rare arrhythmias. Group 4 of patients with HSP and cholelithiasis was characterized by the maximal frequency of arterial hypertension, the highest frequency of arrhythmias, the most often presence of both bundle branch block and the worst EchoCG parameters. Group 5 of patients with HSP and removed GB was characterized by the maximal frequency of presence of left ventricle hypertrophy, the highest heart rate and left axis deviation. Heart structure in these patients can be estimated as better than in patients with cholelithiasis. Conclusions. The heart and GB conditions in patients with HSP are tightly connected. The worsening of GB condition was accompanied by worsening of structural and functional heart parameters. Cholecystectomy can improve heart condition. Patients with HSP and GB disorders need more thorough examination and early correction of biliary diseases.

Background:Children with heart conditions, particularly CHDs, may experience adverse neurodevelopmental and psychosocial outcomes. Our study aimed to: (1) compare national prevalence of mental, behavioural, and developmental disorders among children by heart condition status and (2) identify associated characteristics among children with heart conditions.Methods:Nationally representative data from the National Survey of Children’s Health (2016–2021) on U.S. children aged 6–17 years without Down syndrome were analysed. Caregivers reported whether a healthcare provider told them their child has ever had a heart condition or currently has depression, anxiety, ADHD, behavioural, or conduct problems, Tourette syndrome, autism spectrum disorder, developmental delay, intellectual disability, learning disability, or a speech or other language disorder. Logistic regression analysis compared disorder prevalence by heart condition status and, among children with heart conditions, assessed whether disorders were associated with demographic and contextual characteristics.Results:Among 3,440 children with heart conditions, 42% had an examined disorder, compared to 23% of 133,280 children without heart conditions (adjusted prevalence ratio = 1.8; 95% confidence interval: 1.7, 2.0). Each disorder was more prevalent among children with versus without heart conditions (adjusted prevalence ratio range: 1.9 to 5.1), with anxiety (22.1%), ADHD (20.4%), and learning disabilities (19.6%) most common. Among children with heart conditions, disorders were consistently associated with an increased number of adverse childhood experiences.Conclusion:These findings support clinical guidelines recommending neurodevelopmental and mental health screening and interventions for children with heart conditions and can be used as a national baseline to gauge progress of guideline implementation.

Functional scans in cardiovascular magnetic resonance (CMR) adopting bSSFP sequences suffer from dark band artifacts due to B0 inhomogeneity. The best remedy to mitigate this issue is through cardiac B0 shimming. The development of an optimal B0 shim strategy for the human heart is hindered by a limited understanding of B0 conditions in clinical diagnostic orientations of CMR. Here, we present high-resolution B0 distributions in cardiac imaging planes, derived from simulations utilizing high-resolution computed tomography (CT) images from 1008 subjects, and present an oblique slicing method to derive such B0 distributions. This study also presents a theoretical analysis of spherical harmonic B0 shimming at 3 T using a static global approach and slice-specific dynamic shim updating in the short-axis view of human hearts. The characteristics of cardiac B0 conditions along with spherical harmonic shimming were correlated with the subjects' demographic parameters, with weak or no correlations, suggesting limited demographic commonality and predominantly subject-specific characteristics in cardiac B0. The segmented lung volume shows more significant associations and relatively higher correlations with B0 conditions, indicating that B0 conditions in the heart rely on the anatomy surrounding the heart more than overall body shape and size. This research provides a basis for the development of optimized cardiac B0 shim strategies.

Among children with and without heart conditions of different race/ethnicities, upstream social determinants of health, such as socio-economic status, access to care, and healthcare utilisation, may vary. Using caregiver-reported data from the 2016-19 National Survey of Children's Health, we calculated the prevalence of caregiver employment and education, child's health insurance, usual place of medical care in the past 12 months, problems paying for child's care, ≥2 emergency room visits, and unmet healthcare needs by heart condition status and race/ethnicity (Hispanic, non-Hispanic Black, and non-Hispanic White). For each outcome, we used multivariable logistic regression to generate adjusted prevalence ratios controlling for child's age and sex. Of 2632 children with heart conditions and 104,841 without, 65.4% and 58.0% were non-Hispanic White and 52.0% and 51.1% were male, respectively. Children with heart conditions, compared to those without, were 1.7-2.6 times more likely to have problems paying for healthcare, have ≥2 emergency room visits, and have unmet healthcare needs. Hispanic and non-Hispanic Black children with heart conditions, compared to non-Hispanic White, were 1.5-3.2 times as likely to have caregivers employed <50 weeks in the past year and caregivers with ≤ high school education, public or no health insurance, no usual place of care, and ≥2 emergency room visits. Children with heart conditions, compared to those without, may have greater healthcare needs that more commonly go unmet. Among children with heart conditions, Hispanic and non-Hispanic Black children may experience lower socio-economic status and greater barriers to healthcare than non-Hispanic White children.

Approximately 900,000 U.S. children have heart conditions, such as congenital heart disease (1). These children might be at increased risk for life-threatening infective endocarditis from oral bacteria in the bloodstream (2). Therefore, preventive dental care (i.e., check-ups, dental cleaning, radiographs, fluoride treatment, or sealant) to maintain oral health is important. Oral health status and receipt of preventive dental care were compared between children with heart conditions (2,928) and without (116,826) using population-based 2016-2019 National Survey of Children's Health (NSCH) data. Approximately 83% of children with and 80% without heart conditions received preventive dental care in the past year (p = 0.06). Children with heart conditions were more likely than were those without to have poor oral health (17.2% versus 13.7%; p=0.02) and teeth in fair or poor condition (9.9% versus 5.3%; p<0.01). Among those with a heart condition, having low household income; an intellectual or developmental disability; and no well-child visit or medical home were associated with poor oral health. Receipt of preventive dental care was higher among children aged ≥6 years and those with insurance. Public health practitioners and health care providers can implement strategies (e.g., parent and patient education and collaboration between pediatricians, dentists, and cardiologists) to improve oral health and care among children with heart conditions, especially those with fewer resources and intellectual or developmental disabilities.

Adverse Childhood Experiences (ACEs) have been associated with a higher risk of developing cardiovascular diseases and premature mortality in adults. OBJECTIVES: We evaluated the associations between ACEs and heart diseases among children in the United States. METHODS: Data on children ages 0 to 17 years reported by parents/guardians to have current heart conditions were analyzed. Using Stata version 17 software, descriptive statistics were generated for the demographic characteristics and the various health outcomes using the chi-square of independence. Multivariate logistic regression models were employed to determine the associations between ACEs and heart conditions, the severity of heart conditions, and overall health status. RESULTS: There were 826 children with current heart conditions from a total of 68,753 surveyed children. This corresponded to an estimated 780,000 (1.13%) children living with heart conditions in the U.S. On multivariate logistic models, several ACEs, including household economic hardship, parental/guardian’s alcohol/drug abuse, severe mental health illness of parents/guardians, racial/ethnic discrimination, exposure to neighborhood violence, and accumulation of two or more ACEs, were significantly associated with heart diseases among children. Though the accumulation of two or more ACEs did not have a significant association with the severity of heart condition, it was significantly associated with caregiver reports of undesirable overall health status. CONCLUSIONS: ACEs are significantly associated with heart conditions among children and contribute to unfavorable overall health status among children with heart conditions in the U.S. There is a need for policies and programs that will promptly identify ACEs and mitigate their negative impact on children.

Background: People living with chronic heart conditions often experience poor quality of life (QoL) and reduced well-being; however, the intervention preferences to promote well-being among these individuals are not well known. Purpose: The purpose of this study was to describe QoL and preferences for wellbeing interventions in people with chronic heart conditions and to describe differences by heart condition diagnosis. Method: We conducted a cross-sectional study and recruited participants from a national online support group for people with heart conditions from April 29 to June 3, 2025. We measured QoL (WHO-QOL 28-item) and priorities for interventions via an investigator-developed questionnaire. Descriptive and bivariate analyses were conducted by heart condition. Results: In our preliminary findings among 107 participants [mean age=65.7 years (SD=12.5)], female (53%), White (82%), 67% ≥ 2 heart conditions] most reported being diagnosed with arrhythmias (36%), congenital heart disease (35%), and heart failure (34%), and the fewest reported cardiomyopathy (22%). Participants reported their physical health QoL as the lowest (M = 56.8±12.6), followed by psychological health (M = 62.5±13.1), and social relationships (M = 65.7±19.0). Most participants preferred non-pharmacological wellness interventions (79%) over pharmacological (23%). The highest interest in interventions was for nutrition/weight (80%), exercise (78%), relaxation (78%), mind-body (yoga or tai-chi) (72%), and meditation/mindfulness (69%). Most preferred delivery in-person (64%) or self-guided app/Website (60%). WHO-QOL ratings of Very Satisfied/Satisfied for Health Satisfaction were compared by heart condition (with and without) and were lower for two conditions: cardiomyopathy, (35% vs 63% p=0.015) and arrhythmias (44% vs 65%, p = 0.033). Participants with arrhythmias prioritized social support interventions (74% vs 48%, p = 0.010), while those with cardiomyopathy preferred interventions for depression (70% vs 43%, p = 0.025) (Table 1). Conclusion: We found that people were highly interested in behavioral interventions to promote their well-being. However, preferences for wellness interventions differed by diagnosis. Findings can guide interventions tailored based on condition.

Patients with heart conditions in rural areas may have different responses to health promotion-disease Self-management interventions compared to their urban counterparts. To estimate the impact of a multi-component health promotion nurse intervention on physical function and total health care expenditures among elderly adults with heart conditions and to examine the impact of rural residence on the intervention effect. We analyzed data on 281 community-living Medicare beneficiaries with heart conditions from the Medicare Primary and Consumer-Directed Care Demonstration (a randomized controlled trial). We estimated ordinary least squares (OLS) models to determine the effect of the intervention on the change in functional status and log-linear models to determine the impact of the intervention on total health care expenditures over a 2-year period. The OLS models showed that the nurse intervention resulted in fewer impairments in Activities of Daily Living (ADL) (-0.307 on 0-6 scale, P = .055) at the end of 2 years. The effect of the intervention on ADL appeared to be stronger for rural than for urban participants (-0.490 vs -0.162, respectively). However, the difference was not statistically significant (P = .150). The effect of the intervention on Instrumental Activities of Daily Living (IADL) was not significant (P = .321). Average total health care expenditures were 6.5% ($1,981, 95% CI: -$8,048, $4,087) lower in the nurse group. The nurse intervention led to better physical functioning and has potential to reduce total health care expenditures among high-risk Medicare beneficiaries with heart conditions.

Racial disparities exist in mortality among children with heart conditions, but less is known about disparities in upstream determinants of health. Our objective was to assess differences in economic stability, access to care, and healthcare utilization by race/ethnicity among children with heart conditions. Using caregiver-reported data on 0- to 17-year-olds from the 2016-2019 National Survey of Children’s Health, we calculated prevalence estimates for family economic stability (caregiver educational attainment and work status), child’s healthcare access (insurance type, usual place of care, and problems paying for child’s care), and child’s healthcare utilization (receipt of preventive care, specialty care, and 1 and ≥2 emergency room (ER) visits in the past 12 months) by race/ethnicity (Hispanic, non-Hispanic (NH) Black, and NH White), accounting for complex sampling and weighted to produce national estimates. We used the predicted marginal approach to multivariable logistic regression to generate adjusted prevalence ratios (aPRs) controlling for child’s age and sex. Of 2,596 children with heart conditions, 65.5% were NH White and 52.2% were male. Compared to NH White children, Hispanic and NH Black children, respectively, were 0.9 to 0.8 times less likely to have caregivers who were employed or had more than a high school education. Hispanic and NH Black children were more likely to have public insurance (respective aPRs 1.8, 2.1) and less likely to have a usual place of care (aPRs 0.9, 0.8). Hispanic children were less likely than NH White children to have visited the ER once in the past 12 months, whereas NH Black children were more likely to have visited the ER once (aPR 1.4) and twice or more (aPR 2.5). Among U.S. children with heart conditions, racial/ethnic disparities were seen in indicators of economic stability, access to care, and healthcare utilization.

Background: Recent decades have seen improvements in treatment for acute coronary syndromes (ACS), reduced mortality, and shortened hospital stays. Limited evidence suggests that some patients may leave the hospital with the perception that they are cured. Objective: To describe demographic and clinical characteristics associated with patient perceptions that their heart condition is cured at one week following hospitalization for ACS. Methods: We analyzed data from 397 patients interviewed during hospitalization for ACS in 2011-2013 as part of the Transitions, Risks, and Actions in Coronary Events: Centers for Outcomes Research and Education (TRACE-CORE), and again at one week post-discharge as part of an ancillary study, TRACE-CARE. At one week, patients were asked “How true or false is this statement for you: My heart condition is cured. Would you say that this is definitely true, mostly true, neutral, mostly false, or definitely false?” We considered patients who responded “definitely true” or “mostly true” to perceive that their heart condition was cured. We calculated 6-month GRACE risk scores using clinical data from medical records. We used multivariable logistic regression models to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for associations with cure perceptions. Results: Participants were 26% (n=105) female and 89% (n=350) non-Hispanic white with mean age 60.7±11.0 years. Sixteen percent (n=63) were hospitalized with unstable angina, 69% (n=266) with NSTEMI, and 14% (n=55) with STEMI; 31% (n=124) had a history of CHD; and the average GRACE risk score was 93.6 (SD: 26.6). Seventy-three percent (n=289) received PCI during hospitalization and 11% (n=43) CABG. Discharge occurred the same or next day for 19% (n=76) and within 2-3 days for 54% (n=214). One week post-discharge, 30% (n=120) perceived their heart condition was cured. In a multivariable model, male sex, unstable angina, no history of CHD, and receipt of CABG were associated with greater odds of perceiving oneself cured (Table). Conclusions: One week post-discharge for ACS, 3 in 10 patients perceived their heart condition was cured. Future research should examine additional patient factors related to cure perceptions, and whether these perceptions influence engagement in recommended secondary prevention strategies.

BackgroundCongenital heart conditions are among the most common non-communicable diseases in children and young people (CYP), affecting 13.9 million CYP globally. While survival rates are increasing, support for young people...

We examine relations between housing status, mortgage, financial burden, and healthy aging among older U.S. adults. We combine cross-sectional data from 2012 to 2014 Health and Retirement Study cohorts. Using regression models, we examined associations between owners and renters, mortgage and non-mortgage holders, financial strain, and difficulty paying bills, and poor self-rated health (SRH), heart condition (HC) and hospitalization (past two years). We find that compared to owners, renters had greater likelihood of poor SRH and hospitalization. Regardless of tenure, financial strain was associated with greater likelihood of poor SRH, HC and hospitalization, while difficulty paying bills was associated with poor SRH and HC. Mortgage holders had lower likelihood of poor SRH. Accounting for mortgage status, financial strain was associated with greater likelihood of poor SRH, HC and hospitalization, while difficulty paying bills was associated with poor SRH and HC. Associations between tenure or mortgage status and health were not modified by either financial burden factors. We conclude that there need to be more robust and inclusive programs that assist older populations with housing could improve self-rated health, with particular attention to renters, mortgage holders and those experiencing financial burden.