Deflection of the atrial flap is not the norm. In medicine, this pathology is called mitral valve prolapse. In children, the disease is much more common than in adults. The danger of such a violation lies in the fact that due to poor fit of the valves, there is a failure in the movement of blood flow. As a result, blood partially flows from the ventricle to the atrium. Mitral valve prolapse in children in most cases is a congenital disorder caused by an intrauterine abnormality in the development of internal organs.
From the course of school anatomy
Heart disease occurs against the background of deflection of valves that distinguish between the atria and ventricles. At the time of diastole (relaxation of the heart muscle), the valves should be closed. This is characteristic of normal myocardial function. During systole (contraction of the ventricles), the heart muscle contracts, which leads to the closure of the valves. This prevents the backward movement of blood from the ventricle to the atrium.
These two sections - the atrium and the left ventricle are separated by the mitral valve. The latter includes two connecting flaps. The mitral valve opens during diastole, allowing blood to move. Nearby is the tricuspid valve, it lies between the atrium and the right ventricle.
What causes prolapse
This disease is considered very common among patients under the age of 12 years. There can be many causes for mitral valve prolapse in children. Given that most often this pathology is congenital, functional changes could occur in the womb, when the process of formation and development of the heart tissue of the fetus was ongoing.
If we talk about the acquired form, then it is usually diagnosed in adolescents. In girls, the disease is confirmed much more often than in boys. In the presence of prolapse (sagging, sagging), the valve flaps do not close tight enough when the myocardium contracts, which contributes to the return of blood into the atrium.
Disease in newborns
The occurrence of signs of mitral or tricuspid valve prolapse in a child of the first year of life is associated with one of the factors:
- Features of intrauterine formation of the cardiovascular system.
- Deformation of the cusps, anomalies of their attachment.
- Disorders of innervation on the background of autonomic dysfunctions.
Disproportion of the size of the mitral ring, its expansion or abnormal attachment of the valves to the heart wall is quite capable of serving as the cause of mitral valve prolapse in a child 3 years old. Such violations relate to the problems of the formation of connective tissue, which are inherited and are manifested in increased extensibility of the chords and cusps. In this case, prolapse is not considered a malformation requiring specific treatment. It is a feature of a growing organism that has no dangerous and life-threatening consequences. A congenital form of the disease can be combined with vegetovascular dystonia and can be expressed by similar symptoms.
Acquired Form
Diseases of the heart valves of the heart can provoke disorders of the autonomic system, cause disorders of a psychoemotional nature. The cause of the development of the disease is often injuries in the chest. Rupture of the chord due to a strong mechanical shock leads to the separation of the valve and prevents the full fit of the valves. In such a case, mitral valve prolapse in children and adolescents proceeds with complications and needs immediate surgical treatment.
Often, prolapse at an early age provokes rheumatic heart disease. The disease develops as a result of inflammation of the chords and valves on the background of tonsillitis, pneumonia, scarlet fever. Infectious and inflammatory diseases can affect the heart valves and cause an attack of rheumatism.
How does prolapse manifest
The main symptoms of the disease include tachycardia, that is, heart palpitations. In a 6-year-old child with mitral valve prolapse, the heart rate may change for no apparent reason, while it is accompanied by anxiety, sweating, or shortness of breath. Children often complain of a headache worse in the evening, dizziness. Prelapse occurs in adolescents with prolapse, especially often with a prolonged stay in a stuffy indoors.
Pain in the chest area with sagging mitral valve is also a characteristic symptom. The pain intensifies on the background of psychoemotional disorder, experience. Other symptoms of the disease include:
- Panic attacks, fears.
- Shortness of breath (hyperventilation symptom).
- Attacks of suffocation due to excitement.
- Nosebleeds.
The last sign is due to a decrease in the quality of blood coagulability due to the lack of fiber content of connective tissue.
Degrees of prolapse
By the magnitude of the cusp extension, one can get an idea of the severity of the disease. Mitral valve prolapse in children can be:
- The first degree (protrusion of the sash does not exceed 5 mm).
- The second degree (deflection is 5-9 mm).
- Third degree (leaflets bend by 9 mm or more).
Moreover, the degree of prolapse does not always correspond to the severity of the course of the disease. In order to get a more informative picture of the pathology, it is important to study the volumes of refluxed reverse blood during systole. The length of the stream, which falls into the atrium, distinguish the degree of prolapse:
- Zero At this degree, mitral valve prolapse in children 11 years old and earlier does not show any symptoms. Pathology can only be detected during an ultrasound scan.
- First one. This degree of regurgitation also proceeds latently. At this stage of the disease, the stream length barely reaches 1 cm.
- The second one. With prolapse of this degree, the length of the blood stream can reach 2 cm.
- The third. For this stage of the disease, a jet of more than 2 cm is characteristic.
- Fourth. The most severe degree, since blood spreads over a large gap (more than 3 cm).
What kind of examination you need to pass
Today, the most convenient and informative way to recognize cardiac pathologies in children and adults is ultrasound (echocardiography) and an electrocardiogram. Both methods provide specialists with the opportunity to find out the degree of sagging of the valves in the atrium and the length of the blood stream during casting.
If the pediatrician hears a heart murmur in a child, he directs the patient to undergo diagnostic procedures. Evidence of a protrusion of the valve in the atrium at the time of compression of the ventricles can be a characteristic click that occurs after the systolic phase. The clicks are clearly audible during loading (deep inhalation-exhalation) and in an upright position. Examination of children and listening to the work of the heart muscle are the determining methods of diagnosis.
With mitral valve prolapse, a child of 7 years and older can be prescribed not only ultrasound and ECG, but also additional diagnostic procedures:
- Holter monitoring.
- Roentgenography.
- Catheterization.
How to treat pathology
Such babies who have congenital leaf prolapse are registered with a cardiologist, but no specific therapy is prescribed for the child. In this case, the doctor can give recommendations for swimming, sparing physical education. Professional sports for children and adolescents with this diagnosis are usually prohibited.
Prolapse of the mitral valve of the 1st degree in a child does not require medication or the use of any medical procedures. In order to prevent the progression of the disease, parents need to constantly adjust the psycho-emotional background of the child with the help of sedatives, magnesium-containing agents.
Drug therapy for stage 3 and 4 prolapse
The main objective of drug treatment is to improve the nutrition of the heart muscle, eliminate disorders and dysfunctions at the level of the autonomic nervous system. In order to improve myocardial contractility, “Riboxin” or “Panangin” preparations are prescribed.
If one of the infectious diseases (for example, tonsillitis) was the cause of acquired prolapse, antibiotics are prescribed for the child. It is advisable to take the course of treatment under the supervision of medical staff in a hospital. It is impossible to self-medicate, otherwise parents expose the child to the risk of complications.
Physiotherapy
You can improve the condition of the heart muscle using a course of physiotherapy procedures. Several methods for treating mitral valve prolapse in children:
- Electrophoresis using bromine and magnesium.
- Massage the spine.
- Acupuncture.
With severe valve prolapse, patients are recommended surgery for valve plastic or its complete replacement. Such operations are done both in Russia and abroad. The most popular country for the treatment of heart disease in children is Israel. In this state there is a powerful material and technical equipment and qualified specialists.
The consequences of the disease and prognosis
Mitral valve prolapse in children can lead to serious health problems that cannot be resolved without radical treatment. Severe complications arising from further sagging of the valves include rupture of the chord and the formation of adhesions that impede valve operation.
Functional insufficiency, which leads to shortness of breath, constant weakness and a feeling of fatigue, is considered an equally common consequence of the development of prolapse. If the disease progresses rapidly, a decision is made to install the implant.
A rare case of complications of mitral valve prolapse in adolescence is infectious endocarditis. With this disease, a person's body temperature rises, blood pressure decreases, discomfort, malaise, joint pain occur, and yellowness of the epidermis is observed.
In general, the prognosis for prolapse is favorable. As the child grows older, the state of the heart muscle stabilizes, there is no need for drug treatment.
Often, pathology of the valve of the first degree, cardiologists refuse to consider it an independent disease. In children, mitral valve prolapse is characterized as a temporary violation or borderline state of health that stabilizes with age. As a result of changes in constitutional features, the disease goes away on its own in a predominant number of cases. So, for example, if the child was thin and tall, but subsequently gained the missing body weight, the valve may recover. Prolapse will disappear without any kind of intervention.
What is important for parents to know
Intensive therapeutic and surgical treatment of mitral valve prolapse in children is resorted to in exceptional cases. Before you start taking medication, it’s important to adjust your child’s lifestyle. Toddlers in their first years of life, as a rule, do not lack physical activity, but as they grow older, children become more passive. This should not be allowed, because it is moderate physical activity that strengthens the muscles and connective tissue of the heart valve, as well as the chord.
It is important to understand that for a child with a diagnosis of mitral valve prolapse, debilitating loads are contraindicated. The best option is morning exercises for 15-20 minutes, outdoor games, swimming in the pool. It can be useful and cycling, skiing.
In addition, parents should take care to create a favorable psychological atmosphere at home. The child should be comfortable in the family. Freedom and harmony will help to maintain calm, prevent psycho-emotional disorders and avoid a number of health problems.