Congenital heart disease is a heart defect, of innate origin. Basically, this pathology concerns the septa of the heart, affects the artery, which supplies venous blood to the lungs or one of the main vessels of the arterial system – the aorta, and also There is an increase in the botallov channel (OAP). In congenital heart disease, the blood movement in the large blood circulation (BPC) and small (ICC) is disturbed.
Heart defects are a term that combines certain heart diseases whose main benefit is a change in the anatomical structure of the heart valve device or its largest vessels and the growth of the partitions between the atria or ventricles.
Causes of congenital heart disease
The main causes of congenital heart disease are diseases from the chromosomes – it is almost 5%; Mutation of the gene (2-3%); various factors such as alcoholism and drug addiction of parents; Infectious diseases in the first trimester of pregnancy (rubella, hepatitis), medications (1-2%) and hereditary predisposition (90%).
With various distortions of chromosomes, their mutations appear in a quantitative and structural form. When aberrations of large or medium-sized chromosomes occur, this generally leads to a lethal outcome. But if there are biases in life compatibility then there are several types of congenital diseases. When a third chromosome appears in the set of chromosomes, defects arise between the valves of the valves of the atrial and ventricular septa or a combination of these.
Congenital heart disease with changes in the sex chromosomes is much rarer than in trisomy autosomes.
Mutations of a gene not only lead to congenital heart disease, but also to abnormalities of other organs. Developmental disorders of the CVS (cardiovascular system) are associated with the syndrome of autosomal dominant and autosomal recessive syndrome. These syndromes are characterized by a pattern of damage to the system in a mild or severe severity.
The development of congenital heart disease can contribute to various environmental factors that damage the cardiovascular system. Among them, X-ray radiation could be identified that a woman could receive during the first half of pregnancy; Radiation by ionized particles; some types of medicines; Infectious diseases and viral infections; Alcohol, drugs, etc. Therefore, heart disease formed under the influence of these factors has received the name of embryopathy.
Under the influence of alcohol, most commonly formed VSD (defect of the interventricular septum), OAP (open arterial duct), pathology of the interatrial septum. For example, anticonvulsants lead to the development of pulmonary artery stenosis and aorta, aortic coarctation, OAP.
Ethyl alcohol is the first of the toxic substances, contributing to congenital heart disease. A child born under the influence of alcohol has an embryophytic alcohol syndrome. Alcoholic mothers suffer from almost 40% of children with congenital heart disease. Alcohol is particularly dangerous in the first trimester of pregnancy – this is one of the most critical stages of fetal development.
Very dangerous for the future of the child is the fact that the pregnant woman suffered from rubella. This disease causes a number of pathologies. And the innate pathology of the heart is no exception. The incidence of congenital heart disease after rubella is between 1 and 2.4%. Among the heart diseases are the most common in practice: OAA, AVK, Fallot tetralogy, DMZHP, stenosis of the pulmonary artery.
The data from the experiments show that almost all congenital heart defects are basically of genetic origin, which is consistent with a multifactorial inheritance. Of course, there is heterozygosity of a genetic nature and some forms of UPU are associated with mutations of a gene.
In addition to the aetiological factors that cause congenital heart disease, there is also a risk group in which women fall into the age group; Have violations of the endocrine system; with toxicoses of the first three months of pregnancy; who have stillborn babies in the history, as well as already existing children with congenital heart defects.
Congenital heart disease symptoms
The clinical picture of congenital heart disease is characterized by features of the structure of the defect, the recovery process and the complications resulting from a variety of etiologies. The symptoms of congenital heart disease include shortness of breath, which occurs in the context of low physical exertion, increased heart rate, periodic weakness, paleness or cyanosis of the face, pain in the heart, swelling and fainting.
Congenital heart defects can occur at regular intervals, so there are three major phases.
In the primary, adaptive phase, the patient’s body attempts to adapt to circulatory system disorders caused by a developmental defect. As a result, the symptoms of manifestation of the disease are usually not very pronounced. But during a severe hemodynamic injury, cardiac decompensation quickly develops. If patients with congenital heart disease do not die during the first phase of the disease, there will be improvements in their health and development in about 2-3 years.
In the second phase, the relative compensation and the improvement of the general condition are noticed. And for the second inevitably comes the third, when all the adaptive abilities of the organism eventually develop a dystrophic and degenerative nature of the changes in the heart muscle and in various organs. Basically, the terminal phase leads to the death of the patient.
The most pronounced symptoms of congenital heart disease include cardiac arrhythmia, cyanosis, and heart failure.
Noise in the heart of a systolic character and varying intensity is observed in almost all types of vices. But sometimes they can be absolutely absent or manifest as transience. As a rule, the best audibility is located in the left upper part of the sternum or near the pulmonary artery. Even a slight increase in the shape of the heart makes it possible to hear heart noises.
During the stenosis of the pulmonary artery and TMS (transposition of the main vessels), the cyanosis manifests itself sharply. And with other malformations, it may be missing or small. Cyanosis sometimes has a lasting character or occurs when weeping, crying, so with a periodicity. This symptom may be accompanied by a change in the end phalanges of the fingers and nails. Sometimes such a symptom manifests itself in the pallor of a patient with congenital heart disease.
In some types of vice, the dullness of the heart may change. And its increase will depend on the localization of changes in the heart. To make an accurate diagnosis to determine the shape of the heart, use an X-ray image using both anti-ography and kymography.
In heart failure, a spasm of the peripheral vessels can develop, which is characterized by blanching, cooling of the limbs and the tip of the nose. Spasm manifests as an adaptation of the patient’s body to heart failure.
Congenital heart disease in newborns
Infants have a pretty big heart that has significant backup capabilities. Congenital heart disease is usually formed in 2-8 weeks of pregnancy. The cause of his appearance in the child is various diseases of the mother, contagious and viral; the work of the future mother in harmful production and of course the hereditary factor.
About 1% of newborns suffer from cardiovascular disease. Now it is not difficult to diagnose congenital heart defects early. So it helps to save the lives of many children through medical and surgical treatment.
Congenital heart disease is most commonly diagnosed in male children. And for various deficiencies, there is a certain sexual predisposition. For example, OAA and VSD predominate in women and aortic stenosis, congenital aneurysm, aortic coarctation, Fallot tetralogy and TMA – in males.
One of the most common changes in the heart of children is the non-opening of the septum – this hole is abnormal. Basically, it is the VSW that is located between the upper chambers of the heart. Throughout the baby’s first year of life, some minor defects in the dividing walls may spontaneously shut down and not interfere with the child’s further development. Well, for major pathologies, surgery is indicated.
The fetal circulatory system prior to birth is a circulation that bypasses the lungs, meaning that blood does not flow there but circulates through the arterial duct. If a child is born, this gait usually closes within a few weeks. But if this does not happen, the child is put by the OAU. This creates some stress on the heart.
The cause of severe forms of cyanosis in children is the transposition of two large arteries when the pulmonary artery connects to the left ventricle and the aorta to the right ventricle. This is considered pathology. Without surgical intervention, newborns die during their first days of life. In addition, children with severe congenital heart disease rarely have a heart attack.
Characteristic signs of congenital heart disease in children are low weight, rapid fatigue, and paleness of the skin.
Congenital heart disease
Congenital heart defects can sometimes have a different clinical picture. Therefore, the treatment and treatment methods largely depend on the severity and complexity of the clinical manifestations of the disease. Basically, the picture of his life is absolutely normal, as in healthy people, when the patient is completely compensated for the blemish. As a rule, such patients do not need consultations with doctors. You can be given recommendations whose purpose is to keep the defect in a compensatory state.
First, a patient suffering from congenital heart disease should be limited to hard physical labor. This work, which adversely affects the well-being of the patient, is advisable to switch to another type of activity.
A person with a history of congenital heart disease should refuse to participate in complex sports and participate in competitions. To reduce the strain on the heart, the patient should sleep for about eight hours.
The right diet should accompany patients with congenital heart disease. Foods should be taken three times a day to ensure that plenty of food does not stress the cardiovascular system. All foods should not contain salt, and if heart failure occurs, the salt should not exceed five grams. It should be remembered that only cooked foods should be eaten as they are better for digestion and significantly reduce the burden on all digestive organs. Basically, you should not smoke and drink alcoholic beverages in order not to provoke a cardiovascular system.
One of the methods of treating congenital heart disease is medication when it is necessary to regulate the contractile function of the heart, regulate the water-salt metabolism and remove excess fluid from the body, as well as combat the altered rhythms in the heart To improve metabolic processes in the myocardium.
The treatment of congenital heart disease sometimes changes due to the specificity and severity of the defect. The age and health of the patient are also taken into account. For example, children with small forms of heart disease sometimes do not need treatment. And in some cases, surgical procedures must be performed as early as infancy.
Almost 25% of children with congenital heart disease urgently require early surgery. To determine the location of the defect and its severity, children are put into the heart with a catheter in their first days of life.
The most important surgical method for the treatment of congenital heart disease is the method of deep hypertension, in which a strong cold is used. This type of surgery is performed by babies with a heart in size with a walnut. Applying this method to heart surgery allows the surgeon to perform a complex operation to restore the heart as a result of its complete relaxation.
At the moment, other radical methods of treating congenital heart disease are widespread. Among them, the commissurotomy can be distinguished, in which the dissection of obstructed valves and prostheses is used when the altered mitral or tricuspid atrioventricular valve is removed and then the valve prosthesis is sutured. After such surgical procedures, especially mitral commissurotomy, the prognosis of the surgical treatment is positive.
Basically, patients return to their normal lifestyle after surgery, they are able to work. Children are not limited to physical abilities. However, anyone who has undergone heart surgery should continue to be monitored by the attending physician. A vise that has a rheumatic aetiology requires repeated prevention.