Congenital heart disease
Brief description of the disease
Congenital heart disease - is an anatomical defect of the heart, its vessels or valves that occurs even in utero.
Congenital heart disease in children may be invisible, but it can occur immediately after birth. On average, the disease occurs in 30% of cases and took the 1st place among the diseases that cause the death of newborns and children under one year. After a year the mortality rate falls, and at the age 1-15l. dies around 5% of children.
There are seven main types of congenital heart disease in newborns: ventricular septal pathology, pathology atrial septal, aortic coarctation, aortic stenosis, patent ductus arteriosus, transposition of the great vessels large, pulmonary stenosis.
The main causes of congenital - is the external effects on the fetus in the 1st trimester of pregnancy. Caused by defects of the heart may be a viral disease of the mother (such as rubella), irradiation, drug effects, drug addiction, alcoholism mother.
Important role played by the health and the baby's father, but genetic factors on the development of congenital heart disease in children played the smallest role.
There are also such risk factors and the risk of miscarriage morning sickness in the 1st trimester, the presence in the past pregnancies ending in stillbirth, the presence of a family history of children with congenital (from the next of kin), endocrine pathology of both spouses, the age of the mother.
Symptoms of congenital heart disease
In infants with congenital heart disease is marked bluish or blue-colored lips, ears and skin. Also, cyanosis of the child may show when he cries or breastfeeding. Bluish color of the skin characterized by the so-called "blue heart defect," but there is also the "white congenital" in which the child observed blanching of the skin, cold hands and feet.
At the heart of a child is noisy. This symptom is not primary, but his presence should take care of the additional examination.
There are cases when the defect is accompanied by heart failure. The prognosis for this in most cases is poor.
Anatomical pathology of the heart can be seen on an electrocardiogram, echocardiogram, X-ray images.
If a congenital heart defect shortly after birth is invisible, the child may appear healthy for the first ten years of life. But after that becomes noticeable physical disabilities, manifested cyanosis or paleness of skin, during exercise there is shortness of breath.
Diagnosis of the disease
Primary diagnosis doctor puts the baby at survey and listening to the heart. If there is reason to suspect a congenital heart disease, the child is sent to further examination. Various methods of diagnosis, it is also possible to examine the fetus is in the womb.
For a survey of pregnant women used fetal echocardiography. This ultrasound diagnostics, safe for both mother and fetus, which allows to identify the pathology and planning treatment of congenital heart disease.
Echocardiography - is another type of ultrasound, but the unborn child, helps to see the structure of the heart defects, constricted blood vessels, to evaluate the work of the heart.
Electrocardiography is used to evaluate the cardiac conduction of the heart muscle.
To determine the heart failure used chest X-ray. Since excess fluid can be seen in the lungs, heart enlargement.
Another method of X-ray detection of congenital heart disease is a vascular catheter. Administered through the femoral artery into the bloodstream and make a series of contrast X-ray images. So it is possible to evaluate the structure of the heart, to determine the level of pressure in its chambers.
To estimate blood oxygen saturation pulse oximetry is used - by a sensor worn on the finger of a child, record levels of oxygen.
Treatment of congenital heart disease
The method of treatment of vice is selected depending on its type. So, use minimally invasive catheterization procedures, open surgery, transplantation, drug therapy.
Catheter technique allows the treatment of congenital heart disease without radical surgery. Through a vein in the thigh catheter under x-ray control of it is brought to the heart, and is supplied to the site of the defect special thin instruments.
The operation is prescribed, if you can not use a catheterization. Distinguishes this method is more time-consuming and difficult recovery period.
Sometimes surgical treatment of congenital heart defects, mainly in severe cases, is carried out in several stages.
If defects are not to be treated, the child is shown a heart transplant.
Drug therapy is often used to treat adults, older children. With medicines can improve cardiac function to provide normal blood supply.
Prevention of disease
Conventionally, prevention of congenital heart disease are divided into prevention of their development, prevention of adverse development and the prevention of complications.
Prevention of vice is more in medical and genetic counseling in preparation for pregnancy than to any concrete action. For example, should be warned about the unintended pregnancies among women with a family (or a partner in the family), there are three or more people with birth defects. It is not recommended to have children couples where both partners suffer from this disease. Should carefully examine a woman who suffered rubella.
To prevent unfavorable development of the disease must be on time to make the necessary diagnostic procedures, pick up and carry out the best treatment to correct the condition. For a child with congenital and post-its treatment needs special care careful. Often the mortality of children with congenital aged up to one year is linked to inadequate childcare.
To prevent complications of the disease should be addressed directly to the prevention of these complications.
Because of a congenital heart defect may be: bacterial endocarditis, polycythemia ("blood clots"), causing thrombosis, headaches, inflammation of peripheral vascular disease, vascular brain embolism, respiratory diseases, lung complications and their vessels.