Small anomalies of the heart - Causes, Symptoms and Treatment .MF .
man's heart is laid at the end of the third week of pregnancy and develops throughout the prenatal period.In the process of its development is shaped not only the heart muscle (myocardium), and connective tissue, forming a fibrous "skeleton" of the body and the major vessels (aorta, pulmonary artery, the upper and lower hollow Vienna, the pulmonary veins).During pregnancy, there is a number of physiological characteristics of fetal blood circulation, for example, in his heart, there are vascular communications (oval window between the right and left atria, arterial and venous ducts, eustachian valve - education in the inferior vena cava, which directs a portion of the blood from the right atrium through the ovalwindow into the left atrium).These communications are created by nature to the blood flowed from the fetal heart, circulated by a small body, bypassing the lungs, since they are in a state of functional rest and do not breathe in the womb.To leave all the connective tissue structures of the heart
sometimes happens that during pregnancy there are changes in the development of cardiac connective, or it is not enough to happen in physiological tissue lineages closing holes in the heart of the child.Connective heart structures are either too soft to carry out their functions frame, or immature, and then as a newborn child's development, everything comes back to normal.In such cases we say that a child's small anomalies of heart development.
small anomalies of heart development - it is a large group of states, which includes anatomical abnormalities in the structure of the heart, without causing significant clinical and hemodynamic (defining the work of the heart) disorders.Lesser these anomalies is considered to be because they may disappear in the course of development of the child and does not have a significant effect on the cardiovascular system and the whole body, as opposed to heart disease, such as when defects occur flagrant violation of anatomy and physiologyheart.In recent years, increased frequency of recording cardiac abnormalities that is associated with a mass distribution of the survey newborns by ultrasound of the heart.
If a child present one or two anomalies, then, most likely, we are talking about the innate features of the structure of the heart, does not pose a threat to the child's health;if three or more, then the doctor should think about a patient has a disease such as a connective tissue dysplasia - a disease characterized by connective tissue lesions, not only in the heart, but also in other organs and systems (muscles, bones, urinary, digestive, bronchopulmonary systemand etc).Also, expansion or narrowing of the aortic root and the pulmonary trunk is more common in hereditary connective tissue diseases (eg, Marfan syndrome).
Causes of the child small malformations
heart Why are there anomalies in the data?As already stated, the basis for heart abnormalities on the change in the properties of the connective tissue of the body.The main cause of cardiac connective tissue dysplasia 111 is genetically determined defect type collagen synthesis (protein is used as the main body of the construction material).That is especially congenital heart structure passed the child inherited, especially on the part of the mother.Also, an important role is played here by adverse environmental conditions, stress, inadequate intake of vitamins from food pregnant, the use of toxic substances during pregnancy (drugs, alcohol, nicotine), oxygen starvation of the fetus and all the factors that may have a negative effect on the fetus in utero.
Symptoms and signs of low cardiac malformations
In most cases, the diagnosis of MARS is a random finding during routine ultrasound of the heart newborn babies or young children.As a rule, small anomaly does not manifest itself, but the following complaints may occur:
- in newborns and infants appearance of cyanosis (gray or blue skin coloring), nasolabial triangle, shortness of breath or palpitations when feeding, physical stress (such as after bathingactive games)
- adolescents between hormonal changes and rapid growth of the organism may appear in the complaints of the heart and blood vessels: heart palpitations, feeling fade, outages heart, false angina (pain in the heart), a feeling of "lump" in the throat, decreased exercise tolerance.There may also be manifestations of vegetative-vascular dystonia: dizziness, nausea, fainting, sweating, fatigue, weakness, mild fever.
- in those cases when the patient has some abnormality at the same time it can affect the function of the heart.For example, reverse blood casts in the atrium of the valve prolapse (regurgitation grade 3) and discharge of blood into the right atrium can lead to stagnation of blood through the patent foramen ovale in the lung which is manifested dyspnea with minimal exertion, and lateral chords in the left ventricle andEustachian valve can cause cardiac arrhythmias (sinus tachycardia syndrome shortened PQ).
Diagnosis small heart malformations
presence of anomalies in the structure of the heart doctor may suggest a further stage of the clinical examination of the child.In newborn babies with heart anomalies can be detected, umbilical and inguinal hernia, congenital dislocation of the hip joints.On examination, the doctor can see the teenager tall, elongated limbs and fingers, bending the chest, increased mobility (hypermobility) of the joints.
auscultation (listening in the chest), all small anomalies manifest themselves systolic murmurs, clicks, or a combination thereof.
From instrumental methods of examination appointed ECG (arrhythmias to determine if any) X-ray of the chest cavity (in order to determine whether the heart in diameter and does not stagnate if the blood vessels in the lungs expanded).
most informative is the echocardiogram (ultrasound of the heart).This method allows visualization of the heart and large vessels, to clarify the presence of cardiac anomalies and to determine whether a violation has in his work.
Depending on the location in the US, you can see the following anomaly:
1. atrial septum and atrium:
- patent foramen ovale;
- small aneurysm (protrusion) atrial septum;
- increased more than 1 cm eustachian valve.
2. The mitral valve and left ventricle:
- prolapse (sagging) of the mitral valve (regurgitation with or without);
- additional chord in the left ventricle (tendon strands attached to the valve support and ensure its mobility);
- ectopic fixation tendon chords (in the wrong place).
- displacement of the valve in the cavity of the right atrium (prolapse of the tricuspid valve), in isolated form is rare, often combined with mitral valve prolapse.
4. aorta and pulmonary artery:
- butterfly valve of the aorta (instead of three cusps),
- prolapse of the aortic valve;
- narrowing of the aortic root;
- dilation (widening) of the aortic root;
- pulmonary valve prolapse;
- dilatation of the pulmonary trunk.
Any of the listed buildings of anomalies can occur both independently and in conjunction with others.
Each anomaly appears differently on ultrasound of the heart.For example, if the patient has a dilation or widening of the aortic root or the pulmonary trunk, determined by ultrasound characteristic structural changes, and the presence or absence of intracardiac hemodynamics disorders, in particular a significant difference in pressure in the aorta and the left ventricle cavity volume overload of the right atrium and ventricle.
the presence of PFO observed echo a break in the atrial septum, and Doppler reveal turbulent (with the "twists") the flow of blood around her, and the absence of hemodynamic disturbances.Atrial septal aneurysm is shown on US protrusion into the right atrium, without overloading the right atrium and ventricle.Eustachian valve can be seen as an additional structure is longer than 1 cm on the border of the right atrium and the inferior vena cava.
Ectopic fastening chords on US looks like a thread, not attached to the valves to the ventricles, and in the interventricular septum and posterior wall of the ventricles.If you have a prolapse of the mitral or tricuspid valve prolapse is estimated degree flaps in millimeters, and the degree of regurgitation, depending on to what extent the reverse blood stream fills the cavity of the atria.Additional chord in the cavity of the ventricles are additional linear entity having ehoplotnosti structure, and can be single or multiple, as well as longitudinal, transverse and diagonal.
So, for example, looks like mitral valve prolapse during echocardiography (PML)
Treatment of heart anomalies small
it necessary to treat minor heart anomalies?In cases where the data structure features of the heart no effect on the heart and blood vessels and do not manifest themselves clinically in the treatment of a child needs.It is enough to yearly visits with the cardiologist performing echocardiography.But to use health-building measures aimed at protecting the health of every child, including those with abnormalities of the heart, it is not forbidden.These include the right to schedule a rational alternation of work and rest, sufficient sleep duration, active walk in the fresh air, sound, enriched with vitamins nutrition, adequate exercise (exactly how the sport can be practiced to the patient, the doctor decides individually).
If the patient has noticeable symptoms of small anomalies of the heart, there are a few anomalies occur simultaneously or signs of hemodynamic disorders, it should be the appointment of drugs.vitamins (niacin, riboflavin, thiamin), magnesium and potassium supplements (manna B6, potassium orotate, Pananginum, magnerot), drugs that improve the oxygen supply to the heart muscle (ubiquinone, cytochrome C, carnitine) The most frequently used.In the event of rhythm and conduction disturbances are shown blockers (carvedilol, bisoprolol, etc.).As the treatment of the manifestations of vegetative-vascular dystonia appointed sedative herb (Leonurus, hawthorn, valerian, etc.).
Very rarely, if anomalies are few and they have a significant impact on hemodynamics, significantly impair the overall health outcomes and quality of life, it can be shown to cardiac surgery treatment of heart abnormalities.
In conclusion, it should be noted that parents hear this diagnosis in your child, do not panic, because usually small heart anomalies do not threaten the health and life of the baby.But forget about such innate characteristics of the child is not worth it, you need to have regular check-ups planned with the involvement of instrumental methods of diagnosis.The need for the appointment of drugs solves only a doctor in each individual case.
extremely rare (2 - 4%) in the case of multiple heart abnormalities occur complications, including life-threatening, such as fatal arrhythmias and sudden cardiac death, paradoxical embolism, bacterial endocarditis, severe mitral regurgitation.Prevention of complications is timely access to a doctor in case of complaints on the part of the heart of the patient and perform all diagnostic and treatment measures prescribed by your doctor.
therapists Sazykina OJ