The minimum cardiac threshold for a child is 3 years old. Children's congenital heart defect

According to statistics, today every hundredth child is born with a heart defect, and in one out of a thousand newborns this pathology is severe. In terms of mortality in the first year of life, cardiovascular diseases occupy first place. This is due to the difficulty of diagnosing them in the early stages. It is important for parents to know how heart defects manifest themselves in order to seek qualified help from a doctor in time.

What is a heart defect?

The term “heart disease” unites a whole group of pathologies associated with a violation of the pumping function of our “motor”, which leads to the development of circulatory failure - hypoxia, known to us as “oxygen starvation”.

To put it simply, during the intrauterine development of the fetus or after birth, for certain reasons, which we will talk about a little later, defects in the valve apparatus, blood vessels or septa of the heart arise, due to which it cannot pump blood normally. This leads to a lack of oxygen in the body and a decrease in blood supply to internal organs - a process that doctors call heart failure.

Heart defect in a child- a serious cardiovascular disease, which in the absence of timely medical care can lead to disability and even death.

Heart defects in children are divided into two groups:

• congenital - those anomalies of cardiac development with which the baby is born;

• acquired - pathologies of valves, walls and septa that appear in a child after birth.

Let's look at both types in more detail.

Causes and symptoms of congenital defects

Scientists still cannot say for sure why fetuses develop defects in heart development. According to recent studies, congenital heart defects (CHD) most often occur as a result of the influence of the following factors:

• heredity. If there were already children in the family with a similar pathology, there is a high probability of another one;

• miscarriages and stillborn children. They are not the cause, but they significantly increase the risk of cardiovascular diseases in babies born after them;

• smoking and alcohol. A pregnant woman should know that these bad habits can also provoke abnormalities in the development of a small heart, so the woman needs to quit smoking;

• unfavorable environment. Pregnant women should not work in “harmful” industries, and it is better to bear a child while in an environmentally friendly area, then the likelihood of disruptions in fetal development is significantly reduced;

• infectious diseases suffered by the mother during pregnancy. Thus, rubella with almost 100 percent probability will lead to the appearance of congenital heart disease.

There are about 90 types of congenital heart defects. The most common include patent ductus arteriosus, atrial septal defect, and ventricular septal defect. Some abnormalities of cardiac development are diagnosed during ultrasound examinations during the period of intrauterine fetal formation.

But sometimes a heart defect in a newborn goes unnoticed even during discharge from the hospital, since not all medical institutions are equipped with the necessary equipment to detect such diseases.

Congenital heart disease: symptoms

Parents who left the maternity hospital in full confidence that their baby is healthy should not relax. You should monitor the baby’s behavior and, if the following symptoms appear, immediately contact your pediatrician:

• blue discoloration of the skin in the area of ​​the nasolabial triangle and under the nails. Excessive pallor of the baby may also indicate cardiac pathology;

• rapid fatigue and shortness of breath - their manifestations are observed during feeding, when the baby, after 1-2 minutes of sucking on the mother’s breast, gets tired, stops eating and begins to be capricious;

• rapid or uneven pulse - it is more frequent in a newborn baby than in an adult. The norm is 120-140 beats per minute. If your heart beats faster, go to the doctor;

• underweight. When your baby doesn’t gain weight well enough to reach the norm, you should also consult a doctor.

Most often Congenital heart defect diagnosed in babies with low body weight, in particular in premature babies.

Why does acquired heart disease appear and how does it manifest?

Acquired heart defects (AHD) in children appear as a result of rheumatism, but since the incidence rate among children has recently decreased significantly, the number of acquired heart defects has also become smaller. Most often they appear during adolescence.

Among the most common PPP options:

• infective endocarditis and pericarditis;

• defects of the tricuspid and aortic valves;

• mitral valve prolapse.

The symptoms of CHD and PPS are similar: the child gets tired and out of breath even with light exertion (for example, getting dressed). Sometimes acquired heart defect may have other symptoms. For example, if a child gets sick with infective endocarditis, he will experience nausea, vomiting and fever. Pericarditis is accompanied by swelling and pain, not necessarily in the chest area, pain is often felt in the abdominal area.

A heart defect is diagnosed already during the initial examination by a doctor, when the doctor hears heart sounds using a stethoscope. To clarify the type of anomaly, the following is used:

• echocardiography showing the condition of the internal heart structure;

• phonocardiography, which records the “sound” of a child’s “motor”;

• a general analysis of urine and blood, showing the presence/absence of inflammatory processes in the body.

Treatment of heart disease in children

Heart defects in children are not a death sentence, and timely detection of pathology allows you to develop the correct treatment tactics and restore cardiac function. However, you need to know that drug treatment for this disease is impossible; only heart surgery can help.

Drug therapy is aimed at combating the consequences of the disease. Doctors prescribe drugs that stimulate blood microcirculation, cardiotrophic drugs (to correct metabolism) and antibiotics (for bacterial lesions).

Therefore, do not try to recover with the help of folk remedies - they are powerless against this disease and can only do harm. And remember: emotional experiences and physical activity are harmful to a child with such a diagnosis. He should spend more time in the fresh air and have a scheduled appointment with a doctor every three months.

The child needs to be provided with proper nutrition, enriching the diet with magnesium, potassium, manganese and calcium. Their dose in the menu can be increased by adding apples, prunes, dried apricots, buckwheat, pearl barley and oatmeal and baked potatoes. You will have to limit your intake of fiber, as well as sodium, which is rich in pickles, marinades, salty fish and canned fish. The number of meals will have to be increased to 6 times a day, and the portions will have to be reduced accordingly.

The child should have proper rest and sleep at night. These measures reduce the load on the cardiovascular system and minimize the negative consequences of pathology.

Experts will tell you in this video how to treat heart disease in children and when it is optimal to perform surgery:

From the very beginning of pregnancy, future parents are constantly haunted by the thought: “If only the child was born healthy!” Indeed, there is hardly anything that can worry and frighten more than childhood illnesses. And when it comes to such a terrible diagnosis as congenital heart disease in children, many fall into despair.

In fact, you shouldn’t give up: with timely diagnosis and proper treatment, it is quite possible to save a child from a serious illness.

The phrase “congenital heart defect” in itself is terrifying, and the mysterious abbreviations that the doctor writes in the child’s card can in this case drive parents to panic. However, you should calm down and find out which disorders are characterized by the letter combination of congenital heart disease.

The heart is one of the most important human organs, and its task is to ensure proper blood flow and, as a result, saturate the entire body with vital oxygen and nutrients. Due to the contraction of the heart muscles, venous blood saturated with carbon dioxide enters the lower chambers of the heart - the atria. Passing into the ventricles - the upper chambers of the heart, the blood is again enriched with oxygen and sent to the main arteries, through which it is delivered to the organs and tissues, giving them all the useful substances and taking away carbon dioxide and metabolic products. The blood then passes through the veins and enters the atrium again. The passage of blood from the chambers and its uniform and timely release into the arteries is regulated by muscle valves.

Blood circulation in the body occurs in two directions. The systemic circulation originates in the left atrium and ends in the right ventricle. This vascular pathway maintains the vital functions of all tissues and organs. However, the heart constantly needs oxygen, so the pulmonary circulation connects it only with the lungs, starting from the right atrium, passing through the pulmonary arteries and returning to the left ventricle.

It is obvious that the heart and blood vessels are a clear, impeccably streamlined system, where unimportant details simply do not exist. The slightest error in the functioning of any of the components of the organ can cause disturbances in the body as a whole, and in particularly serious cases, even lead to death. Therefore, improperly functioning heart chambers, untimely opening valves or damaged large vessels are classified as heart defects.

According to statistics, for every thousand healthy babies there are 6-8 children with heart pathologies. Congenital heart disease in newborns is the second most common disease of the cardiovascular system.

Most often, the occurrence of pathologies of the heart and blood vessels is caused by the following reasons.

1. Infectious diseases in early pregnancy. Such diseases are especially dangerous in the first trimester, between 3 and 8 weeks of pregnancy, when the baby’s heart and blood vessels are forming. The most insidious disease is rubella, which causes severe damage to the fetus.
2. Age and health status of the mother. With age, the body's defenses gradually weaken, and during pregnancy, the endocrine and immune systems are rebuilt in such a way as to maximally support the woman's health, even to the detriment of the unborn child. Therefore, the older future mom and, the more chronic diseases she has, the higher the risk of improper formation of the baby’s cardiovascular system.
3. Failure to maintain a healthy lifestyle during pregnancy - smoking, drug use, alcoholic beverages, uncontrolled use of medications or working in hazardous industries - negatively affects the body, and primarily the functioning of the heart.
4. Heredity. Unfortunately, the tendency to heart pathologies can be transmitted at the genetic level. And if among your maternal or paternal relatives someone has been diagnosed with a congenital heart defect, then the pregnancy must be monitored very closely, since the risk of the disease is extremely high.

No one can give a 100% guarantee that a child will not develop a heart defect. However, the expectant mother is able to minimize this risk. Proper nutrition, giving up bad habits, strengthening the immune system and carefully planning pregnancy will ensure the normal development and proper formation of all organs of the unborn baby.

How does pathology manifest itself?

Often, after identifying a child’s heart pathologies, parents are frightened not so much by the diagnosis itself as by the lack of necessary information. The formulations used by doctors often not only fail to clarify the situation, but also create even more fear. Therefore, it is important to roughly understand what is meant by a particular diagnosis.

In total, about one hundred types of congenital heart defects are classified, but the following pathologies are the most common.

1. Hypoplasia is insufficient development of one of the ventricles. With this disorder, only part of the heart works effectively. It does not occur too often, but is one of the most serious defects.
2. Transposition of the great vessels (TMS) is an extremely severe heart defect, which is characterized by a mirror arrangement of the arteries. In this case, the process of enriching the blood with oxygen is disrupted.
3. Obstruction defects. Associated with improper formation of openings in blood vessels. Most often, in children with heart disease, stenosis (abnormal narrowing of blood vessels or heart valves) and atresia (partial closure of the lumen of blood vessels) are determined. Particularly dangerous is coarctation of the aorta, a narrowing of the largest blood vessel in the body.
4. Atrial septal defect (ASD) is a violation of the development of tissue between the chambers of the heart, as a result of which blood moves from one atrium to another, and the stability of blood circulation is disrupted.
5. Ventricular septal defect (VSD) is the most common heart defect. It is characterized by underdevelopment of the tissue wall between the right and left ventricles, which leads to incorrect blood circulation.

Often heart defects are combined with each other, so when making a diagnosis it is necessary to indicate all lesions of the heart and blood vessels. Hence the possible numerous abbreviations in children's cards, which frighten parents so much.

Circulatory disorders primarily affect the color of the skin. Based on this, heart defects are divided into two groups: pale and blue.

Pale or white defects are abnormal narrowing of blood vessels, defects in the septa between the chambers of the heart. Arterial and venous blood do not mix. Children with such pathologies have unhealthy pale skin. Blue heart defects include transposition of the great vessels and tetralogy of Fallot (complex heart defect with vasoconstriction, septal defect and underdevelopment of one of the ventricles). With such disorders, the autonomy of all cardiac chambers is impaired, as a result of which arterial and venous blood is mixed. Because of this, the skin acquires a bluish or grayish tint, which is especially noticeable on the skin of the extremities and in the area of ​​the nasolabial triangle.

In addition to an unhealthy skin tone, the following symptoms of congenital heart disease in newborns are noted:

• severe shortness of breath;
• cardiopalmus;
• fast fatiguability;
• poor appetite, slow weight gain, frequent regurgitation;
• heart murmurs when listening with a stethoscope.

Each of these symptoms separately does not indicate the presence of a heart defect. However, the presence of more than two unfavorable signs requires immediate contact with specialists, since any heart defect leads to serious complications. If mild disturbances in the functioning of the heart and blood vessels can lead to slow development of the child, frequent fainting and dizziness, decreased immunity, then more severe ones at any time can lead to acute heart failure and death. Therefore, if there is a suspicion that there is something wrong with the child’s heart, you should not wait: in this case, every second counts, and the examination must be carried out as soon as possible. Heart disease is especially dangerous because it may not manifest itself in any way in the first year of life. That is why ultrasound of the heart at the age of 6-9 months is included in the list of mandatory examinations for children in the first year of life.

Treatment of congenital heart disease in children

The choice of treatment for congenital heart disease in newborns depends on the results of the examination. Diagnosis of cardiac dysfunction includes the following procedures:

• electrocardiogram - detection of heart rhythm disturbances;
• radiography of the heart - study of vascular patency;
• ultrasound examination - identifying abnormalities in the structure of the heart;
• echocardiogram - study of the functioning of the heart;
• Doppler - study of blood flow characteristics.

If a child is ultimately diagnosed with a heart defect, the question of surgical intervention is raised. However, the decision about surgery can only be made by specialists - a cardiologist and a cardiac surgeon, so contacting them in a short time can save the baby’s life.

In some cases, surgery may be delayed. If the blood supply to the tissues and lungs is slightly impaired and no serious threat to the child’s life has been identified at the moment, the operation is performed at an older age, when the patient is stronger. It happens that surgical intervention remains in question for a long time: sometimes the pathology corrects itself. This especially often concerns the so-called oval window - an additional duct that does not close at birth for some reason. Such cases require regular monitoring by a cardiologist. However, in no case should you hope that everything will go away on its own - constant consultations with a doctor and strict adherence to all his recommendations are vital.

For severe heart defects, operations can be performed as early as infancy. The type of intervention depends on the type of pathology. This may include ligation or intersection of the vessel (with an open ductus arteriosus), patching and plastic surgery of the tissues of the septum between the heart chambers, catheterization to dilate narrowed vessels, removal of a section of the aorta, movement of vessels (with transposition), transplantation of heart valves and installation of a homograft (vascular prosthesis). ). In complex cases, more than one operation may be required with an interval of several months to a year.

When treating heart disease, the postoperative period is no less important than the operation itself. The child is prescribed painkillers and drugs to improve cardiac function, as well as all necessary procedures. Regardless of age, a small patient will need careful care and strict adherence to all medical instructions before and after surgery.

It is necessary to take care of the health of the unborn baby even before pregnancy. Correct lifestyle and exclusion of influences dangerous for expectant mothers environment will increase the chances of having a healthy baby. However, it is unfortunately impossible to completely insure yourself against diseases.

Modern diagnostic methods have come a long way. Therefore, it is possible to identify disturbances in the formation of the cardiovascular system even before the birth of the child. Already at the beginning of the second trimester, it is possible to determine the presence or absence of cardiac pathologies based on the results of an ultrasound examination. Regularly undergoing all necessary examinations will help identify abnormalities in the baby’s development as early as possible.

If an ultrasound does not reveal any pathologies, this is not a reason to lose vigilance, because signs of improper heart function may appear later. Even if nothing bothers the child, doctors recommend doing an ultrasound of the heart in infancy, when the baby can sit up confidently.

If a heart defect has been identified, there is no reason to panic: you need to undergo all the necessary examinations and contact specialists as soon as possible. In no case should you rely on chance: congenital heart disease is an insidious and unpredictable disease.

The appearance of a baby in a family is always happiness. But the joy of parents fades away sharply when they hear a diagnosis such as heart disease. Unfortunately, recently heart defects in children are quite common. This disease is associated with impaired development of the heart and large vessels in children, which leads to changes in blood flow, overload and insufficiency of the myocardium. Heart disease in children is congenital. According to statistics, from 5 to 8 children out of a thousand have this cardiovascular disease. All types of congenital pathologies are diverse in their anatomical features and severity. Many of them are found in various combinations. With forms incompatible with life, children do not live to see a year. After the first year of life, mortality decreases, and in the period from 1 to 15 years, about 5% of sick children die from heart defects. As you can see, this disease is very serious, requiring a special approach and comprehensive treatment.

Symptoms of heart disease

Some types of birth defects are diagnosed and successfully treated in the early stages, while others remain asymptomatic for several months or even years. After three years, the following deviations can be noticed in sick children:

• poor appetite
• liver enlargement
• rapid breathing
• frequent colds
• heart rhythm disorder
• difficulty performing physical activity

Older children may also complain of pain in the chest area or under the shoulder blade, dizziness and headaches. Symptoms of heart disease in newborns may vary depending on the specific abnormality, but common to all are heart failure and insufficient supply of nutrients and oxygen to tissues and organs.

According to the characteristics of blood discharge, congenital heart defects are blue and white. As a rule, a decrease in oxygen concentration in arterial blood occurs with the birth of a baby. Due to metabolic disorders, toxic metabolic products accumulate in the blood. This phenomenon is based on the mixing of arterial and venous blood inside the heart. These are blue defects, in which the child experiences cyanosis of the skin, ears, lips, and rapid breathing.

White defects are characterized by the discharge of venous blood from left to right. With white defects, babies experience pale skin and cold extremities. Having a defect in the form of a heart defect, the child quickly gets tired during feeding and sucks poorly at the breast. The pediatrician may hear a heart murmur and look for slow weight gain. However, heart murmurs may not always indicate the presence of a disease. Therefore, if a heart defect is suspected in newborns, consultation with a cardiologist is necessary.

To date, it is not possible to determine the cause of congenital heart defects in children. This vital organ is laid down and formed from the 2nd to the 8th week of pregnancy, that is, during a period when a woman often does not yet know about motherhood. Therefore, it is very important at this time to avoid the influence of harmful factors that can lead to the development of defects. Highest value among them are the following:

• bad habits of the mother (smoking, drug use)
• the effect of certain medications (antibiotics, hormonal pills)
• heredity
• gene and chromosomal mutations
• chronic diseases of women ( diabetes, endocrine diseases)
• infectious diseases that a woman suffered during pregnancy (rubella, herpes, influenza)
• excessive exposure, radiation
• harmful working conditions
• woman's age (over 35 years old)

Remember, the earlier heart defects are detected in newborns, the greater the hope for its timely and successful treatment.

Treatment of heart disease

Congenital heart defects in children are treatable in 90% of cases. Today, thanks to modern medicine, this disease can be successfully cured. Like any other disease, heart disease is easier to treat if it is detected at an early stage. Therefore, as soon as you notice unusual changes in the baby’s behavior and condition, contact a specialist. Additional examination will be prescribed if the doctor confirms that the symptoms may be signs of heart disease. Heart defects can be diagnosed from birth in the first 3 months of a child’s life using the following methods:

1) electrocardiography - this ultrasound method helps determine how the heart works, its structure, and also checks the function of the valves,

2) cardiac catheterization - this method allows you to determine any defects, their size, location and severity,

3) echocardiography is a very accurate diagnostic method that allows you to assess the structural features and contractility of the myocardium.

Congenital heart disease in children can be diagnosed in utero. As a rule, this can be done starting from the 14th week of pregnancy, when the woman undergoes an ultrasound. At the slightest suspicion of a heart defect in the fetus, as well as if the woman is at risk, she is sent to a specialized institution. If congenital heart disease is detected in the fetus, the birth will take place under the supervision of specialists in a specialized hospital, where the child will subsequently be operated on.

Children with mild heart defects need to be monitored by a cardiologist and undergo regular examinations. Over time, their heart may heal on its own. If a newborn has a heart defect, it is necessary to spend time with him in the fresh air more often, and protect him from infections and stress. Treatment of heart disease depends on the degree of its complexity. Severe defects require surgical intervention in the first days of the baby’s life. Sometimes operations are carried out in several stages: initially, the child’s condition is alleviated, and then they are prepared for surgery to completely eliminate the defects.

Surgery for heart defects can be open or closed. During closed surgery, the heart is not affected, and the operation is performed on the large blood vessels around it. In open operations, the heart cavity is opened. During the operation, the heart and lungs are turned off from the blood circulation. And the blood is enriched with oxygen and pumped throughout the body using a heart-lung machine. After surgery, children need a high-calorie diet and intensive care.

If your child is diagnosed with a heart defect, do not panic - modern medical technologies make it possible to treat all types of defects and give positive results.

Heart disease is a congenital or acquired anomaly of the structures of the cardiovascular system, which leads to the development of disorders of the systemic (in the whole body) blood flow. Most often, this pathology is congenital and is diagnosed in utero or immediately after the birth of a child, less often - at an older age. The main signs are bluish or pale skin, shortness of breath, swelling, and retarded physical development. Timely treatment of heart disease in children in most cases allows not only to avoid disability and ensure a high quality of life, but also to save life.

Congenital heart pathology is usually diagnosed in the first few days of a newborn’s life. However, there are cases when it goes unnoticed and is revealed only years later. Acquired defects are now relatively rare. This is due to the widespread introduction of antibacterial agents and effective treatment of streptococcal infections.

Types of anomalies

A wide range of different heart defects are diagnosed in children. It is very important to determine exactly what kind of anomaly the patient has, because the prognosis and effectiveness of treatment in the future depends on this. The following main types are distinguished.

• Pale type defects. These are defects of the interventricular or interatrial septum, which are characterized by an increase in blood flow in the lungs with the development of pulmonary pathology and global circulatory disorders.
• Blue type defects. They are characterized by reduced blood oxygen saturation, which leads to hypoxia and cyanosis of the skin.
• Narrowing of the lumen of the main vessels. Pathology that creates an obstacle to the exit of blood from the ventricles.

Congenital

The following congenital anomalies are most often diagnosed.

• Ventricular septal defect. This is the most common congenital heart defect in newborns. If the “window” is small, expectant therapy is often recommended, since in almost half of children with this pathology, spontaneous closure of the defect occurs during the first year of life. If there is a large hole, then surgery is recommended.
• Atrial septal defect. It is an opening in the wall between the right and left atria. This defect does not close on its own, so surgery is necessary.
• Atresia (absence) of the pulmonary artery. With this anomaly, blood from the right ventricle cannot flow into the pulmonary vessels. The pathology leads to a lack of oxygen saturation of red blood cells in the lungs. This type of defect leads to the death of the child within a few days, and therefore requires urgent surgical intervention.
• Pulmonary valve stenosis. Associated with an abnormality of the valve leaflets at the exit of the right ventricle. In this case, the valve does not open enough, which leads to overload of the heart muscle. Without surgery, the child may die within the first three to four weeks of life.
• Tetralogy of Fallot. This is one of the most severe and complex heart defects. It is characterized by the presence of four different abnormalities diagnosed simultaneously. This is a “window” between the ventricles, narrowing of the pulmonary artery, abnormal position of the aorta and hypertrophy of the muscles of the right ventricle. The development of an infant with such a heart defect is slow, and there is a slow, unexpressed cyanosis.
• Transposition of cardiac vessels. A very serious and life-threatening defect when the ventricles from which large vessels emerge are “confused.” As a result, oxygen does not reach the tissues at all, which without medical intervention leads to death.

Purchased

The most common acquired defects are:

• bicuspid valve insufficiency;
• mitral stenosis;
• aortic stenosis;
• aortic valve defect.

The clinical picture of acquired defects is combined with symptoms of rheumatism. As with congenital anomalies, lack of timely treatment can lead to increased blood pressure in the lungs or the development of heart failure.

Why is it developing?

In the first months of its intrauterine existence, the child goes through a number of stages in the development of organs and systems. Violation of any of them leads to abnormal formation of anatomical structures. It is still unknown exactly why such a failure in development occurs. In 80% of cases, the etiology (cause) of a congenital heart defect cannot be established.

It is believed that the following factors can cause white and blue heart defects in newborns:

• genetic defects;
• viral infections;
• metabolic diseases and diabetes mellitus in the mother;
• the presence of bad habits in the mother (alcohol abuse);
• taking medications.

Certain groups of drugs and some viruses have been proven to have a harmful effect on the fetus. Pharmaceutical drugs that can provoke heart defects include a group of antiepileptic drugs that increase the risk of congenital anomalies by one and a half times. The role of rubella viruses, herpes and cytomegalovirus has also been proven. Infection is especially dangerous in the first trimester of pregnancy.

Acquired heart disease in a child usually develops after suffering an acute rheumatic attack, septic complications, or, less commonly, chest trauma.

What is the danger

Depending on the type of defect (pale or blue), various disturbances in blood flow occur, as a result of which either it is not saturated with oxygen or it does not flow in sufficient quantities to the organs. The presence of an abnormality in the structure of the heart leads to the development of a number of compensation mechanisms, which subsequently cause gross changes in the tissues. Significant heart defects can lead to the most tragic consequences – the death of a child.

Symptoms of heart disease in children

If there is a heart defect, it is very important to identify it in a timely manner, because the prognosis for the health and life of the child largely depends on this. The main signs of heart disease in children are as follows:

• breathing problems (frequent, with increased inhalation);
• cyanosis of the skin, lips, nail plates;
• the appearance of shortness of breath or bluishness of the face during feeding;
• increased heart rate;
• swelling in the legs and abdomen;
• rapid fatigue of the child, shortness of breath;
• developmental delay.

Symptoms of heart disease in children can have varying severity and appear both immediately after birth and at different periods of life. In addition, minor defects sometimes do not manifest themselves with any external signs at all or are characterized only by psychological characteristics (psychological maladjustment, emotional instability, increased anxiety).

The presence of any symptoms indicating a heart defect should prompt parents to consult a cardiologist and undergo an examination. You should not use various folk remedies on the advice of friends. They are ineffective and will not help cure heart disease. The sooner cardiac pathology is identified and its treatment is started, the better the prognosis.

Diagnostics

Activities aimed at identifying a congenital defect consist of three stages.

1. Prenatal diagnosis.
2. Initial examination by a neonatologist, then observation by a pediatrician.
3. Specialized cardiac examination.

Acquired heart defects are diagnosed based on physical examination data, a clinical history of rheumatism, and ultrasound results.

Prenatal

Such diagnostics make it possible to diagnose many heart defects even before the birth of the child. Modern ultrasound machines detect cardiac pathology in utero starting from the 16th week of a child’s development. However, a period of 20-22 weeks is considered optimal.

Even the detection of very severe anomalies does not mean that we will talk about terminating the pregnancy. Rather, the newborn will need special care and appropriate treatment.

Pediatrician examination

Often the reason for conducting a specialized diagnosis of heart disease is the identification of pathological heart murmurs in a child, which are heard by the pediatrician during the initial examination. A heart defect is indicated by a rough scraping noise that does not change its character with changes in body position, and splitting of heart sounds.

However, it should be remembered that in 33% of newborns, heart murmurs can be heard and then disappear (up to six months of age). This is not a pathology and is associated with an adaptive mechanism aimed at adapting the newborn to new conditions of existence outside the mother’s body. If after six months the heart murmur persists, a heart defect should be suspected.

To clarify the cause of the heart murmur, echocardioscopy (ultrasound method) is sufficient. If a pathology is detected, further examination is carried out in specialized centers.

Cardiological

The scope of diagnosis of heart disease in children is determined, first of all, by the severity of clinical symptoms and the expected diagnosis. The following methods are the most informative.

• Echocardioscopy (ultrasound of the heart). This method provides very accurate information about the size of all four chambers of the heart, the condition of the valve apparatus, and the characteristics of heart contractions. During the examination, the speed of blood flow and its direction are also determined, and areas of turbulence are identified. The procedure is completely painless, however, it is necessary to calm the child and ensure his immobility.
• Electrocardiography (ECG). The method makes it possible to detect arrhythmias, conduction disturbances, and changes in the electrical axis of the heart. However, this examination is less informative than ultrasound.
• Holter monitoring. It consists of conducting continuous electrocardiography throughout the day. Using this method, explosive rhythm disturbances are diagnosed.
• X-ray of the heart and lungs. Helps determine the size of the heart and its shape, pathological changes in the lungs.
• Cardiac catheterization. This is an invasive examination method, it is performed only in large specialized centers and is used for severe heart defects. During the procedure, a catheter is inserted through a peripheral vein and advanced toward the heart. The technique helps to study the pressure difference and blood oxygen concentration in the chambers of the heart.
• Computed and magnetic resonance imaging. Modern tomographs provide the opportunity to obtain very clear images of the structures of the beating heart. Using special computer add-ons, three-dimensional images are obtained, which is necessary before surgery.

How are defects acquired in the womb treated?

Treatment of congenital heart defects is most often surgical. According to clinical recommendations, the urgency of the operation, indications and contraindications are determined by the existing pathology, the condition of the child, and the severity of pulmonary hypertension.

Severe anomalies (pulmonary atresia, transposition of blood vessels) require surgery in the first few days after birth for health reasons. In the presence of milder defects, sometimes they adhere to a wait-and-see approach or postpone surgical treatment and carry it out after a year or more.

The following types of heart surgeries are currently used:

• radical – complete restoration of the normal anatomy of the heart is carried out;
• palliative – they allow only temporary improvement of hemodynamics;
• with separation of blood circulation circles - Without complete restoration of the anatomy of the heart, blood flows from the right and left ventricles are separated.

Also, technically, heart surgery can be closed or open. In the latter case, the blood circulation is turned off and the heart cavity is opened.

Small defects are operated on using intravascular surgical techniques, when a surgical incision is not even required. According to doctors, such interventions are well tolerated by children and do not require long-term rehabilitation. How to treat blue or pale heart disease in infants in this way will be advised at a specialized cardiac surgery center.

Rehabilitation

After surgical treatment, the child will need some time to rehabilitate, the duration of which depends on the complexity and technique of the intervention. At home, you should adhere to the following recommendations:

• proper nutrition and rest;
• fluid restriction;
• compliance with semi-bed rest;
• taking prescribed medications (cardiac glycosides, diuretics);
• physical therapy, massage, electrophoresis.

Therapy of acquired valve pathology

The therapeutic approach depends on the severity of clinical manifestations and the presence of complications. For compensated defects, medical examination, good nutrition, adherence to a regimen, and limitation of physical activity are recommended.

In severe cases of the defect, accompanied by heart failure, the addition of drugs (cardiac glycosides, cardioprotectors) is required. According to indications, surgery is performed.

Risks and prevention

To exclude cardiac pathology in the fetus, an ultrasound examination and a number of genetic tests are performed, the results of which can indirectly determine developmental defects.

There is no specific prevention of heart defects in young children. During pregnancy, the mother needs to give up bad habits and use medicines only if there is compelling evidence. From a psychosomatic point of view, it is recommended to avoid stress and negative emotions. For acquired defects, timely antibiotic therapy for streptococcal infections is indicated.

Thus, heart disease in a child is a rather complex pathology that requires careful attention on the part of parents and medical personnel. The best option is prenatal diagnosis, which makes it possible to identify developmental anomalies in the early stages of pregnancy. In addition, any symptoms in a newborn or infant that indicate a heart defect should be the basis for contacting a pediatric cardiologist and performing an echocardioscopy. Modern medicine in many cases makes it possible to effectively eliminate pathology and ensure the full development of the child.

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Congenital heart disease in newborns is the formation of various anatomical defects in the elements of the heart. Typically, such pathologies begin to develop in the prenatal period. In newborns, clinicians identify about 20 types of different defects.

For convenience, they were all divided into three groups:

• congenital heart defects in children of the “white type”. This group includes defects, as a result of the formation of which there is a reflux of blood from the arterial circulation into the venous one. These include aortic defects, patent ductus arteriosus, ventricular and atrial septal defects;
• “Blue type” congenital heart disease. A characteristic symptom of pathologies of this group is persistent cyanosis. It progresses due to the reflux of venous blood into the arterial bloodstream. Such congenital defects include tetralogy of Fallot, transposition of the great blood vessels, atresia of the aorta, pulmonary artery and venous ostium (right);
• CHD, in which there is the formation of an obstruction to normal blood flow, but this is not associated with an arteriovenous shunt. These include stenosis, coarctation, ectopia of the heart, hypertrophy of cardiac elements, etc.

Etiology

Heart defects in newborns can develop due to:

• various mutations at the gene level;
• unfavorable environmental situation in the area where the pregnant woman lives;
• the woman has a history of abortions, miscarriages, and stillborn children;
• the use of certain groups of pharmaceuticals during pregnancy. Antibiotics, antiviral and other drugs with strong effects pose a particular danger to the fetus;
• hereditary predisposition. The risk that a baby will develop a heart defect increases many times if the pregnant woman has close relatives with the same pathology;
• illnesses of an infectious nature that a woman suffered while carrying a child. Particularly dangerous include cytomegaly. The risk especially increases if these pathologies affect a woman in the early stages of pregnancy. The fact is that it is during this period that all organs are formed;
• age of the pregnant woman. Scientists have noticed a trend that the older a woman is, the higher the likelihood that she will have a child with a heart defect. Currently, the risk group includes representatives of the fair sex who have crossed the 35-year mark;
• strong x-ray training;
• consumption of large doses of alcoholic beverages by a woman while carrying a child. Recently, this reason has come to the fore in the development of heart defects. Alcohol has a detrimental effect not only on the mother’s body, but also on the body of her unborn baby.

Symptoms

Symptoms indicating a heart defect in newborns directly depend on the type of defect, as well as on the severity of the pathological process. Small-sized defects practically do not manifest themselves at all, which greatly complicates their timely diagnosis. But it is worth noting that even severe forms of anomalies can be completely asymptomatic, which often causes the death of a newborn in the first days of his life. It is possible to save the life of a baby with severe defects that prevent the heart from functioning normally only through surgical intervention. Conservative therapy is out of the question.

The main signs that may indicate the presence of abnormalities in the baby’s cardiovascular system:

• increased respiratory movements per minute;
• the formation of edema (especially in the legs);
• weakness;
• lethargy;
• the child sucks weakly at the breast and may even refuse it completely;
• expressed;
• frequent regurgitation;
• cyanosis. It is especially pronounced on the limbs and in the area of ​​the nasolabial triangle;
• heart murmurs. They can only be identified by a qualified doctor during auscultation.

Degrees

The degree of the disease is determined depending on the severity of the symptoms. In total, clinicians distinguish 4 of them:

Grade 1 – the baby’s condition is relatively stable. Cardiac activity is within normal limits. Typically, no specific treatment is required at this stage;

Stage 2 – symptoms gradually increase. Problems arise with feeding the child, and respiratory function is also impaired;

3rd degree - the clinic is supplemented by neurological manifestations, since the brain is not sufficiently supplied with blood;

4th degree – terminal. If it progresses, the patient experiences depression of respiratory and cardiac activity. It usually ends in death.

Diagnostics

Today, the most informative method that makes it possible to identify the presence of anomalies in the structure of the heart is ECHO cardiography. This method gives the doctor the opportunity to assess the condition of all elements of the heart - chambers, septa, valves, holes. Doctors also often resort to Doppler ultrasound. The method makes it possible to obtain information about the intensity of blood flow and its turbulence.

Additional diagnostic methods:

• radiography;

Therapeutic measures

For heart defects, the only correct method of treatment is surgical intervention. Medication can only dull the severity of symptoms. Now they resort to two types of operations: open and minimally invasive.

Minimally invasive surgeries are more suitable for correcting abnormalities of the septa between the atria and ventricles. The X-ray endovascular method allows the surgeon to install an occluder that will close the formed defect.

Open surgical intervention is performed in case of detection of severe combined defects. During the operation, the sternum is opened. Thus, the doctor has direct access to the patient's heart. These interventions, although traumatic, are very effective.

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Diseases with similar symptoms:

Heart defects are anomalies and deformations of individual functional parts of the heart: valves, septa, openings between vessels and chambers. Due to their improper functioning, blood circulation is disrupted, and the heart ceases to fully perform its main function - supplying oxygen to all organs and tissues.

A disease that is characterized by the formation of pulmonary insufficiency, presented in the form of a massive release of transudate from the capillaries into the pulmonary cavity and ultimately promoting infiltration of the alveoli, is called pulmonary edema. Speaking in simple words, pulmonary edema is a situation where fluid stagnates in the lungs and has leaked through the blood vessels. The disease is characterized as an independent symptom and can develop on the basis of other serious ailments of the body.