Heart failure in a child - what kind of disease is it, what are its symptoms and how to treat it? Read about all this in the article.
The disease often leads to disability, a deterioration in the quality of life, and also the death of the child. However, it is worth noting that with timely comprehensive treatment, the prognosis for recovery is very good, since the existing disease can be completely cured. In order to recognize the presence of the disease in time, it is important to know exactly what symptoms are characteristic of it. When the first signs appear, you should immediately consult a doctor for diagnosis and treatment.
Features of the disease
If timely pathology of the heart in newborns and older children is detected, then they can be saved and prevent complications. However, in most cases, dangerous symptoms go unnoticed for a long period of time, and then heart failure may develop in the child. This is a condition in which, as a result of reduced contractility, blood circulation is disturbed inside the heart itself and beyond. In the presence of such a pathology, the whole organism suffers.
Often there is a chronic form of insufficiency in children, developing as a result of the presence of various pathologies of the heart and blood vessels. The main danger of such a pathological condition is that it can occur latently, therefore, without timely diagnosis, heart failure in a child goes into a particularly serious, life-threatening stage.
In newborns, it is mainly provoked by congenital heart defects, especially if they are severe and combined. In older children, a similar problem often arises as a result of various injuries in which damage to the heart muscle occurs.
Classification
According to the classification, heart failure in a child can be acute and chronic. Acute is characterized by the fact that it develops rapidly as a result of a violation of the contractility of the myocardium and a simultaneous decrease in the minute and systolic blood volume. Clinically, the symptoms are extremely severe: acute renal failure, pulmonary edema, cardiogenic shock.
The chronic form of the disease, as a rule, develops as a result of a disease of the cardiovascular system, which leads to a decrease in the pumping function of the human heart. It is manifested by fatigue and shortness of breath.
In addition, there are diastolic and systolic forms of the disease.
Also, the pathology is left ventricular and right ventricular. The left ventricular form is characterized by the fact that it affects the pulmonary circulation and is often called pulmonary. It manifests itself in the form of cyanosis, shortness of breath and cough, and in more dangerous cases, pulmonary edema is observed.
With the right ventricular form, the right heart and a large circle of blood circulation suffers, which is why it is called cardiovascular failure. In children with this pathology, the spleen and liver increase, and swelling also occurs.
Right-sided failure
In children, cardiovascular insufficiency of the right atrium is associated with stagnation of blood in a large circle of blood circulation. Among the main manifestations of the disease, the following should be highlighted:
- swelling;
- disruption of the liver, intestines and stomach;
- stagnation of blood;
- nausea and vomiting.
External swelling is mainly manifested on the legs, and it significantly increases in the evening. In this case, edema does not affect the shoulders, face and hands, and in bedridden children they are concentrated in the lumbar region. In a newborn child, swelling is not very pronounced, but in it an affliction can manifest itself by cyanosis on the back of the feet and hand.
Left-sided failure
Heart failure in a young child, and especially in newborns, is mainly provoked by a malfunction of the left ventricle of the heart. With this type of pathology, signs such as:
- rapid pulse;
- dyspnea;
- sweating and fatigue;
- wet wheezing in the chest.
It is worth noting that many children complain about a lack of air. Parents must pay attention to such fairly characteristic signs as intermittent and rapid breathing, as well as shortness of breath even with little physical exertion.
In addition, among the main signs of illness in newborns, sleep disturbance, attempts to sit down or lie down so that the chest is slightly raised can be noted. In this position, the wheezing subsides, and the attack of suffocation weakens. Stagnation of blood provokes a cough without sputum production. Without timely treatment, a prolonged increase in pressure provokes pulmonary edema. This condition is very dangerous and requires urgent medical attention.
Chronic form
Chronic heart failure in children is a syndrome that occurs with the complication of many diseases and affects other organs. Pathology develops slowly: over several weeks or maybe even years.
Now there are two types of chronic insufficiency. This form is much more common with disorders in the cardiovascular system.
Acute form
Acute cardiovascular failure in children is a syndrome that is developing rapidly. It is accompanied by cardiac asthma, pulmonary edema.
Acute insufficiency in children often develops due to rupture or trauma of the walls of the left ventricle, as well as insufficiency of the mitral and aortic valve.
Degrees of illness
Doctors distinguish 3 degrees of heart failure in children, which are characterized by various signs. The first degree is considered the easiest. Among the main signs of pathology, nervousness, weakness and restless sleep can be distinguished. If the baby's body is subjected to rather heavy loads, then there is severe shortness of breath, the pulse accelerates. After the complex treatment, the state of health stabilizes, and all the symptoms of the disease disappear.
The second degree is further divided into two forms. In the first form, even with a slight load, shortness of breath appears. The child complains of a deterioration in appetite, restless sleep, pain in the right hypochondrium and heart palpitations. Symptoms are more pronounced.
In the second form of the disease, the well-being of the child worsens. Even in a completely calm state, the pulse quickens, the liver increases, shortness of breath occurs, colic appears, insomnia, the skin turns blue and swelling occurs.
The third degree is the most difficult, and the patient feels very poor. Shortness of breath does not stop, and swelling spreads throughout the body. This degree is characterized by the fact that it is irreversible. It is possible to normalize the patient’s well-being, but the effect will be short-lived. In the heart and other organs, dangerous and severe pathologies arise, affecting the nervous system.
The third degree manifests itself in the form of drowsiness, depression, however, at the same time, mental overexcitation and insomnia can be observed, as well as clouding of consciousness.
Causes of early childhood
Heart failure is a condition of the cardiac muscle, in which it cannot contract and throw out the required amount of blood; as a result, congestion in the circulation circles is observed. In infants and children under 3 years old, the causes of heart failure are usually associated with the presence of congenital heart defects. Among the main risk factors, the following should be highlighted:
- genetic predisposition;
- chronic alcoholism of a woman;
- taking certain drugs during pregnancy;
- early viral infection.
Among the main causes of heart failure in children, cardiac heart defects can be distinguished. In this case, immediately after the birth of the child, characteristic signs are observed, in particular, cyanosis, severe anxiety, shortness of breath, convulsions, loss of consciousness. Without urgent surgery, a child may die.
Causes of Older Age
If signs of heart failure are observed in older children, then the reason for this may be:
- previous rheumatism;
- hypertension
- cardiomyopathy;
- myocarditis;
- infectious endocarditis.
All these disorders and pathologies can trigger a rapid deterioration in well-being and the development of heart failure. It is very important to determine the presence of signs of the disease in a timely manner and visit a doctor for diagnosis and treatment.
Main symptoms
Symptoms of heart failure in children can be very different, it all depends on which part of the heart is affected. Among the main signs of the pathology in infants, one can distinguish such as:
- frequent crying;
- anxiety;
- persistent and severe sweating;
- respiratory failure.
During breastfeeding, the baby very quickly loses strength and stops sucking milk, and also begins to cry.
Among the main symptoms of the disease in preschool children, the following should be highlighted:
- children try to sit or lie down;
- decreased physical activity of the child;
- children do not really want to participate in games;
- shortness of breath appears during an attack of fear, as well as during active games.
In adolescents, during the period of rapid development of the body, shortness of breath appears, which many parents do not attach much importance to for a long time. At the very beginning of the development of the disease, no painful manifestations are observed. If pain occurs during active movements or when coughing in the heart, this is an occasion to consult a doctor. Blue lips and excessive pallor of the skin may also be observed. In this case, it is necessary to provide timely assistance to the child.
First aid
If you suspect acute heart failure, you must immediately call an ambulance. During an attack, oxygen starvation occurs. Be sure to provide first aid to the affected child. Emergency care is as follows:
- you need to unfasten the gate and ensure the supply of fresh air;
- the child needs to be arranged in a comfortable position;
- reassure the victim, distract him from fear and pain;
- to reduce blood flow to the heart, make baths for arms and legs;
- You can also apply a venous tourniquet, and after 20 minutes, relax it.
If the pressure has risen, then the child needs to be given a half or a whole tablet of Nitroglycerin, which he must put under his tongue. To save his life, it is necessary to take all the necessary measures for quick hospitalization. Transportation should be carried out as carefully as possible.
Diagnostics
The treatment of heart failure in children requires prior competent and comprehensive diagnosis. It is carried out in non-invasive ways:
- radiography;
- electrocardiography;
- exercise test;
- ultrasound diagnostics.
In particularly difficult cases, cardiac catheterization may be indicated for an accurate diagnosis. Timely diagnosis is important, since if the diagnosis is not made in a timely manner, this can lead to very dangerous consequences. Heart failure leads to a decrease in blood supply to the internal organs, as well as the brain. As a result of this, the child can be significantly behind in mental and mental development and, if treatment is not started in a timely manner, then growth may stop. This applies not only to height, but also to the lack of growth of internal organs.
Therapy Features
In the treatment of acute heart failure in children, clinical recommendations are aimed at prolonging and improving the quality of life of the child. Applied therapy must necessarily be comprehensive, and it includes exposure to a provoking factor, increased contractility of the heart muscle, and the prevention of complications.
In heart failure in children, clinical guidelines relate to diet. Diet therapy is aimed at increasing the number of meals. You need to eat in small portions 5-6 times a day. Food consumed should be varied, enriched with vitamins, trace elements. It is especially important to include foods high in calcium and potassium in your diet. It is necessary to exclude spicy and fatty foods, tea, chocolate, coffee from the usual diet.
Be sure to reduce physical activity. In especially severe cases, you need to observe bed rest. After normalization of well-being, you need to gradually return to physical activity, since a lack of exercise can lead to muscle atrophy. When conducting drug therapy, such drugs are prescribed as:
- cardiac glycosides ("Digitoxin", "Digoxin", "Lantoside");
- cardiotonics ("Dobutamine");
- diuretics (Veroshpiron, Furosemide).
For the prevention of thrombosis and thromboembolism, the use of such drugs as Warfarin, Heparin is indicated. To normalize the metabolism in cells and improve trophism, magnesium and potassium preparations are prescribed. With restless behavior of children, antidepressants and sedatives can be prescribed.
In case of respiratory failure, oxygen therapy is prescribed. With strict adherence to clinical recommendations for heart failure in children, the prognosis for life is quite favorable. The sooner the disease is identified and the treatment is carried out, the more favorable the prognosis for the life and development of the child. If the therapy is timely carried out, then there is a greater chance that the parents and the child after a few years will not remember the disease.