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 it true that such a diagnosis is terrible and what are the treatment methods used for?

Diagnosis of "heart disease" in a child

There are cases when people live with one kidney, withhalf of the stomach, without the gallbladder. 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 medical subtleties, thenthe described disease is associated with the malfunctioning of the heart valves, along with which the organ 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 approximately 1% onlyborn babies suffer from this ailment. Why is heart disease in newborn babies so common? It all depends on what kind of lifestyle the mother leads during the gestation of the fetus.

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

• took alcohol;
• smoked;
• exposed to radiation;
• suffered from a viral illness or vitamin deficiency;
• took the forbidden medication.

If you notice early symptoms of heart disease in childrenand time to start treatment, that is, the chances of fully restoring 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 urgent operation will be needed.

Acquired Heart Disease

Acquired heart defects in children are usuallyOccur due to malfunction of the valve system. This problem is solved surgically: valve replacement helps to return to the former 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, it is rheumatic endocarditis that causes the development of the disease.
2. Diffuse connective tissue disease. Pathologies such as lupus erythematosus, scleroderma, dermatomyositis and other diseases often result in kidney and heart complications.
3. Thoracic injury. Any powerful blows to the chest area are likely to cause the development of a defect.
4. Unsuccessful heart surgery. After already performed operations on the heart, such as valvulotomy, complications occur that provoke the development of the defect.
5. Atherosclerosis. This is a chronic disease of the arteries and vessels, atherosclerotic plaques begin to form on the walls of which. Rarely enough, but atherosclerosis also causes changes in the work and structure of the heart.

From this list it is clear that if a vice has developedHearts in a child, the reasons for this can be very diverse. But finding them is important, if only to ensure that the prescribed treatment is competent and most effective.

Symptoms

Heart defects in children are accompanied by specific symptoms that you need to be aware of and sound the alarm if they appear in a baby.

On duty, the pediatrician can hearsick child heart murmur. After their detection, the attending physician must prescribe an ultrasound. But the diagnosis of “heart disease” may not be confirmed, since the growing children have functional heart sounds - this is the norm.

In the first months of life the physical development of babiesIt is very intensive, every month they should add at least 400 g in weight. 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 fast fatigue of a 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.

Methods of research

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

1. First, during pregnancy, establishthe development of the disease in a child is almost impossible. An experienced specialist during transvaginal ultrasound may notice certain changes in the functioning of the baby’s heart, but many pathologies in this period are not yet manifested. Above, categories of women who are at risk were indicated - it is better for such mothers to take the initiative and to undergo a transabdominal ultrasound scan in the 20th week of pregnancy.
2. Secondly, after the birth of children research onheart disease is not included in the list of mandatory tests and examinations. And parents themselves do not take the initiative and do not conduct additional diagnostic procedures.
3. Third, from the very beginning the symptoms of the disease are notmake themselves felt. And even if the child feels that something is wrong with him, he cannot explain it. Parents are too busy with everyday cares to regularly take their baby to certain examinations.

Newborns usually do only ECG and moreseveral tests, this, as a rule, the diagnosis ends. However, an electrocardiogram at such a young age is not able to detect congenital heart disease. If, however, to conduct an ultrasound, it is possible to determine the disease at an early stage. Much depends on the experience of the specialist who does the ultrasound. It is better to repeat the procedure in several clinics at once, especially if a heart defect is suspected.

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 not a reason to despair.

The course of the disease does not always lead to sadthe consequences. For example, the failure of the left atrioventricular valve of 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 III and IV degree,accompanied by dyspnea during physical exertion, edema of the lower extremities, liver problems, requires immediate treatment and urgent surgical intervention.

Diagnosis

Symptoms of heart disease in children seenparents and pediatricians are not yet grounds for diagnosis. As mentioned above, systolic murmur is also observed in healthy children, therefore, ultrasound cannot be done here.

Echocardiogram may register signsoverload of the left heart ventricle. It may also require an additional x-ray of the chest, which will show changes not only in the heart, but also signs of deviation of the esophagus. After that, you can 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.

Treatment of heart disease with conservative methods

The confirmed signs of heart disease in children is a reason to begin immediate treatment in order to prevent irreversible changes in the organ.

Doctors do not always turn to surgicalmethods - 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 ailment we are considering.

If a heart disease is detected in children, treatmentsuggests a competent mode of the day. Such children definitely need to lead an active and mobile lifestyle, accompanied by moderate physical exertion. But overwork - physical or mental - is categorically contraindicated. Avoid aggressive and hard sports, but walking, rollerblading or cycling and so on will be useful.

It is possible that medical therapy will be required to help eliminate heart failure. Diet also holds a key place in the treatment of the disease.

Treatment of the disease by surgical methods

When a heart disease is found in children, operations are mandatory if it is about the last stages of the disease, which cannot be managed with medicines and diet.

With the development of new technologies, surgicaltreatment became available not only for children from a year, but even for infants. When an acquired heart disease is diagnosed, the main goal of a surgical intervention is to preserve 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 made of mechanical or biological materials. Actually, the cost of the operation depends on it.

The operation is done on the open heart in conditionsartificial blood circulation. Rehabilitation after such surgery is long, requires patience, and most importantly - attention to the little patient.

Bloodless operation

It’s no secret that due to health conditions not allexperiencing similar heart surgery. And this fact depressed medical scientists, so for many years they have been 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 incisions in the chest, without a scalpeland in fact, without blood, was successfully held in Russia in 2009 by a Russian professor and his French colleague. The patient was considered hopelessly ill because he was diagnosed with aortic stenosis. This valve should have been replaced, but for various reasons, the likelihood that the patient will survive was not very high.

The prosthesis was inserted into the patient without a cut(through a puncture in the thigh). Then, using a catheter, the valve was sent in the right direction - to the heart. The special technology of the prosthesis allows for the introduction to roll it into a tube, but as soon as it enters the aorta, it opens up to normal size. Such operations are recommended for older people and some children who are not able to undergo a full-scale surgical intervention.

Rehabilitation

Cardiac rehabilitation is divided into several stages.

The first lasts from three to six months. During this period, a person is trained in special rehabilitation exercises, a nutritionist explains new nutritional principles, and a cardiologist observes positive changes in the work of an organ, and a psychologist helps to adapt to new living conditions.

Central to the program is givenproper physical exertion, since it is necessary to keep in tune not only the heart muscle, but also the heart vessels. Physical activity helps control blood cholesterol levels, blood pressure levels, and also helps get rid of excess weight.

Constantly lie down and rest after the operation -is harmful. The heart has to get used to the usual rhythm of life, and it is precisely the measured physical loads that help it to do this: walking, running, exercise bikes, swimming, walking. Basketball, volleyball, and strength training equipment are contraindicated.