“Heart defect in a child” - sometimes these words sound like a sentence. What is this disease? Is such a diagnosis really terrible and by what methods is the treatment carried out?
The diagnosis of "heart disease" in a child
There are times when people live with one kidney, with half a stomach, without a gall bladder. But it is impossible to imagine a person who lives without a heart: after this organ stops its work, within a few minutes life in the body fades completely and irrevocably. That is why the diagnosis of “heart disease” in a child is so scary for parents.
If you do not go into medical subtleties, then the described disease is associated with improper functioning of the heart valves, with which the organ itself gradually fails. This problem is the most common cause of heart disease, but not the only one. In addition, there are cases when the disease develops as a result of an incorrect structure:
- organ walls;
- cardiac septum;
- large heart vessels.
Such changes can be birth defects, but can be acquired throughout life.
Congenital heart defect
If a child was born with heart disease, then this disease is called congenital.
Statistics show that approximately 1% of just born babies suffer from this ailment. Why is heart disease in newborns so common? It all depends on what kind of lifestyle the mother leads during the bearing of the fetus.
The question of whether or not the baby will be healthy is decided in the first months of pregnancy. The risk of having a baby with a heart defect increases significantly if the expectant mother during this period:
- drank alcohol;
- smoked;
- exposed to radiation;
- suffered from a viral disease or vitamin deficiency;
- took illegal drugs.
If it is too early to notice the symptoms of heart disease in children and start treatment on time, that is, the chances are to fully restore the normal functioning of the organ. Conversely, if the problem is discovered late, then irreversible changes will occur in the structure of the heart muscle, and an emergency operation will be needed.
Acquired Heart Disease
Acquired heart defects in children, as a rule, occur due to improper operation of the valve system. This problem is solved surgically: valve replacement helps to return to the previous active life.
Causes of the disease
Acquired heart disease in a child is formed due to many reasons.
- Rheumatic endocarditis. This disease affects the heart valves, in the stroma of which granulomas form. In 75% of cases, it is rheumatic endocarditis that causes the development of the disease.
- Diffuse connective tissue diseases. Pathologies such as lupus erythematosus, scleroderma, dermatomyositis and others, often cause complications in the kidneys and heart.
- Chest injury. Any powerful blows to the chest area with a high degree of probability can cause the development of defect.
- Unsuccessful heart surgery. After heart surgery has already been performed, such as valvulotomy, complications occur that provoke the development of the defect.
- Atherosclerosis. This is a chronic disease of arteries and blood vessels, on the walls of which atherosclerotic plaques begin to form. Rarely enough, but atherosclerosis also becomes the cause of changes in the work and structure of the heart.
From this list it is clear that if a child has a heart defect, the reasons for this can be very diverse. But it is important to find them, if only so that the prescribed treatment is competent and most effective.
Symptoms
Heart defects in children are accompanied by specific symptoms that you need to know about and sound the alarm if they appear in the baby.
On a routine examination, the pediatrician can hear a heart murmur in a sick child . After their discovery, the attending physician must definitely prescribe an ultrasound. But the diagnosis of "heart disease" may not be confirmed, because in growing children, functional heart murmurs are the norm.
In the first months of life, the physical development of babies is very intense, every month they should put on weight at least 400 g. If this does not happen, then you need to go directly to a cardiologist, since the lack of weight gain is one of the main signs of heart problems.
The lethargy and fatigue of the child are also an obvious signal of health problems. If shortness of breath is added to all this, then the risk of hearing an unpleasant diagnosis increases.
Research methods
Unfortunately, heart defects in children are rarely detected on time. There are several reasons for this.
- Firstly, during pregnancy it is almost impossible to establish the development of the disease in the child. An experienced specialist during transvaginal ultrasound may notice certain changes in the work of the baby’s heart, but many pathologies at this time are not yet manifested. The categories of women who are at risk were identified above - it is better for such mothers to take the initiative and undergo transabdominal ultrasound at the 20th week of pregnancy.
- Secondly, after the birth of children, heart disease tests are not included in the list of mandatory tests and examinations. And parents themselves do not take the initiative and do not carry out additional diagnostic procedures.
- Thirdly, from the very beginning, the symptoms of the disease do not make themselves felt. And even if the child feels that something is wrong with him, he cannot explain this. Parents are too busy with everyday worries to regularly take their baby to certain examinations.
Usually, only an ECG and a few more tests are done for newborns, and as a rule, the diagnosis ends here. However, an electrocardiogram at such a young age is not able to detect congenital heart disease. If an ultrasound scan is carried out, it is possible to determine the disease at an early stage. Here a lot depends on the experience of the specialist who makes ultrasound. It is better to repeat the procedure at once in several clinics, especially if there is a suspicion of heart disease.
Course of the disease
If the symptoms of heart disease in children lead you to the doctor’s office, and the diagnosis is confirmed, this is not a reason to despair.
The course of the disease does not always lead to sad consequences. For example, insufficiency of the left atrioventricular valve of I and II degrees allows people to live from 20 to 40 years without surgery, while maintaining a certain degree of activity.
But the same diagnosis, but of the III and IV degree, accompanied by shortness of breath during physical exertion, edema of the lower extremities, liver problems, requires an immediate course of treatment and urgent surgical intervention.
Diagnosis
Signs of heart disease in children, noticed by parents and a pediatrician, are not yet the basis for a diagnosis. As mentioned above, systolic murmur is also observed in healthy children, so ultrasound is indispensable here.
An echocardiogram can detect signs of congestion in the left heart ventricle. Perhaps an additional chest x-ray will also be required, on which changes will be visible not only in the heart, but also signs of deviation of the esophagus. After that, you can already finally talk about whether the child is sick or healthy.
Unfortunately, the ECG is not able to help in the diagnosis of heart disease in the early stages: changes in the cardiogram are noticeable when the disease is already actively progressing.
Conservative treatment of heart disease
Confirmed signs of heart disease in children are an occasion to begin immediate treatment to prevent irreversible changes in the organ.
Doctors do not always turn to surgical methods - for some patients, surgery is not required, at least until a certain time. What is really needed is the prevention of the disease that triggered the ailment under consideration.
If heart disease is detected in children, treatment involves a competent regimen of the day. Such children need to lead an active and moving lifestyle, accompanied by moderate physical exertion. But overwork - physical or mental - is strictly contraindicated. Avoid aggressive and heavy sports, but walking, skating or cycling and so on will be useful.
It is possible that drug therapy will be needed to help eliminate heart failure. Diet also occupies a key place in the treatment of the disease.
Surgical treatment of the disease
When a heart defect is detected in children, surgery is mandatory, if it comes to the last stages of the disease, which can not cope with medicines and diet.
With the development of new technologies, surgical treatment has become available not only for children from one year old, but even for infants. When an acquired heart defect is diagnosed, the main goal of the surgical intervention is to maintain the efficiency of a person’s own heart valves. In the case of birth defects or disorders that are not corrected, valve replacement is required. Prosthetics can be performed from mechanical or biological materials. Actually, the cost of the operation depends on this.
The operation is performed on an open heart in cardiopulmonary bypass. Rehabilitation after such surgical intervention is long, requires patience, and most importantly - attention to the little patient.
Bloodless operation
It is no secret that due to health conditions, not everyone experiences such heart surgery. And this fact depressed medical scientists, so for many years they were looking for ways to increase patient survival. In the end, there was such a technology of surgical intervention as “bloodless operation”.
The first operation without breast incisions, without a scalpel and virtually without blood was successfully performed in Russia in 2009 by a Russian professor and his French colleague. The patient was considered hopelessly ill, as he revealed stenosis of the aortic valve. This valve should have been replaced, but for various reasons, the likelihood that the patient will survive was not very high.
A prosthesis was inserted into the aorta without breast incisions (through a puncture in the thigh). Then, using a catheter, the valve was directed in the right direction - to the heart. A special technology for the manufacture of the prosthesis allows you to roll it into the tube during insertion, but as soon as it enters the aorta, it opens to normal size. It is these operations that are recommended for people of advanced age and some children who are not able to undergo a full-scale surgical intervention.
Rehabilitation
Cardiological rehabilitation is divided into several stages.
The first lasts from three to six months. During this period, a person is taught special rehabilitation exercises, a nutritionist explains new principles of nutrition, and a cardiologist observes positive changes in the work of the body, a psychologist helps to adapt to new living conditions.
The central place in the program is given to the correct physical exertion, since it is necessary to keep in tone not only the heart muscle, but also the heart vessels. Physical activity helps to control blood cholesterol, blood pressure, and also helps to lose weight.
Constantly lying and resting after surgery is harmful. The heart should get used to the usual rhythm of life, and just dosed physical activities help him to do this: walking, running, exercise bikes, swimming, walking. Basketball, volleyball, and also weight training equipment are contraindicated.