Heart defects - what is it? Congenital and acquired heart defects, their diagnosis

The diagnosis of "heart disease" means the presence of a violation in the structure of the heart muscle. It can be either congenital or acquired. In the first case, the disease can be diagnosed in a newborn child, in the second it develops for some time, mainly in childhood. In severe cases, surgery is required to completely cure heart defects.

What is congenital heart disease?

A pathological condition can be observed already when a child is born. Previously, this disease was considered deadly for newborns, but progress in surgical intervention has contributed to the successful elimination of the threat. Nevertheless, not all adults suffering from heart disease in infancy continue treatment in adulthood, and this therapy in most cases is simply necessary.

Symptoms

Symptoms and signs of the disease can occur only a few years after the birth of the baby. They can also occur again years after surgery or completion of therapy. In adults, the following signs of pathology are most often observed:

• heart rhythm disturbance (arrhythmia);
• bluish tint of the skin (cyanosis);
• labored breathing;
• rapid onset of feelings of fatigue after physical exertion;
• dizziness or a tendency to faint;
• swelling of body tissues or internal organs (edema).

If the symptoms of pathology are cause for concern (and especially if they manifest as severely labored breathing or chest pain), you should immediately consult a doctor.

Causes

The heart is divided into four hollow chambers - two on the right side and two on the left. These parties perform different functions, together contributing to the implementation of the main work of the heart - pumping blood.

The right half of the organ directs blood to the lungs through vessels called the pulmonary arteries. Enriched with oxygen, the blood then enters the left half of the heart through the pulmonary (pulmonary) veins. Then, saturated with oxygen, it passes through the aorta and goes to all parts of the body.

This disease - a congenital heart disease - most often develops in a child already in the womb. In the first month of gestation, the fetal heart begins to beat. At this moment, the organ is a tube vaguely reminiscent of the shape of a heart. Soon after, structures begin to develop, from which two halves of the heart muscle are formed, and large blood vessels involved in the circulation of blood from the organ and vice versa.

During this period of intrauterine development, malformations often manifest. Science does not know exactly what serves as a specific reason for the development of pathological conditions, but a significant role is most likely played by genetic prerequisites, medication and the presence of other chronic diseases.

Risk factors

There are known circumstances in which heart defects most often develop. Is this an unequivocal sentence or just a theoretical possibility? The following risk factors for the appearance of congenital heart defects should not be considered as absolute prerequisites for the development of pathology, however, some features of the genetics and the state of health of the mother can really affect the health of the unborn child. Among these features are:

• Measles rubella. If a woman had rubella during pregnancy, the disease could cause pathological changes in the structure of the fetal heart.
• Diabetes. If a pregnant woman is diagnosed with diabetes of the first or second type, there is a risk of developing disorders in the structure of the heart muscle of the fetus. Gestational diabetes, however, does not increase the risk of heart disease.
• Medicines The use of certain drugs prohibited for use by pregnant women can lead to a variety of birth defects, including heart defects. Among these medicines are, for example, isotretinoin, used in the treatment of acne, and lithium, which is prescribed for bipolar affective disorder, causing sharp mood swings or a hypomanic state.
• Drinking alcohol during pregnancy can also lead to a baby developing congenital heart defects.

What kind of misfortune is heredity?

Congenital heart defects are often a hereditary pathology transmitted from parents to children. They accompany many genetic syndromes.

So, half of the children with Down syndrome caused by the presence of an extra 21st chromosome (trisomy) have heart defects. Modern genetic studies make it possible to detect such pathological conditions in the early stages of fetal development.

Complications

Congenital and acquired heart defects often lead to complications only years after the completion of primary therapy. Since the severity of the defect can vary greatly, the disease, according to statistics, leads to a variety of complications. In adults, most often manifested:

• Heart rhythm disturbances (arrhythmia). Such disturbances occur when the electrical impulses of the heart, which coordinate the heartbeat, are not functioning properly. As a result, too fast, too slow, or simply irregular heartbeat is observed. Arrhythmia is typical for patients with heart defects. It arises either due to the fact that the defect prevents the normal conduct of electrical impulses, or due to the accumulation of connective tissue - the formation of a scar at the site of the previous corrective operation. In some patients, arrhythmia takes on severe forms and, if not properly treated, can lead to sudden irreversible cardiac arrest.
• Infectious heart diseases (endocarditis). The internal structure of the heart includes four chambers and four valves, covered with a sheath - endocardium. Endocarditis is called inflammation of this inner lining. The disease usually occurs when bacteria or other microorganisms penetrate into another part of the body (for example, the mouth) and subsequently into the bloodstream. With blood, they are transported to the heart and settle there, causing inflammation. In the absence of adequate treatment, endocarditis can damage or destroy heart valves, as well as provoke a stroke. If you have a prosthesis instead of a heart valve, or if you have treated it with a prosthetic material (or if the heart defect is not completely cured), your doctor will prescribe antibiotics to reduce the risk of developing an infectious disease.
• Stroke. Stroke occurs if the flow of blood to a part of the brain is stopped or severely reduced, as a result of which the brain tissue is deprived of oxygen and nutrients.
• Some congenital and acquired heart defects increase the likelihood of a stroke: pathological changes in the heart allow blood clots (blood clots) from a vein to go into the heart and then rise to the brain. Certain types of arrhythmias also increase the risk of blood clots leading to stroke.
• Heart failure. This diagnosis means that the heart is not able to pump enough blood to satisfy all the needs of the body. The disease "heart disease" very often leads to the development of heart failure. Over time, this violation can also develop as a result of other ailments, including coronary artery disease (for example, rheumatic heart disease often results from atherosclerosis) and high blood pressure. These ailments deprive the heart muscle of the necessary strength - as a result, it weakens or becomes too rigid to normally fill up and pump blood efficiently. Chronic heart failure can be cured by drug therapy. Measures such as performing physical exercises, limiting salt (sodium) in food, managing stress and losing weight, also help prevent fluid buildup and improve quality of life.
• Pulmonary hypertension. This type of high blood pressure affects only the arteries in the lungs. Some types of heart defects increase blood flow to the lungs. As the pressure rises, the lower right chamber of the heart muscle (the right ventricle) is pumping blood more intensively through the lungs, gradually leading to weakening of the heart. If this problem is not recognized in time, there will be a danger of irreversible damage to the pulmonary arteries.
• Pathology of the heart valves. Although many types of heart defects do not cause anxiety at a young age, as they grow older, the disorders become more pronounced. Sometimes a valve that has undergone surgical treatment or replacement in childhood requires new surgery in adulthood. Other medical procedures that were performed in childhood, also sometimes have to be repeated after several years.

Diagnostics

If the doctor suspects a congenital heart defect or believes that current health problems may be caused by its existence, he will perform an initial medical examination, including listening to the heart with a stethoscope.

If a specialist detects a heartbeat, this may indicate the presence or progression of a pathological condition - including heart defects. What is it and how is it treated? To answer these questions and make an accurate diagnosis, the doctor will prescribe other studies, which usually include:

• Electrocardiogram (ECG). This study allows you to record the electrical activity of the heart muscle. Heart disease syndrome interrupts electrical signals, leading to cardiac arrhythmias (arrhythmias). The presence of pathology can also be judged by the patterns of signals.
• Chest x-ray. Radiography images will allow the doctor to more accurately assess the condition of the heart and lungs.
• Echocardiogram . Pictures of an echocardiogram are made using sound waves. Fixed research results are widely used in the diagnosis of heart defects.
• An electrocardiogram with physical activity. This study is aimed at checking the general health and electrical activity of the heart. During exercise, heart rate and blood pressure are additionally measured. The load usually consists of working on a special treadmill or on an exercise bike. Sometimes special sensors are required to check oxygen consumption. If physical activity is contraindicated for the patient, the doctor replaces them with special medications that increase the pulse or increase blood flow. The echocardiogram method in combination with exercises on simulators is an equally effective way to detect heart disease. Diagnosis in this case is considered complex.
• Computed tomography (CT) or magnetic resonance imaging (MRI). These types of studies are often used in the diagnosis of cardiovascular diseases. To take a picture by computed tomography, the patient lies on a table inside the machine, in a shape similar to a donut. An x-ray tube inside the mechanism moves along the body and takes pictures of the heart and chest. Heart MRI is an imaging study that uses a magnetic field and radio waves to create an image of an internal organ. To take a picture, the patient lies on a table inside the machine, which looks like a long tube (capsule). This mechanism creates a magnetic field ordering atomic particles in some cells. When atomic particles are affected by radio waves, the response signals can determine which type of tissue the corresponding cells belong to. On the basis of the received signals, a picture of the heart muscle is taken - and the diagnosis of heart disease is made or refuted (the disease is subject to further classification).
• Cardiac catheterization. This study is aimed at checking blood flow and pressure in the heart. A catheter is inserted into the artery in the perineum, on the neck or arm, which is then carefully guided to the chambers of the heart muscle using an X-ray apparatus that broadcasts real-time images of internal organs. A dye is introduced through the catheter, and the X-ray machine captures images of the heart and blood vessels. The same procedure allows you to measure the pressure in the chambers.

Pregnancy

Heart disease during pregnancy contributes to the development of complications, so experts recommend consulting a doctor before conception. As a rule, patients with mild pathologies have every chance of successfully bearing the fetus, however, some women with heart defects are strongly advised by doctors to abandon pregnancy planning. It is also important to understand that if one person in a couple is diagnosed with a heart defect, the violation is likely to be transmitted by inheritance to the child. If you are concerned about this issue, sign up for a consultation with a specialist in genetics in advance.

Acquired Heart Defects

What is it? These are pathological conditions, the development of which began after the birth of the child. Violations are associated with changes in heart valves - stenosis and / or insufficiency. The causes of such defects are infections, inflammatory processes, autoimmune reactions, overload of the heart chambers; the most common prerequisites for pathology are rheumatism, endocarditis (infection) and atherosclerosis (coronary artery disease). Atherosclerotic or rheumatic heart disease can be either isolated or combined - depending on the number of affected valves. The same diagnostic tests are used to confirm the presence of congenital or acquired heart disease.

Treatment

Since there are varying degrees of heart disease, treatment methods can be very diverse. The doctor may offer to directly correct the violation itself or to cure the complication that developed due to it. Treatment methods include:

• Regular examinations by a specialist. Relatively non-dangerous heart defects do not require intensive therapy - it is enough to periodically check the state of your health with a doctor. The frequency of inspections is determined by a specialist.
• Medicines Some pathologies respond to drug therapy; patients take medications that improve the functioning of the heart muscle. Sometimes you also need to take drugs that prevent blood clots or help regulate heart rate.
• Implant devices. Devices that control heart rate (pacemakers) or correct potentially dangerous irregular rhythms (implantable cardioverter defibrillators, ICDs) can alleviate some of the complications caused by congenital heart defects.
• Catheterization. Some catheter procedures contribute to the treatment of pathologies without surgical intervention. A thin tube is placed in the vein of the lower limb and is passed through the vessel to the heart using radiographic images. As soon as the catheter reaches the localization of the defect, tiny tools are passed through it to correct the pathology.
• Open heart surgery is a surgical procedure recommended when catheterization is ineffective.
• Heart transplantation is an alternative to other methods of treating severe organ defects.

Heart disease is treated with quality lifestyle changes. As a rule, the patient is recommended to adhere to the principles of a healthy diet, lead a moderately active lifestyle, lose weight and monitor the regularity of prescribed medications.