Heart disease in children: why it happens, risk factors, diagnosis
Medical statistics are shocking: every hundredth born child is diagnosed with a heart defect. Always heart defects in children (UPU) indicate that the sentence of death, major surgery or lifelong disabilities?
The purpose of this article is to give readers objective information about children's innate cardiopathology because not all of them are possible to detect in the prenatal stage, or while in the hospital: the same medstatistika says that more than a quarter of children with defects detected at a later age - and quite unexpectedly.
Another objective of our publication, an explanation of the causes of heart disease: many of them are quite reversible as directly dependent on the lifestyle of the mother and the environment. That is, health problems the child can be avoided if you know and aware of potential risks.
What is VPS and what are they
Congenital heart disease in children - an anomaly, which is put at the embryonic stage and represents the various defects of the ventricular, walls of the aorta, great vascular.
Specialists have more than thirty types of congenital heart defects, but not all of them occur with the same frequency.
The undisputed leader among children's congenital cardiopathology remains ventricular septal defect: it is diagnosed in approximately 30-50 percent of all cases.
In second place - patent ductus arteriosus, which is a tenth part of all diagnosed CHD.
With a frequency of 5-7% meet:
- Tetralogy Of Fallot;
- Atrial septal defect;
- Stenosis of the pulmonary artery;
- Coarctation of the aorta;
- Transposition of the great arteries;
- Stenosis of the aorta;
- Atrioventricular communication without the trisomy of the 21st chromosome.
Other types of CHD occur in 1.5-2 percent of patients.
There are also observations that say about gender differences in heart disease in children. So, boys are more susceptible to transposition of the great vascular, coarctation of aorta stenosis of aorta atresia of pulmonary artery atresia of the tricuspid valve.
Girls are diagnosed with tetralogy of Fallot, patent ductus arteriosus, Ebstein's anomaly, common arterial trunk and atrial septal defect.
From congenital anomalies of the heart dies a fifth of children, and 90 per cent in the first year of life. However, medicine gradually finds opportunities forsave kids even with very severe defects, so the number of deaths among them is reduced.
Why is this happening
The development of the cardiovascular system of the embryo goes through several critical periods, during which the influence of various negative factors impact particularly strongly and is able to cause the formation of anomalies.
Experts believe that the most dangerous are the periods from 14 to 60-th day after ovulation - at this time the likelihood of heart disease is very high.
What are these factors?
- Teratogens (substances that cause various deformities and malformations);
- Genetic defects;
- Illness of the mother, her age 35 years;
- Available congenital heart disease one of the parents of the child or both.
Each of these factors should be considered separately.
Teratogenic substances no wonder the top of the list: they are the most common culprits for the formation of heart defects in children.
All that eating and drinking pregnant woman, all she breathes and how it is treated from various diseases, has an impact on the emerging fetus. Not all substances that enter the mother's blood, safe for the unborn child, and his cardiovascular system.
So, the most dangerous are:
- Anticonvulsants (drugs that are forced to take a pregnant woman for the treatment of epilepsy and other diseases that cause convulsions);
- Hormones (insulin, corticosteroids);
- Warfarin - a means of thinning the blood;
- The Central nervous system stimulants (amphetamine, etc.);
- Immunosuppressants (drugs that suppress the excessive activity of the immune system).
So taking any medications during pregnancy (even a familiar and vital) needs to be negotiated with watching a pregnant woman obstetrician-gynecologist and specialists.
A significant role in the development of CHD is played by the conditions of life and labour of the expectant mother. The woman who breathes in the fumes of paints, lacquers, fuel takes a lot of risks of having a baby with malformations.
Smoking and drugs the mother also puts in great danger the health of the future baby.
Unfavorable environment (high radiation, man-made accidents with emissions of harmful substances) increase significantly the probability of birth of sick children of women who live in close proximity to disadvantaged areas.
Illness of the mother
Every woman, diagnosed with a serious chronicdiseases, should first well consider the decision to become a mother: their course and the necessity of taking many vital drugs can cause the formation of severe heart defects.
The risk of having a child with CHD is particularly high in women who suffer:
- Systemic lupus erythematosus;
- Phenylketonuria (phenylalanine in the blood - more than 16 mg/100 ml);
- Hypertension with poorly controlled blood pressure.
Sometimes even healthy women in the first trimester of pregnancy suffer some infectious disease that also can cause various heart defects in children.
As mentioned above, in the first weeks of pregnancy formed the children's heart is most vulnerable, so the further the gestation and birth can be very problematic, if the mother was discovered:
- Infections caused by herpes viruses the first two types.
The question of the fate of pregnancy in these cases should be decided by experts - it is quite possible that abortion will be the best solution.
Children born with genetic defects, have a variety of congenital diseases, forms of underdevelopment, often deformities. Most of them die in the first hours or days of life, but some survive and manage to live long enough.
The doctor will direct the examination of the heart and blood vascular baby syndrome and down's syndrome, a syndrome of Shereshevsky-Turner, Marfan syndrome and other similar diseases, because the likelihood of developing CHD in these children is very high.
If one parent already has (or had, but healed) congenital heart disease, there is a big enough risk of detection of such pathology in the unborn child, so women of these families require special monitoring throughout the pregnancy.
How is it diagnosed
Most heart defects in children diagnosed in fetal stage: the possibilities of modern medical equipment can detect cardiopathology of the fetus in the early stages, when it is permissible to have an abortion.
The examination is performed at 12-16 weeks of pregnancy by the method of transvaginal echocardiography this diagnostic method is most informative and accurate.
The indications for its implementation are:
- The woman's age (35 years and older);
- Large fruit;
- Cases of CHD in the family;
- Miscarriages and abortions that took place earlier;
- Chronic maternal illness (diabetes, SLE, epilepsy, cardiovascular disease).
You should not ignore the survey: it is possible to avoid many problems in the future.
Not all children, however, congenital heart defects are diagnosed at the embryonic level, or in the time spent with his mother in the hospital: some of the cases are detected accidentally or after calling the doctor about certain complaints.
Parents need to be attentive to the complaints of the child to poor health. It is useful to prove and observation because of CHD in children is manifested by the following features:
- Paleness of the skin;
- A bluish tinge of the lips;
- Fatigue even after minimal exertion;
- Sweating and weakness;
- Shortness of breath;
- Retarded physical and mental development.
There may also be complaints of dizziness, chest pain, fainting.
All of these symptoms should alert parents immediately turn to the specialists for examination.
When to do surgery?
Most congenital heart defects are operated quite successfully, and then the children grow up healthy people. However, in each case, the advisability and timing of surgical treatment of cardiopathology dares strictly individually.
What does it depend? In the first place - the degree of severity of the defect and how it flows. For example, small ventricular septal defect children do not make any complaints, feel fine and do not need treatment: they prescribe a course of AB therapy for the prevention of infective endocarditis (e.g., during dental extractions).
Certain types of heart defects children sometimes "outgrow" themselves: it can happen with an open arterial duct and atrial septal defect - they have some children close spontaneously, especially if you have a small diameter (not more than 7-8 mm).
The more severe manifestations of CHD has, the more likely it is necessary to do the operation - that is the main rule, which adhere to specialists.
Was healthy and suddenly defect?
Yes, it happens. In some cases suddenly detected acquired heart disease in children, who throughout his life was considered completely healthy.
This happens after suffering and poorly treated sore throats, and other infections of ENT-organs, rheumatism, the causative agent of which are Streptococcus and Staphylococcus.
The infection causes inflammation of the endocardium, the inner lining of the heart. The inflammatory process affects primarily the valve apparatus (most often left), with the result that the children affectedmitral or aortic valve.
Sometimes in the pathological process involved of chords, papillary muscles, the inner surface of the Atria and ventricles.
Acquired heart defects are:
- Defects bicuspid valve;
- Aortic valvular heart disease;
- Tricuspid valvular disease;
- Concomitant vices.
They all require urgent examination and treatment depending on the severity of patients. In some cases, children receive only conservative treatment, other surgical.
The prognosis of these diseases is different: it ranges from relatively favorable to unfavorable and depend on how advanced the disease that caused the development of heart disease in children.
Thus, the active form of rheumatism or frequent sore throat worsen the function of the heart, so the effort of doctors in the treatment of congenital heart disease is always directed primarily to the relief of the infectious or allergic process in the joints, remove tonsils, and other measures.
Valvular heart disease, occurring in children, very rarely have some kind of fatal nature, which cannot be influenced. In the vast majority of cases this trouble can be avoided if you stick to the following rules and principles:
To plan pregnancy after the preliminary examination and prolecia chronic diseases.
Carefully make the decision about a possible maternity if a woman has a serious illness that can cause a heart defect in the fetus.
Carefully monitor the health and to the birth, and after.
To avoid the development of acquired heart disease need to carefully monitor the condition of the teeth, nasopharynx, tonsils, especially where love "to settle down" Staphylococcus and Streptococcus.