Symptoms of CHD in babies, toddlers, preteens, and teens

Congenital heart disease, or CHD, involves heart defects and conditions that babies are born with. Sometimes CHD can be detected prenatally, but it is often diagnosed after birth and can present at any age. 

There are some common symptoms of CHD that may indicate that a child’s heart should be evaluated by a pediatric cardiologist.  Here are some of the symptoms that cardiologists look for when evaluating a patient for possible CHD.


  • Persistent fast breathing
  • Heavy breathing, also known as retractions (skin pulling in under rib cage or under neck)
  • Long feeding time, refusal to eat
  • Low energy/activity level
  • Poor weight gain
  • Gums and tongue turning blue, or a blue/grey tinge to the skin

Persistent fast breathing is one of the more common signs of heart disease in babies. Although a baby’s breathing can vary throughout the day, babies with CHD can breathe fast for several hours at a time, even without being upset or otherwise stressed.

 Sometimes turning blue, especially in the hands or feet, can just be a vascular phenomenon, but a cardiologist will want to evaluate a baby whose gums and tongue turn blue. 

“Parents should know that not all heart disease is associated with the sound of a heart murmur,” Dr. Watson said. “I get concerned about potential CHD when parents say a baby is feeding differently from their older children, if it takes a long time to eat or the baby needs to take frequent breaks while feeding. It can be hard to define, but if a parent or caregiver feels that things are just not right with their child, it warrants further investigation.” 

Toddlers and Young Children


  • Poor energy level, tiring easily
  • Gums and tongue turning blue, or a blue tinge to the skin
  • Poor growth/weight gain
  • Chest pain
  • Rapid heartbeat or breathing
  • Passing out
  • Losing their breath during activities sooner than their peers

“Toddlers are a tough age group because they cannot necessarily communicate what they’re feeling given their language development at this age,” Dr. Watson said. “Most commonly, heart disease will cause a low energy level. Toddlers play for most of the day, and if they are only playing for a few minutes before tiring, that could be a sign of CHD.”

Other symptoms that warrant further investigation include complaints of chest pain when running and playing, worrying about their heart when exercising and saying that they feel their heart “beeping,” which could be a sign of an irregular heart rhythm. 



  • Problems with growth/development
  • Fainting/passing out
  • Gums and tongue turning blue, or a blue tinge to the skin
  • Chest pain, especially with exercise
  • Rapid heartbeat or breathing
  • Losing their breath during activities sooner than their peers
  • Palpitations, or hearts beating abnormally or skipping a beat
  • Dizziness with exercise

Preteens and teens should be evaluated for CHD if they complain of issues such as a persistent fast heartbeat during exertion or exercise, shortness of breath or extreme fatigue. 

“If you have a teen who is very active or an athlete, and there is a significant decline in their performance or they’re much more tired than they used to be, we want to take a closer look at the heart’s structure and function,” Dr. Watson said. 

There are many kinds of CHD and particular variations can make a dramatic difference in what a child will need in terms of treatment. Responses, severity, and treatments for CHD can vary substantially between children. 

Dr. Watson recommends utilizing MYchart to read the physician’s notes after appointments with the pediatric cardiologist. In addition, if a child is scheduled to undergo any procedures or play sports, be sure to ask the provider about any issues at the appointment so that additional work up or testing can be done at the office visit. 

“Parents and caregivers know their child better than anyone,” Dr. Watson said. “If they have any concerns about a child’s health, we can find a lot of answers from a 15-minute, noninvasive echocardiogram. I’d rather them call and it turn out to be a false alarm than risk not getting evaluated and missing something important.”

This is not a comprehensive list of all signs and symptoms. Please contact your child’s doctor if your child experiences any symptoms that concern you.


City Call Program Links Community Hospital and Children’s Heart Center 



For more information about Children’s Healthcare of Atlanta Cardiology and our pediatric cardiology specialists, click here.

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