A child with a heart defect is overheated. Heart disease in newborns: characteristics, causes, symptoms and treatment

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, the child, for certain reasons, which we will talk about a little later, develops defects in the valve apparatus, blood vessels or septa of the heart, 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 porridge and baked potatoes. You will have to limit your intake of fiber, as well as sodium, which is rich in pickles, marinades, salted 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:

One of the most commonly diagnosed anomalies in the development of the cardiovascular system in children is considered to be congenital heart disease. Such an anatomical disorder of the structure of the heart muscle, which occurs during the period of intrauterine development of the fetus, threatens with serious consequences for the health and life of the child. Timely medical intervention can help avoid a tragic outcome due to congenital heart disease in children.

The task of parents is to navigate the etiology of the disease and know about its main manifestations. Due to the physiological characteristics of newborns, some heart pathologies are difficult to diagnose immediately after the baby is born. Therefore, you need to carefully monitor the health of a growing child and respond to any changes.

Classification of congenital heart defects in children

Congenital heart disease provokes disruption of blood flow through the vessels or in the heart muscle.

The earlier a congenital heart defect is detected, the more favorable the prognosis and outcome of treatment of the disease.

Depending on the external manifestations of the pathology, the following types of congenital heart disease are distinguished:

"White" (or "pale") defects

Such defects are difficult to diagnose due to the lack of obvious symptoms. A characteristic change is the pallor of the child’s skin. This may indicate that insufficient arterial blood is reaching the tissues.

"Blue" vices

The main manifestation of this category of pathology is blue discoloration of the skin, especially noticeable in the area of the ears, lips and fingers. Such changes are caused by tissue hypoxia, provoked by the mixing of arterial and venous blood.

The group of “blue” defects includes transposition of the aorta and pulmonary artery, Ebstein’s anomaly (displaced place of attachment of the tricuspid valve leaflets to the cavity of the right ventricle), tetralogy of Fallot (the so-called “cyanotic disease”, a combined defect combining four pathologies - stenosis of the outflow tract of the right ventricle , dextraposition of the aorta, high and hypertrophy of the right ventricle).

Considering the nature of circulatory disorders, congenital heart defects in children are classified into the following types:

Message with blood discharge from left to right (patent ductus arteriosus, ventricular or atrial septal defect).
Message with blood discharge from right to left (tricuspid valve atresia).
Heart defects without shunting (stenosis or coarctation of the aorta, pulmonary stenosis).

Depending on the complexity of the violation of the anatomy of the heart muscle, the following congenital heart defects in childhood are distinguished:

simple defects (single defects);
complex (a combination of two pathological changes, for example, narrowing of the cardiac orifices and valvular insufficiency);
combined defects (combinations of multiple anomalies difficult to treat).

Causes of pathology

Impaired differentiation of the heart and the appearance of congenital heart disease in the fetus provokes the impact of unfavorable environmental factors on a woman during the period of bearing a child.

The main reasons that can cause cardiac abnormalities in children during their intrauterine development include:

genetic disorders (chromosome mutation);
smoking, consumption of alcohol, narcotic and toxic substances by a woman during pregnancy;
infectious diseases suffered during pregnancy (rubella and influenza virus, chickenpox, hepatitis, enterovirus, etc.);
unfavorable environmental conditions (increased background radiation, high levels of air pollution, etc.);
use of medications that are prohibited during pregnancy (as well as drugs whose influence and side effects have not been sufficiently studied);
hereditary factors;
somatic pathologies of the mother (primarily diabetes mellitus).

These are the main factors that provoke the occurrence of heart disease in children during their prenatal development. But there are also risk groups - these are children born to women over 35 years of age, as well as those suffering from endocrine dysfunction or toxicosis of the first trimester.

Symptoms of congenital heart disease

Already in the first hours of life, a child’s body can signal abnormalities in the development of the cardiovascular system. Arrhythmia, rapid heartbeat, difficulty breathing, loss of consciousness, weakness, bluish or pale skin indicate possible heart pathologies.

But symptoms of congenital heart disease may appear much later. Parents' concern and immediate seeking of medical help should cause the following changes in the child's health:

blueness or unhealthy pallor of the skin in the area of the nasolabial triangle, feet, fingers, ears and face;
difficulty feeding the child, poor appetite;
delay in weight and height gain in the baby;
swelling of the limbs;
increased fatigue and drowsiness;
fainting;
increased sweating;
shortness of breath (constant difficulty breathing or temporary attacks);
changes in heart rate independent of emotional and physical stress;
heart murmurs (determined by listening to a doctor);
pain in the heart, chest.

In some cases, heart defects in children are asymptomatic. This makes it difficult to identify the disease in its early stages.

Regular visits to the pediatrician will help prevent the worsening of the disease and the development of complications. During each routine examination, the doctor must listen to the sound of the child’s heart sounds, checking for the presence or absence of murmurs - nonspecific changes that are often functional in nature and do not pose a threat to life. Up to 50% of murmurs detected during a pediatric examination may be accompanied by “minor” defects that do not require surgical intervention. In this case, regular visits, monitoring and consultations with a pediatric cardiologist are recommended.

If the doctor doubts the origin of such noises or observes pathological changes in sound, the child must be referred for a cardiac examination. The pediatric cardiologist listens to the heart again and prescribes additional diagnostic tests to confirm or refute the preliminary diagnosis.

Manifestations of the disease in varying degrees of complexity are found not only in newborns. Vices can make themselves felt for the first time already in adolescence. If a child who outwardly looks absolutely healthy and active, shows signs of developmental delay, has blue or painful pale skin, shortness of breath and fatigue even from light exertion, then an examination by a pediatrician and consultation with a cardiologist is necessary.

Diagnostic methods

To study the condition of the heart muscle and valves, as well as to identify circulatory abnormalities, doctors use the following methods:

Echocardiography is an ultrasound examination that allows one to obtain data on the pathologies of the heart and its internal hemodynamics.
Electrocardiogram – diagnosis of heart rhythm disturbances.
Phonocardiography is the display of heart sounds in the form of graphs, allowing you to study all the nuances that are not available when listening with the ear.
with Doppler - a technique that allows the doctor to visually assess blood flow processes, the condition of the heart valves and coronary vessels by attaching special sensors to the patient’s chest area.
Cardiorhythmography is a study of the characteristics of the structure and functions of the cardiovascular system, its autonomic regulation.
Cardiac catheterization - inserting a catheter into the right or left chambers of the heart to determine the pressure in the cavities. During this examination, ventriculography is also performed - an X-ray examination of the chambers of the heart with the introduction of contrast agents.

Each of these methods is not used by a doctor in isolation - to accurately diagnose the pathology, the results of different studies are compared to establish the main hemodynamic disorders.

Based on the data obtained, the cardiologist determines the anatomical variant of the anomaly, clarifies the phase of the course, and predicts the likely complications of the heart defect in the child.

If there were heart defects in the family of any of the future parents, the woman’s body was exposed to at least one of the dangerous factors during the period of bearing the child, or the unborn child is at risk of possible development of congenital heart disease, then the pregnant woman should warn the obstetrician-gynecologist observing her about this .

The doctor, taking into account such information, should pay special attention to the presence of signs of cardiac anomalies in the fetus and apply all possible measures to diagnose the disease in the prenatal period. The task of the expectant mother is to undergo ultrasound and other examinations prescribed by the doctor in a timely manner.

The best results with accurate data on the state of the cardiovascular system are provided by the latest equipment for diagnosing childhood heart defects.

Treatment of congenital heart disease in children

Congenital heart abnormalities in childhood are treated in two ways:

Surgical intervention.
Therapeutic procedures.

In most cases, the only possible chance to save a child’s life is the first radical method. The fetus is examined for the presence of pathologies of the cardiovascular system even before it is born, so most often the issue of prescribing an operation is decided during this period.

In this case, childbirth is carried out in specialized maternity wards operating at cardiac surgery hospitals. If the operation is not performed immediately after the birth of the child, surgical treatment is prescribed as soon as possible, preferably in the first year of life. Such measures are dictated by the need to protect the body from the development of possible life-threatening consequences of congenital heart disease - heart failure, etc.

Modern cardiac surgery involves open-heart surgery, as well as using catheterization techniques, supplemented by X-ray imaging and transesophageal echocardiography. Elimination of cardiac defects is effectively carried out using balloon plasty, endovascular treatment (methods of inserting walls and sealing instruments). In combination with surgery, the patient is prescribed medications that increase the effectiveness of treatment.

Therapeutic procedures are an auxiliary method of combating the disease and are used when it is possible or necessary to postpone the operation to a later date. Therapeutic treatment is often recommended for “pale” defects, if the disease does not develop rapidly over months and years and does not threaten the child’s life.

During adolescence, acquired heart defects in children can develop - a combination of corrected defects and newly emerging anomalies. Therefore, a child who has undergone surgical correction of pathology may later need repeated surgery. Such operations are most often performed using a gentle, minimally invasive method in order to eliminate the burden on the psyche and body of the child as a whole, and also to avoid scars.

When treating complex heart defects, doctors do not limit themselves to correctional methods. In order to stabilize the child’s condition, eliminate the threat to life and maximize its life expectancy for the patient, a number of step-by-step surgical interventions are required to ensure adequate blood supply to the body and the lungs in particular.

Timely detection and treatment of congenital and heart diseases in children allows the majority of young patients to develop fully, lead an active lifestyle, maintain a healthy state of the body and not feel disadvantaged morally or physically.

Even after successful surgery and the most favorable medical prognosis, the main task of parents is to ensure that the child has regular visits and examinations by a pediatric cardiologist.

Diapers

Swaddling

During the development of a baby in the mother's womb, sometimes the processes of growth and formation of tissues and organs are disrupted, which leads to the appearance of defects. One of the most dangerous are heart defects.

Heart defects are the second most common pathology in newborns.

What is a heart defect?

This is the name for pathologies in the structure of the heart and large vessels that extend from it. Heart defects interfere with normal blood circulation, are detected in one out of 100 newborns and, according to statistics, are in second place in congenital pathologies.

Forms

First of all, a distinction is made between a congenital defect with which a child is born, as well as an acquired defect that occurs as a result of autoimmune processes, infections and other diseases. In childhood, congenital defects are more common, which are divided into:

Pathologies in which blood is discharged to the right side. Such defects are called “white” because of the child’s pallor. With them, arterial blood enters the venous blood, often causing an increase in blood flow to the lungs and a decrease in blood volume in the systemic circle. Defects in this group are defects in the septa separating the cardiac chambers (atria or ventricles), the ductus arteriosus functioning after birth, coarctation of the aorta or narrowing of its bed, as well as pulmonary stenosis. With the latter pathology, blood flow into the vessels of the lungs, on the contrary, decreases.
Pathologies in which blood discharge occurs to the left. These defects are called “blue” because one of their symptoms is cyanosis. They are characterized by the entry of venous blood into arterial blood, which reduces the oxygen saturation of the blood in the systemic circle. With such defects, the small circle can be either depleted (with a triad or with tetralogy of Fallot, as well as with Ebstein’s anomaly) or enriched (with an incorrect location of the pulmonary arteries or aorta, as well as with the Eisenheimer complex).
Pathologies in which there are obstructions to blood flow. These include anomalies of the aortic, tricuspid or mitral valve, in which the number of their valves changes, their insufficiency occurs, or valve stenosis occurs. This group of defects also includes incorrect placement of the aortic arch. In such pathologies, there is no arterial-venous discharge.

Symptoms and signs

In most babies, heart defects that formed in utero manifest clinically even during the baby’s stay in the maternity hospital.

Among the most common symptoms are:
Increased heart rate.
Blue discoloration of the limbs and face in the area above the upper lip (called the nasolabial triangle).
Paleness of the palms, tip of the nose and feet, which will also be cool to the touch.
Bradycardia.
Frequent regurgitation.
Shortness of breath.
Weak breastfeeding.
Insufficient weight gain.
Fainting.
Edema.

Sweating.

Doctors have not yet identified the exact causes of these pathologies, but it is known that disorders of the development of the heart and blood vessels are provoked by the following factors:

Genetic predisposition.
Chromosomal diseases.
Chronic diseases in the expectant mother, for example, thyroid disease or diabetes.
The age of the expectant mother is more than 35 years.
Taking medications during pregnancy that have a negative effect on the fetus.
Unfavorable environmental situation.
Staying a pregnant woman in conditions of increased radioactive background.
Smoking in the first trimester.
Use of drugs or alcohol in the first 12 weeks after conception.
Poor obstetric history, for example, previous miscarriage or abortion, previous premature birth.
Viral diseases in the first months of pregnancy, especially rubella, herpes infection and influenza.

The most dangerous period for the formation of heart defects is the period from the third to the eighth weeks of pregnancy. It is during this period that the heart chambers, its septa, and great vessels are formed in the fetus.

The following video explains in more detail the causes that can lead to congenital heart defects.

Phases

In every child, the development of a heart defect goes through the following three phases:

The stage of adaptation, when the child’s body mobilizes all its reserves to compensate for the problem. If there are not enough of them, the child dies.
The stage of compensation, during which the child’s body works relatively stably.
The stage of decompensation, in which reserves are exhausted, and the baby develops heart failure.

Diagnostics

You can suspect the development of a congenital heart defect in a child during routine ultrasound examinations during pregnancy. Some pathologies become noticeable to the ultrasound doctor already from the 14th week of gestation. If obstetricians know about the defect, they develop special tactics for managing childbirth and decide with cardiac surgeons the issue of surgery on the child’s heart in advance.

In some cases, ultrasound during pregnancy does not show a heart defect, especially if it is associated with a pulmonary circulation that does not function in the fetus. Then it is possible to identify pathology in a newborn after examining and listening to the baby’s heart. The doctor will be alerted by pallor or cyanosis of the toddler's skin, changes in heart rate and other symptoms.

Treatment

In most cases, heart defects in a newborn require surgical treatment. Surgery is performed for children with heart defects depending on the clinical manifestations and severity of the pathology. Some children are indicated for immediate surgical treatment immediately after the defect is discovered, while others undergo intervention during the second phase, when the body has compensated for its strength and will more easily endure the operation.

If the defect causes decompensation, surgical treatment is not indicated, since it will not be able to eliminate the irreversible changes that have appeared in the child’s internal organs.

Most often, a heart defect in a newborn can only be corrected through surgery.

After clarification of the diagnosis, all children with congenital defects are divided into 4 groups:

Babies who do not require urgent surgery. Their treatment is delayed for several months or even years, and if the dynamics are positive, surgical treatment may not be required at all.
Infants who should be operated on in the first 6 months of life.
Babies who need to be operated on in the first 14 days of life.
Babies who are sent to the operating table immediately after birth.

The operation itself can be performed in two ways:

Endovascular. Small punctures are made to the child and through large vessels they are approached to the heart, monitoring the entire process using X-rays or ultrasound. In case of septal defects, the probe brings an occluder to them, closing the hole. If the ductus arteriosus is not closed, a special clip is placed on it. If the child has valve stenosis, balloon repair is performed.
Open. The chest is cut open and the baby is connected to artificial circulation.

Before and after surgical treatment, children with the defect are prescribed medications of different groups, for example, cardiotonics, blockers and antiarrhythmic drugs. For some defects, the child does not require surgery or drug therapy. For example, this situation is observed with a bicuspid aortic valve.

Consequences

In most cases, if time is missed and surgery is not performed on time, the child’s risk of various complications increases.

One of the most dangerous complications following a congenital defect and after heart surgery is endocarditis, which is caused by bacteria entering the heart. They affect not only the inner lining of the organ and its valves, but also the liver, spleen and kidneys. To prevent this situation, children are prescribed antibiotics, especially if surgical intervention is planned (treatment of a fracture, tooth extraction, adenoid surgery, etc.).

Undoubtedly, all developmental defects must be diagnosed in the fetus in utero. An important role is also played by the pediatrician, who will be able to promptly identify and refer such a child to a pediatric cardiologist.

If you are faced with this pathology, then let’s look at the essence of the problem, and also tell you the details of the treatment of children’s heart defects.

Congenital and acquired heart defects occupy the second position among all developmental defects.

Congenital heart disease in newborns and its causes

Organs begin to form in the 4th week of pregnancy.

There are many reasons for the appearance of congenital heart disease in a fetus. It is impossible to single out just one.

Classification of defects

1. All congenital heart defects in children are divided according to the nature of the blood flow disturbance and the presence or absence of cyanosis of the skin (cyanosis).

Cyanosis is a blue discoloration of the skin. It is caused by a lack of oxygen, which is delivered with the blood to organs and systems.

Personal experience! In my practice, there were two children with dextracardia (the heart is located on the right). Such children live normal healthy lives. The defect is detected only by listening to the heart.

2. Frequency of occurrence.

Ventricular septal defect occurs in 20% of all heart defects.
Atrial septal defect accounts for 5 - 10%.
Patent ductus arteriosus accounts for 5 - 10%.
Pulmonary stenosis, stenosis and coarctation of the aorta account for up to 7%.
The remaining part is accounted for by other numerous, but rarer defects.

Symptoms of heart defects in newborns

In newborns we evaluate the act of sucking.

You need to pay attention to:

If a baby has a heart defect, he sucks sluggishly, weakly, with breaks of 2 - 3 minutes, shortness of breath appears.

Symptoms of heart disease in children older than one year

If we talk about older children, here we evaluate their physical activity:

Can they climb the stairs to the 4th floor without shortness of breath? Do they sit down to rest during games?
whether respiratory diseases, including pneumonia and bronchitis, are common.

With defects with depletion of the pulmonary circulation, pneumonia and bronchitis are more common.

Clinical case! In a woman at 22 weeks, an ultrasound of the fetal heart revealed a ventricular septal defect and hypoplasia of the left atrium. This is a rather complex vice. After the birth of such babies, they are immediately operated on. But the survival rate, unfortunately, is 0%. After all, heart defects associated with underdevelopment of one of the chambers in the fetus are difficult to treat surgically and have a low survival rate.

Komarovsky E. O.: “Always watch your child. A pediatrician may not always notice changes in health status. The main criteria for a child’s health are: how he eats, how he moves, how he sleeps.”

The heart has two ventricles, which are separated by a septum. In turn, the septum has a muscular part and a membranous part.

The muscular part consists of 3 areas - inflow, trabecular and outflow. This knowledge of anatomy helps the doctor make an accurate diagnosis according to the classification and decide on further treatment tactics.

Symptoms

If the defect is small, then there are no special complaints.

If the defect is medium or large, then the following symptoms appear:

retardation in physical development;
decreased resistance to physical activity;
frequent colds;
in the absence of treatment - development of circulatory failure.

Defects in the muscle part close on their own due to the child’s growth. But this is subject to small sizes. Also, in such children it is necessary to remember about lifelong prevention of endocarditis.

For large defects and the development of heart failure, surgical measures should be performed.

Atrial septal defect

Very often the defect is an accidental discovery.

Children with atrial septal defect are prone to frequent respiratory infections.

With large defects (more than 1 cm), the child may experience poor weight gain and the development of heart failure from birth. Children undergo surgery when they reach five years of age. The delay in surgery is due to the likelihood of spontaneous closure of the defect.

Open duct of Botall

This problem accompanies premature babies in 50% of cases.

The ductus botallus is a vessel that connects the pulmonary artery and the aorta in the fetal life of the baby. After birth it tightens.

If the size of the defect is large, the following symptoms are detected:

We wait up to 6 months for spontaneous closure of the duct. If in a child older than one year it remains unclosed, then the duct must be removed surgically.

When diagnosed in the maternity hospital, premature babies are given the drug indomethacin, which scleroses (glues) the walls of the vessel. This procedure is not effective for full-term newborns.

Coarctation of the aorta

This congenital pathology is associated with a narrowing of the main artery of the body - the aorta. In this case, a certain obstacle to blood flow is created, which forms a specific clinical picture.

Happening! A 13-year-old girl complained about a promotion. When measuring pressure on the legs with a tonometer, it was significantly lower than on the arms. The pulse in the arteries of the lower extremities was barely palpable. Cardiac ultrasound revealed coarctation of the aorta. For 13 years, the child has never been examined for congenital defects.

Usually, narrowing of the aorta is detected at birth, but may occur later. Such children even have their own peculiarity in appearance. Due to poor blood supply to the lower part of the body, they have a fairly developed shoulder girdle and puny legs.

It occurs more often in boys. As a rule, coarctation of the aorta is accompanied by a defect in the interventricular septum.

Normally, the aortic valve should have three cusps, but it so happens that there are two of them from birth.

Children with a bicuspid aortic valve do not particularly complain. The problem may be that such a valve will wear out faster, which will cause the development of aortic insufficiency.

When grade 3 insufficiency develops, surgical valve replacement is required, but this can happen by the age of 40-50.

Children with a bicuspid aortic valve should be monitored twice a year and endocarditis should be prevented.

Sports heart

Regular physical activity leads to changes in the cardiovascular system, which are referred to as “athletic heart.”

An athletic heart is characterized by an increase in the cavities of the cardiac chambers and myocardial mass, but cardiac function remains within the age-related norm.

Athletic heart syndrome was first described in 1899, when an American doctor compared a group of skiers and people with a sedentary lifestyle.

Changes in the heart appear 2 years after regular training 4 hours a day, 5 days a week. Athletic heart is more common among hockey players, sprinters, and dancers.

Changes during intense physical activity occur due to the economical work of the myocardium at rest and the achievement of maximum capabilities during sports activities.

Sports heart does not require treatment. Children should be examined twice a year.

In preschoolers, due to the immaturity of the nervous system, the regulation of its work is unstable, so they adapt less well to heavy physical activity.

Acquired heart defects in children

The most common acquired heart defect is a valve defect.

Of course, children with an unoperated acquired defect must be observed by a cardiologist or therapist throughout their lives. Congenital heart defects in adults are an important problem that should be reported to your physician.

Diagnosis of congenital heart defects

Clinical examination by a neonatologist of the child after birth.
Fetal ultrasound of the heart. Conducted at 22-24 weeks of pregnancy, where the anatomical structures of the fetal heart are assessed
At 1 month after birth, ultrasound heart screening, ECG.
The most important examination in diagnosing the health of the fetus is ultrasound screening in the second trimester of pregnancy.
Assessment of weight gain in infants, feeding patterns.
Assessment of exercise tolerance, physical activity of children.
When listening to a characteristic heart murmur, the pediatrician refers the child to a pediatric cardiologist.
Ultrasound of the abdominal organs.

In modern medicine, if you have the necessary equipment, diagnosing a congenital defect is not difficult.

Treatment of congenital heart defects

Heart disease in children can be cured surgically. But, it should be remembered that not all heart defects need to be operated on, since they can heal spontaneously and take time.

The determining tactics of treatment will be:

Surgical intervention can be minimally invasive, or endovascular, when access occurs not through the chest, but through the femoral vein. This is how small defects, coarctation of the aorta, are closed.

Prevention of congenital heart defects

Since this is a congenital problem, prevention should begin in the prenatal period.

Avoid smoking and toxic effects during pregnancy.
Consultation with a geneticist if there are congenital defects in the family.
Proper nutrition for the expectant mother.
Treatment of chronic foci of infection is mandatory.
Physical inactivity worsens the functioning of the heart muscle. Daily gymnastics, massages, and work with a physical therapy doctor are required.
Pregnant women should definitely undergo ultrasound screening. Heart defects in newborns should be monitored by a cardiologist. If necessary, it is necessary to promptly refer to a cardiac surgeon.
Mandatory rehabilitation of operated children, both psychological and physical, in sanatorium-resort conditions. Every year the child must be examined in a cardiology hospital.

Heart defects and vaccinations

It should be remembered that it is better to refuse vaccinations if:

development of heart failure of the 3rd degree;
in case of endocarditis;
for complex defects.

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.

Prenatal diagnosis.
Initial examination by a neonatologist, then observation by a pediatrician.
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 – 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 defects 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. An operation is performed according to indications.

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 medications only if there are compelling indications. 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.