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 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:

• consumed alcohol;
• smoked;
• was exposed to radiation;
• suffered from a viral illness or vitamin deficiency;
• took illegal medicines.

If early symptoms of heart disease in children are noticedand on time to begin treatment, that is, the chances of fully recovering 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 due to malfunction 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 blow to the chest area with a high degree of probability can 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 can be seen that if the defect developedthe child's heart, 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 you need to know about and to alarm if they appear in the baby.

At the on-duty examination the pediatrician can hear fromsick child noises in the heart. After their detection, the attending physician must prescribe an ultrasound. But the diagnosis of "heart disease" may not be confirmed, since the growing babies functional murmurs in the heart - this is the norm.

In the first months of life, the physical development of childrenis very intense, every month they should add at least 400 grams. If this does not happen, then you need to 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. First, during pregnancy, establishthe development of the disease in the child is almost impossible. 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 apparent. Above, the categories of women who are at risk have been identified - these mothers should take the initiative and undergo a transabdominal ultrasound at the 20th week of pregnancy.
2. Secondly, after the birth of children,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 are notmake 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 only make ECG and moreseveral tests, this, as a rule, the diagnosis ends. However, an electrocardiogram at such a young age is not capable of detecting congenital heart disease. If you perform an ultrasound study, you can 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 sadconsequences. 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 degrees,accompanied by dyspnoea with physical exertion, swelling of the lower extremities, liver problems, requires an immediate course of treatment and urgent surgical intervention.

Diagnosis

Symptoms of heart disease in children, seenparents and pediatrician, are not yet grounds for diagnosing. As already mentioned above, systolic murmur is also observed in healthy children, therefore, ultrasound can not be dispensed with.

An echocardiogram can record symptomsoverload of the left ventricle. Probably, in addition still it will be 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.

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 illness we are considering.

If heart disease in children is diagnosed, treatmentrequires 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.

The treatment of the disease by operational methods

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, surgicaltreatment 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 done on an open heart in conditionsartificial circulation. Rehabilitation after such a surgical intervention is long, requires patience, and most importantly - attention to a small patient.

Bloodless operation

It is not a secret that, in view of the state of health, not allexperience such operations on the heart. 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 scalpeland 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 stenosis of the aortic valve. This valve should be replaced, but due to various reasons the probability that the patient would survive was not very high.

Prosthesis patient was injected into the aorta without breast incisions(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 supervises positive changes in the body's work, the psychologist helps to adapt to new conditions of life.

The central place in the program is allocatedcorrect physical activity, since it is necessary to keep in the 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 lie and relax 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.