Heart disease in newborns is a disease that requires surgical treatment. Any changes in the tissues and structures of the heart cause a whole complex of symptoms, including heart failure, dyspnea, cyanosis, edema of the extremities, weakness, delay in physical development and many other conditions seriously worsening the quality of life.
What is heart disease?
The heart of each person has two upper chambers( atria) and two lower chambers( ventricles).Thanks to the four heart valves, blood is consistently flowing from the atria to the ventricles and is sent to the main arteries along a large or small circle of blood circulation.
Normally, the valves let blood flow in only one direction. However, with certain anatomical defects in the structure of the heart, the valve apparatus or blood vessels, the blood flow is disrupted. These defects are called heart defects.
Heart defects are divided into acquired and congenital.
Acquired defects of heart arise due to rheumatism, infectious endoc
Congenital heart defects of occur at 2-8 weeks of gestation and are diagnosed in newborns and young children.
Congenital heart diseases occur in 7-17 infants of a thousand. The most common of these are the defect of the interventricular septum, the defect of the interatrial septum and the open arterial duct.
At risk are:
- children with Down syndrome and other chromosomal abnormalities;
- preterm infants;
- babies with multiple extracardiac malformations.
Each case requires qualified cardiac and cardiosurgical care, otherwise 75% of children with a diagnosis of heart disease would not live to be one year old. Nevertheless, the possibilities of modern surgery can cure the disease in 97% of patients.
Heart defects in newborns can occur for a variety of genetic or environmental reasons.
Genetic factors include point gene changes and chromosomal mutations, expressed as loss or re-duplication of DNA segments( the most common cause is trisomy 21).Genetic mutations, in turn, are caused by environmental causes:
- ionizing radiation ( exposure to radiation);
- chemical mutagen ( alcohol and tobacco products, phenols of varnishes and paints, nitrates, lithium, some antibiotics and other teratogenic medicines);
- biological factors ( rubella virus during pregnancy, diabetes mellitus, systemic lupus erythematosus, mother phenylketonuria).
Studies conducted in the 1970s showed that congenital malformations can be divided into "male"( stenosis and coarctation of the aorta), "female"( open arterial duct, Lautebacher's disease) and "neutral"( defect of the interventricularpartitions, Ebstein's anomaly).
In modern cardiology, congenital heart disease is divided into two functional groups.
The first group of are defects caused by the formation of bypass paths through which oxygen-enriched blood is pumped back into the lung tissue. This provokes a load on the vessels carrying blood to the lungs and right ventricle of the heart. These include non-transmission of the arterial duct, defects of the interatrial and interventricular septum.
The second group of - defects caused by the appearance of obstructions to the blood flow, due to which the load on the heart is significantly increased. This, for example, coarctation or narrowing of the aorta, stenosis of the pulmonary or aortic valvular heart.
Some congenital heart defects can be diagnosed as early as 16-20 weeks of pregnancy during ultrasound. Because of the peculiarities of the fetal circulation, heart disease does not affect its intrauterine development, except for extremely severe pathologies, which usually lead to the death of the embryo in the early stages. The disease manifests itself after birth, when the body is reconstructed into two circles of blood circulation, but it is not always easy to diagnose it - sometimes it is asymptomatic.
If heart disease has not been detected by ultrasound or during planned screening in the hospital, parents can recognize it in a newborn child later in the following symptoms:
- cyanosis or unusual pallor of the face, nasolabial triangle, fingers and feet;
- swelling of the extremities and bulging in the heart;
- causeless cry, in which the child's skin turns blue or turns pale, and cold sweat appears on the forehead;
- sluggish sucking, frequent regurgitation, severe anxiety when pinned to the chest and slow gain in weight;
- shortness of breath in combination with bluish skin - episodic or persistent;
- a causeless increase or decrease in heart rate.
All these symptoms require immediate consultation of the pediatrician and cardiologist.
During the examination, the specialist can hear specific noises when evaluating the tone of the heart sounds, and also assign an ECG and an X-ray.
Correction of congenital heart disease in children takes into account the fact that the disease has three phases of development:
Emergency phase. The stage of primary adaptation, which begins with the moment of birth. The body uses all reserves and compensates for congenital heart disease.
Relative compensation phase .After the stress, the work of organs and systems stabilizes in a certain way until the reserves are exhausted.
Decompensation phase. The stage of depletion of reserves, after which the structures of the heart and vessels can not perform the assigned functions, as a result of which cardiac insufficiency occurs.
Obviously, medical methods of treating congenital heart disease can not be effective. Therefore, a planned operation is performed in the second phase when the disease enters the stage of compensation or emergency in the first phase, if the newborn is too weak. Treatment in the third phase of the disease is not carried out because of irreversible organ changes.
In modern cardiac surgery, minimally invasive techniques for the treatment of congenital heart disease using ultrasound and an endoscope are used. However, both before and long after the surgery, babies with congenital heart disease will be under the control of a cardiologist. If the operation is contraindicated or the stage of the disease requires postpone surgical intervention for a certain period, the child is prescribed maintenance therapy.
Even with timely measures taken and quality surgical treatment, congenital heart disease does not pass without a trace. Therefore, the parents of a child with such a diagnosis should strengthen the immunity of the baby and monitor his physical activity.