Heart disease in a child. Congenital and acquired heart defects in children

"Heart disease in a child" - sometimes these words sound like a verdict. What does this disease represent? Is such a diagnosis so terrible in fact and by what methods is the treatment carried out?

Diagnosis of "heart disease" in a child

There are cases when people live with one kidney, half stomach, without gall bladder. But to imagine a person who lives without a heart is impossible: after this organ stops working, within a few minutes the life in the body fades completely and irrevocably. That's why the diagnosis of "heart disease" in a child so scares parents.

If you do not go into the medical subtleties, then the described disease is associated with the malfunctioning of the heart valves, with which the body itself gradually goes out of action. 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 irregular structure:

• Walls of the organ;
• Cardiac septa;
• Large cardiac vessels.

Such changes can be congenital defects, but can be acquired during life.

Congenital heart defect

If a child is born with a heart defect, then this disease is called congenital.

Statistics show that about 1% of newly born babies suffer from this ailment. Why is heart failure in newborn babies so common? It all depends on what kind of lifestyle the mother leads during the fetal gestation.

The question of whether or not the baby will be healthy is decided in the first months of pregnancy. The risk of having a child with a heart disease increases significantly if the expectant mother during this period:

• Used alcohol;
• Smoked;
• Was exposed to radiation;
• Suffered from a viral illness or vitamin deficiency;
• Took illegal medicines.

If you notice early symptoms of heart disease in children and start treatment on time, then there is a chance to completely restore the normal functioning of the body. Conversely, if the problem is detected late, the heart muscle structure will undergo irreversible changes, and urgent surgery will be required.

Acquired heart disease

Acquired heart defects in children, as a rule, occur because of the incorrect operation of the valve system. This problem is solved surgically: valve replacement helps to return to the old active life.

Causes of the disease

Acquired heart disease in a child is formed due to many reasons.

1. Rheumatic endocarditis. This disease affects the heart valves, in the stroma of which granulomas are formed. In 75% of cases, rheumatic endocarditis is the cause of the development of the disease.
2. Diffuse diseases of connective tissue. Such pathologies as lupus erythematosus, scleroderma, dermatomyositis and others, often give complications to the kidneys and the heart.
3. Trauma of the chest. Any powerful blows to the chest area with a high probability may lead to the development of vice.
4. Unsuccessful heart surgery. After already performed operations on the heart, for example valvulotomy, complications occur that provoke the development of vice.
5. Atherosclerosis. This is a chronic disease of arteries and vessels, on the walls of which atherosclerotic plaques begin to form. It is rare, but atherosclerosis also causes changes in the work and structure of the heart.

From this list it is clear that if the heart disease in a child has developed, the reasons for this can be very diverse. But to find them is important, if only to ensure that the prescribed treatment was literate and most effective.

Symptoms

Heart defects in children are accompanied by specific symptoms, which need to be known and alarmed if they occur in the baby.

At the on-duty examination the pediatrician can hear a sick child with heart murmurs. After their detection, the attending physician must appoint ultrasound. But the diagnosis of "heart disease" may not be confirmed, since the growing babies functional murmur in the heart is the norm.

In the first months of life, the physical development of babies is very intense, each month they need to add at least 400 grams. If this does not happen, you should go straight to the cardiologist, since the lack of weight gain is one of the main signs of heart problems.

Lethargy and fast fatigue of the child are also an obvious signal about health problems. If all of this adds dyspnea, the risk of hearing an unpleasant diagnosis increases.

Methods of research

Heart defects in children, unfortunately, are rarely detected on time. There are several reasons for this.

1. Firstly, during pregnancy, it is almost impossible to establish the development of the disease in a 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 evident. The above categories of women who are at risk - such mothers are better to take the initiative and at the 20th week of pregnancy undergo a transabdominal ultrasound.
2. Secondly, after the birth of children, studies on heart disease are not included in the list of mandatory tests and examinations. And parents independently do not show initiative and do not conduct additional diagnostic procedures.
3. Thirdly, from the very beginning the symptoms of the disease do not make themselves felt. And even if a child feels that something is going wrong with him, he can not explain it. Parents are too busy with daily worries to regularly drive their baby to certain surveys.

Newborns usually do only an ECG and several other tests, as a rule, the diagnosis ends here. However, an electrocardiogram at such a young age is not capable of detecting congenital heart disease. If you perform an ultrasound, there is an opportunity to determine the disease at an early stage. Here much depends on the expertise of a specialist who does ultrasound. It is better to repeat the procedure immediately in several clinics, especially if there is a suspicion of heart disease.

Course of the disease

If the symptoms of heart disease in children brought you to the doctor's office, and the diagnosis was confirmed - this is no reason to despair.

The course of the disease does not always lead to sad consequences. For example, failure of the left atrioventricular valve I and II degree allows people to live from 20 to 40 years without surgery, while maintaining a certain degree of activity.

But the same diagnosis, but already III and IV degree, accompanied by dyspnoea with physical exertion, edema of the lower extremities, liver problems, requires an immediate course of treatment and urgent surgical intervention.

Diagnosis

Symptoms of heart disease in children, noticed by parents and a pediatrician, are not yet grounds for diagnosing. As mentioned above, systolic murmur is also observed in healthy children, so there is no need to do ultrasound here.

An echocardiogram can record signs of an overload of the left heart ventricle. Probably, in addition still it is required a roentgen of a thorax on which changes not only in heart will be visible, but also signs of deviation of an esophagus. After this, you can already finally say whether the child is ill or healthy.

Unfortunately, ECG is not able to help in the diagnosis of heart disease in the early stages: changes on the cardiogram are noticeable when the disease is already actively progressing.

Treatment of heart disease conservative methods

Confirmed signs of heart disease in children - this is an occasion to begin immediate treatment to prevent irreversible changes in the organ.

Not always doctors turn to surgical methods - some patients do not need surgery, at least until a certain time. What is really needed is the prevention of the disease that provoked the illness we are considering.

If cardiac infarction in children is detected, treatment requires a literate regime of the day. Such children need to lead an active and mobile way of life, accompanied by moderate physical exertion. But fatigue - physical or mental - is categorically contraindicated. It is necessary to avoid aggressive and heavy sports, but useful will be sports walking, rollerblading or cycling and so on.

It is possible that medication will be needed to help relieve heart failure. The diet also takes a key place in the treatment of the disease.

Surgical treatment of the disease

When heart disease in children is detected, surgery is mandatory, if it is a question of the last stages of the disease, which can not be cured by medication and diet.

With the development of new technologies, surgical treatment became available not only for children from year to year, but even for babies. When the acquired heart disease is diagnosed, the main goal of surgical intervention is to maintain the working capacity of the human heart valves. In the case of congenital defects or disorders that do not undergo correction, 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 conditions of artificial circulation. Rehabilitation after such a surgical intervention is long, requires patience, and most importantly - attention to a small patient.

Bloodless operation

It's no secret that, in view of the state of health, not everyone experiences such heart operations. And this fact depressed the medical scientists, so for many years they were looking for ways to improve the survival of patients. 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 carried out in Russia in 2009 by a Russian professor and his French counterpart. The patient was considered hopelessly ill, as he was diagnosed with aortic valve stenosis. This valve should be replaced, but due to various reasons, the probability that the patient would survive was not very high.

The prosthesis was inserted into the aorta without incisions of the breast (through a puncture in the thigh). Then, with the help of a catheter, the valve was directed to the right side - to the heart. A special technology for making a prosthesis allows you to roll it into a tube when you insert it, but as soon as it enters the aorta, it opens up to normal size. It is these operations that are recommended for elderly people 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 the new principles of nutrition, and a cardiologist watches for positive changes in the body's work, the psychologist helps to adapt to new living conditions.

The central place in the program is allocated to the correct physical loads, 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 level, blood pressure level, and also helps to get rid of excess weight.

Constantly lying and resting after surgery is harmful. The heart should get used to the usual rhythm of life, and it's just physical exercise that helps it: athletic walking, running, exercise bicycles, swimming, walking. Contraindicated basketball, volleyball, as well as power simulators.