Heart defects in children: symptoms and treatment. Heart defect in a child. Congenital and acquired heart defects in children. "Blue" defects and their symptoms

Heart problems in a child frighten most young mothers. Indeed, it is precisely congenital or acquired lesions of this organ that are considered by ordinary people to be the most dangerous, capable of significantly changing the life of each patient.

But, in order to understand the real essence of things, all young mothers should pay a little more attention to information about what symptoms and signs may indicate that the child has a congenital heart pathology.

In our publication today, I would like to consider: what kind of condition is heart disease in children, why do some people have healthy children, and others with heart defects? What symptoms of cardiac development abnormalities should first of all alert young mothers, forcing them to consult a cardiologist? And, most importantly, how should certain heart defects be treated in children? Is surgery always required for the pathology in question?

Symptoms of heart defects in childhood

Let us recall that congenital heart defects in children are abnormalities in the development of the heart muscle, its valve structures, walls, and vascular bed that arise during the prenatal stage of development; acquired defects are the same cardiac pathologies that arise during the patient’s life.

Signs or symptoms of congenital heart disease occur in one child out of every hundred newborns and, unfortunately, occupy one of the leading places among the causes of child mortality.

Acquired heart defects can occur in young patients of all ages and can also be fatal

At the same time, the capabilities of modern medicine are actively expanding every year, and today, almost sixty percent of small patients who have been successfully operated on in a timely manner due to congenital or acquired anomalies of the structure/function of the heart are able to lead a full life.

Why are some people born already having certain heart defects in children? How can you timely notice and recognize the symptoms of such a pathology in your child? In fact, it is not so easy for young mothers to notice signs of a serious pathology in a newborn in a timely manner, and we all understand why.

The fact is that a newborn child does not have objective opportunities to complain about his problems, and young mothers, as a rule, are not very experienced and cannot recognize the symptoms of the disease in time. That is why doctors conduct the necessary routine examinations of all newborn children without exception, excluding or confirming the development of cardiac pathology.

What symptoms of pathology in a child (newborn or older) should alert relatives and doctors? First of all, it is important to pay attention to the following manifestations of the problem:

The reasons why our children develop congenital or acquired heart anomalies can be very different:

• Acquired pathologies in a child of any age (except newborns) can develop after previous infections - acute rheumatic fever, tonsillitis, myocarditis, etc.

Congenital pathologies usually arise due to negative effects on the mother's pregnancy. Problems arise when a pregnant woman has suffered from rubella or systemic lupus.

If the mother was exposed to radiation, pesticides, toxins, smoked or drank alcohol, this can also cause the child to become ill.

And since such external influences can become the causes of the development of childhood cardiac pathology, doctors warn all pregnant women to monitor not only the course of pregnancy, but also their own health, and the correctness of their own lifestyle while carrying a baby!

Types of acquired heart defects in young patients

We have already noticed that acquired defects of the heart muscle in a child, sometimes called valvular defects, are disturbances in the functioning of the organ caused by changes in the valve structures of a morphological or functional type.

Such pathological changes in the valves are: insufficiency or stenosis of the valve apparatus, resulting from previous infections, inflammation, autoimmune problems, physical or emotional overload.

Depending on the damage to a particular valve, doctors distinguish the following types of pathology:

• if the aortic valve structure is damaged - aortic stenosis or aortic valve insufficiency;
• with pathology affecting the mitral valve - mitral stenosis or mitral valve insufficiency;
• when there is damage to the tricuspid valve structure - tricuspid stenosis or tricuspid valve insufficiency;
• with damage to the valvular structure of the pulmonary trunk - Pulmonary valve stenosis or pulmonary valve insufficiency.

Tricuspid valve insufficiency

Let us note that minimally expressed compensated valvular heart defects of the acquired type may not manifest themselves clinically and may not prevent children from leading a normal (full) life!

Types of pathologies

Today, as before, many continue to conditionally divide heart defects in newly born babies of a congenital nature into white and blue. White and blue heart abnormalities are distinguished by the presence or absence of mixing of arterial and venous blood flows, respectively.

In addition, a more recent classification of congenital heart pathologies in children identifies:

Tetralogy of Fallot (disorder)

It should also be noted that congenital cardiac anomalies can be recorded by doctors in older children, but in such cases doctors talk about the untimeliness or inadequacy of the primary diagnosis, about the erroneous failure to determine the compensated congenital pathology.

Diagnostics

Today, the Doppler Echocardiography technique can be considered the most effective method for diagnosing heart defects in children, during which doctors are able to assess the severity or severity of the anomaly.

However, along with this, qualified doctors, in order to make a correct diagnosis, must take into account the data obtained during examination, history taking, auscultation, palpation and percussion of the heart of small patients.

It cannot be said that some heart defects can be detected by carrying out simpler studies:

• standard electrocardiography;
• X-ray examination;
• basic echocardiography;
• Ultrasound of the heart, etc.

But, in any case, only a qualified, experienced cardiologist can make any diagnostic conclusions based on the studies, who should also raise questions regarding this or that type of pathology treatment.

Treatment

Treatment options for congenital or acquired heart defects in children are fundamentally divided into: surgical techniques, as the only radical ones, and medications, which are considered rather auxiliary.

The need for surgical treatment of a specific cardiac anomaly is determined by:

• type of vice;
• the severity of the patient's condition;
• degree of decompensation of the defect;
• the age of the young patient;
• the general health of the baby;
• and the presence of concomitant pathology in the patient.

As a rule, for heart defects associated with narrowing (stenosis) of certain cardiac structures, with circulatory failure in certain areas of the heart muscle, doctors recommend commissurotomy or valvuloplasty. Insufficiency of individual valve structures of the heart usually requires implantation (prosthetics) of the affected valve structures.

One of the most commonly diagnosed anomalies in the development of the cardiovascular system in children is considered to be congenital heart disease. Such an anatomical disorder of the structure of the heart muscle, which occurs during the period of intrauterine development of the fetus, threatens with serious consequences for the health and life of the child. Timely medical intervention can help avoid a tragic outcome due to congenital heart disease in children.

The task of parents is to navigate the etiology of the disease and know about its main manifestations. Due to the physiological characteristics of newborns, some heart pathologies are difficult to diagnose immediately after the baby is born. Therefore, you need to carefully monitor the health of a growing child and respond to any changes.

Classification of congenital heart defects in children

Congenital heart disease provokes disruption of blood flow through the vessels or in the heart muscle.

The earlier a congenital heart defect is detected, the more favorable the prognosis and outcome of treatment of the disease.

Depending on the external manifestations of the pathology, the following types of congenital heart disease are distinguished:

• "White" (or "pale") defects

Such defects are difficult to diagnose due to the lack of obvious symptoms. A characteristic change is the pallor of the child’s skin. This may indicate that insufficient arterial blood is reaching the tissues.

• "Blue" vices

The main manifestation of this category of pathology is blue discoloration of the skin, especially noticeable in the area of ​​the ears, lips and fingers. Such changes are caused by tissue hypoxia, provoked by the mixing of arterial and venous blood.

The group of “blue” defects includes transposition of the aorta and pulmonary artery, Ebstein’s anomaly (displaced place of attachment of the tricuspid valve leaflets to the cavity of the right ventricle), tetralogy of Fallot (the so-called “cyanotic disease”, a combined defect combining four pathologies - stenosis of the right ventricular outflow tract , dextraposition of the aorta, high and hypertrophy of the right ventricle).

Considering the nature of circulatory disorders, congenital heart defects in children are classified into the following types:

1. Message with blood discharge from left to right (patent ductus arteriosus, ventricular or atrial septal defect).
2. Message with blood discharge from right to left (tricuspid valve atresia).
3. Heart defects without shunting (stenosis or coarctation of the aorta, pulmonary stenosis).

Depending on the complexity of the violation of the anatomy of the heart muscle, the following congenital heart defects in childhood are distinguished:

• simple defects (single defects);
• complex (a combination of two pathological changes, for example, narrowing of the cardiac orifices and valvular insufficiency);
• combined defects (combinations of multiple anomalies difficult to treat).

Causes of pathology

Impaired differentiation of the heart and the appearance of congenital heart disease in the fetus provokes the impact of unfavorable environmental factors on a woman during the period of bearing a child.

The main reasons that can cause cardiac abnormalities in children during their intrauterine development include:

• genetic disorders (chromosome mutation);
• smoking, consumption of alcohol, narcotic and toxic substances by a woman during pregnancy;
• infectious diseases suffered during pregnancy (rubella and influenza virus, chickenpox, hepatitis, enterovirus, etc.);
• unfavorable environmental conditions (increased background radiation, high levels of air pollution, etc.);
• use of medications that are prohibited during pregnancy (as well as medications whose influence and side effects have not been sufficiently studied);
• hereditary factors;
• somatic pathologies of the mother (primarily diabetes mellitus).

These are the main factors that provoke the occurrence of heart disease in children during their prenatal development. But there are also risk groups - these are children born to women over 35 years of age, as well as those suffering from endocrine dysfunction or toxicosis of the first trimester.

Symptoms of congenital heart disease

Already in the first hours of life, a child’s body can signal about abnormalities in the development of the cardiovascular system. Arrhythmia, rapid heartbeat, difficulty breathing, loss of consciousness, weakness, bluish or pale skin indicate possible heart pathologies.

But symptoms of congenital heart disease may appear much later. Parents' concern and immediate seeking medical help should cause the following changes in the child's health:

• blueness or unhealthy pallor of the skin in the area of ​​the nasolabial triangle, feet, fingers, ears and face;
• difficulty feeding the child, poor appetite;
• delay in weight and height gain in the baby;
• swelling of the limbs;
• increased fatigue and drowsiness;
• fainting;
• increased sweating;
• shortness of breath (constant difficulty breathing or temporary attacks);
• changes in heart rate independent of emotional and physical stress;
• heart murmurs (determined by listening to a doctor);
• pain in the heart, chest.

In some cases, heart defects in children are asymptomatic. This makes it difficult to identify the disease in its early stages.

Regular visits to the pediatrician will help prevent the worsening of the disease and the development of complications. During each routine examination, the doctor must listen to the sound of the child’s heart sounds, checking for the presence or absence of murmurs - nonspecific changes that are often functional in nature and do not pose a threat to life. Up to 50% of murmurs detected during a pediatric examination may be accompanied by “minor” defects that do not require surgical intervention. In this case, regular visits, monitoring and consultations with a pediatric cardiologist are recommended.

If the doctor doubts the origin of such noises or observes pathological changes in sound, the child must be referred for a cardiac examination. The pediatric cardiologist listens to the heart again and prescribes additional diagnostic tests to confirm or refute the preliminary diagnosis.

Manifestations of the disease in varying degrees of complexity are found not only in newborns. Vices can make themselves felt for the first time already in adolescence. If a child, who looks absolutely healthy and active, shows signs of developmental delay, has blue or painful pale skin, shortness of breath and fatigue even from light exertion, then an examination by a pediatrician and consultation with a cardiologist is necessary.

Diagnostic methods

To study the condition of the heart muscle and valves, as well as to identify circulatory abnormalities, doctors use the following methods:

• Echocardiography is an ultrasound examination that allows one to obtain data on the pathologies of the heart and its internal hemodynamics.
• Electrocardiogram – diagnosis of heart rhythm disturbances.
• Phonocardiography is the display of heart sounds in the form of graphs, allowing you to study all the nuances that are not available when listening with the ear.
• with Doppler - a technique that allows the doctor to visually assess blood flow processes, the condition of the heart valves and coronary vessels by attaching special sensors to the patient’s chest area.
• Cardiorhythmography is a study of the characteristics of the structure and functions of the cardiovascular system, its autonomic regulation.
• Cardiac catheterization - inserting a catheter into the right or left chambers of the heart to determine the pressure in the cavities. During this examination, ventriculography is also performed - an X-ray examination of the chambers of the heart with the introduction of contrast agents.

Each of these methods is not used by a doctor in isolation - to accurately diagnose the pathology, the results of different studies are compared to establish the main hemodynamic disorders.

Based on the data obtained, the cardiologist determines the anatomical variant of the anomaly, clarifies the phase of the course, and predicts the likely complications of the heart defect in the child.

If there were heart defects in the family of any of the future parents, the woman’s body was exposed to at least one of the dangerous factors during the period of bearing the child, or the unborn child is at risk of possible development of congenital heart disease, then the pregnant woman should warn the obstetrician-gynecologist observing her about this .

The doctor, taking into account such information, should pay special attention to the presence of signs of cardiac anomalies in the fetus and apply all possible measures to diagnose the disease in the prenatal period. The task of the expectant mother is to undergo ultrasound and other examinations prescribed by the doctor in a timely manner.

The best results with accurate data on the state of the cardiovascular system are provided by the latest equipment for diagnosing childhood heart defects.

Treatment of congenital heart disease in children

Congenital heart abnormalities in childhood are treated in two ways:

1. Surgical intervention.
2. Therapeutic procedures.

In most cases, the only possible chance to save a child’s life is the first radical method. The fetus is examined for the presence of pathologies of the cardiovascular system even before it is born, so most often the issue of prescribing an operation is decided during this period.

In this case, childbirth is carried out in specialized maternity wards operating at cardiac surgery hospitals. If the operation is not performed immediately after the birth of the child, surgical treatment is prescribed as soon as possible, preferably in the first year of life. Such measures are dictated by the need to protect the body from the development of possible life-threatening consequences of congenital heart disease - heart failure, etc.

Modern cardiac surgery involves open-heart surgery, as well as using catheterization techniques, supplemented by X-ray imaging and transesophageal echocardiography. Elimination of cardiac defects is effectively carried out using balloon plasty, endovascular treatment (methods of inserting walls and sealing instruments). In combination with surgery, the patient is prescribed medications that increase the effectiveness of treatment.

Therapeutic procedures are an auxiliary method of combating the disease and are used when it is possible or necessary to postpone the operation to a later date. Therapeutic treatment is often recommended for “pale” defects, if the disease does not develop rapidly over months and years and does not threaten the child’s life.

During adolescence, acquired heart defects in children can develop - a combination of corrected defects and newly emerging anomalies. Therefore, a child who has undergone surgical correction of pathology may later need repeated surgery. Such operations are most often performed using a gentle, minimally invasive method in order to eliminate the burden on the psyche and body of the child as a whole, and also to avoid scars.

When treating complex heart defects, doctors do not limit themselves to correctional methods. In order to stabilize the child’s condition, eliminate the threat to life and maximize its life expectancy for the patient, a number of step-by-step surgical interventions are required to ensure adequate blood supply to the body and the lungs in particular.

Timely detection and treatment of congenital and heart diseases in children allows the majority of young patients to develop fully, lead an active lifestyle, maintain a healthy state of the body and not feel disadvantaged morally or physically.

Even after successful surgery and the most favorable medical prognosis, the main task of parents is to ensure that the child has regular visits and examinations by a pediatric cardiologist.

The appearance of a baby in a family is always happiness. But the joy of parents fades away sharply when they hear a diagnosis such as heart disease. Unfortunately, recently heart defects in children are quite common. This disease is associated with impaired development of the heart and large vessels in children, which leads to changes in blood flow, overload and insufficiency of the myocardium. Heart disease in children is congenital. According to statistics, from 5 to 8 children out of a thousand have this cardiovascular disease. All types of congenital pathologies are diverse in their anatomical features and severity. Many of them are found in various combinations. With forms incompatible with life, children do not live to see a year. After the first year of life, mortality decreases, and in the period from 1 to 15 years, about 5% of sick children die from heart defects. As you can see, this disease is very serious, requiring a special approach and comprehensive treatment.

Symptoms of heart disease

Some types of birth defects are diagnosed and successfully treated in the early stages, while others remain asymptomatic for several months or even years. After three years, the following deviations can be noticed in sick children:

• poor appetite
• liver enlargement
• rapid breathing
• frequent colds
• heart rhythm disorder
• difficulty performing physical activity

Older children may also complain of pain in the chest area or under the shoulder blade, dizziness and headaches. Symptoms of heart disease in newborns may vary depending on the specific abnormality, but common to all are heart failure and insufficient supply of nutrients and oxygen to tissues and organs.

According to the characteristics of blood discharge, congenital heart defects are blue and white. As a rule, a decrease in oxygen concentration in arterial blood occurs with the birth of a baby. Due to metabolic disorders, toxic metabolic products accumulate in the blood. This phenomenon is based on the mixing of arterial and venous blood inside the heart. These are blue defects, in which the child experiences cyanosis of the skin, ears, lips, and rapid breathing.

White defects are characterized by the discharge of venous blood from left to right. With white defects, babies experience pale skin and cold extremities. Having a defect in the form of a heart defect, the child quickly gets tired during feeding and sucks poorly at the breast. The pediatrician may hear a heart murmur and look for slow weight gain. However, heart murmurs may not always indicate the presence of a disease. Therefore, if a heart defect is suspected in newborns, consultation with a cardiologist is necessary.

To date, it is not possible to determine the cause of congenital heart defects in children. This vital organ is laid down and formed from the 2nd to the 8th week of pregnancy, that is, during a period when a woman often does not yet know about motherhood. Therefore, it is very important at this time to avoid the influence of harmful factors that can lead to the development of defects. The most important among them are the following:

• bad habits of the mother (smoking, drug use)
• the effect of certain medications (antibiotics, hormonal pills)
• heredity
• gene and chromosomal mutations
• chronic diseases of women (diabetes mellitus, endocrine diseases)
• infectious diseases that a woman suffered during pregnancy (rubella, herpes, influenza)
• excessive exposure, radiation
• harmful working conditions
• woman's age (over 35 years old)

Remember, the earlier heart defects are detected in newborns, the greater the hope for its timely and successful treatment.

Treatment of heart disease

Congenital heart defects in children are treatable in 90% of cases. Today, thanks to modern medicine, this disease can be successfully cured. Like any other disease, heart disease is easier to treat if it is detected at an early stage. Therefore, as soon as you notice unusual changes in the baby’s behavior and condition, contact a specialist. Additional examination will be prescribed if the doctor confirms that the symptoms may be signs of heart disease. Heart defects can be diagnosed from birth in the first 3 months of a child’s life using the following methods:

1) electrocardiography - this ultrasound method helps determine how the heart works, its structure, and also checks the function of the valves,

2) cardiac catheterization - this method allows you to determine any defects, their size, location and severity,

3) echocardiography is a very accurate diagnostic method that allows you to assess the structural features and contractility of the myocardium.

Congenital heart disease in children can be diagnosed in utero. As a rule, this can be done starting from the 14th week of pregnancy, when the woman undergoes an ultrasound. At the slightest suspicion of a heart defect in the fetus, as well as if the woman is at risk, she is sent to a specialized institution. If congenital heart disease is detected in the fetus, the birth will take place under the supervision of specialists in a specialized hospital, where the child will subsequently be operated on.

Children with mild heart defects need to be monitored by a cardiologist and undergo regular examinations. Over time, their heart may heal on its own. If a newborn has a heart defect, it is necessary to spend time with him in the fresh air more often, and protect him from infections and stress. Treatment of heart disease depends on the degree of its complexity. Severe defects require surgical intervention in the first days of the baby’s life. Sometimes operations are carried out in several stages: initially, the child’s condition is alleviated, and then they are prepared for surgery to completely eliminate the defects.

Surgery for heart defects can be open or closed. During closed surgery, the heart is not affected, and the operation is performed on the large blood vessels around it. In open operations, the heart cavity is opened. During the operation, the heart and lungs are turned off from the blood circulation. And the blood is enriched with oxygen and pumped throughout the body using a heart-lung machine. After surgery, children need a high-calorie diet and intensive care.

If your child is diagnosed with a heart defect, do not panic - modern medical technologies make it possible to treat all types of defects and give positive results.

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Heart disease in a child is the most complex nosological entity in medicine. Every year, per 1000 newborns, there are 10-17 children with this problem. Early detection and referral for treatment guarantees a favorable prognosis for later life.

Undoubtedly, all developmental defects must be diagnosed in the fetus in utero. An important role is also played by the pediatrician, who will be able to promptly identify and refer such a child to a pediatric cardiologist.

If you are faced with this pathology, then let’s look at the essence of the problem, and also tell you the details of the treatment of children’s heart defects.

1. Diseases of the mother during pregnancy.
2. An infectious disease suffered in the 1st trimester, when the development of cardiac structures occurs at 4-5 weeks.
3. Smoking, mother's alcoholism.
4. Ecological situation.
5. Hereditary pathology.
6. Genetic mutations caused by chromosomal abnormalities.

There are many reasons for the appearance of congenital heart disease in a fetus. It is impossible to single out just one.

Classification of defects

1. All congenital heart defects in children are divided according to the nature of the blood flow disturbance and the presence or absence of cyanosis of the skin (cyanosis).

Cyanosis is a blue discoloration of the skin. It is caused by a lack of oxygen, which is delivered with the blood to organs and systems.

2. Frequency of occurrence.

1. Ventricular septal defect occurs in 20% of all heart defects.
2. Atrial septal defect accounts for 5 - 10%.
3. Patent ductus arteriosus accounts for 5 - 10%.
4. Pulmonary stenosis, stenosis and coarctation of the aorta account for up to 7%.
5. The remaining part is accounted for by other numerous, but rarer defects.

Signs of heart disease in children

• one of the signs of defects is the appearance of shortness of breath. First it appears during exercise, then at rest.

Dyspnea is an increased rate of breathing;

Symptoms of heart defects in newborns

You need to pay attention to:

• starting breastfeeding;
• Is the baby actively sucking?
• duration of one feeding;
• does the breast drop during feeding due to shortness of breath;
• Does pallor appear when sucking?

If a baby has a heart defect, he sucks sluggishly, weakly, with breaks of 2 - 3 minutes, shortness of breath appears.

Symptoms of heart disease in children older than one year

If we talk about older children, here we evaluate their physical activity:

• Can they climb the stairs to the 4th floor without shortness of breath? Do they sit down to rest during games?
• whether respiratory diseases, including pneumonia and bronchitis, are common.

Clinical case! In a woman at 22 weeks, an ultrasound of the fetal heart revealed a ventricular septal defect and hypoplasia of the left atrium. This is a rather complex vice. After the birth of such babies, they are immediately operated on. But the survival rate, unfortunately, is 0%. After all, heart defects associated with underdevelopment of one of the chambers in the fetus are difficult to treat surgically and have a low survival rate.

Violation of the integrity of the interventricular septum

The heart has two ventricles, which are separated by a septum. In turn, the septum has a muscular part and a membranous part.

The muscular part consists of 3 areas - inflow, trabecular and outflow. This knowledge of anatomy helps the doctor make an accurate diagnosis according to the classification and decide on further treatment tactics.

If the defect is small, then there are no special complaints.

If the defect is medium or large, then the following symptoms appear:

• retardation in physical development;
• decreased resistance to physical activity;
• frequent colds;
• in the absence of treatment - development of circulatory failure.

For large defects and the development of heart failure, surgical measures should be performed.

Atrial septal defect

Very often the defect is an accidental discovery.

Children with atrial septal defect are prone to frequent respiratory infections.

With large defects (more than 1 cm), the child may experience poor weight gain and the development of heart failure from birth. Children undergo surgery when they reach five years of age. The delay in surgery is due to the likelihood of spontaneous closure of the defect.

Open duct of Botall

This problem accompanies premature babies in 50% of cases.

If the size of the defect is large, the following symptoms are detected:

• poor weight gain;
• shortness of breath, rapid heartbeat;
• frequent ARVI, pneumonia.

We wait up to 6 months for spontaneous closure of the duct. If in a child older than one year it remains unclosed, then the duct must be removed surgically.

When diagnosed in the maternity hospital, premature babies are given the drug indomethacin, which scleroses (glues) the walls of the vessel. This procedure is not effective for full-term newborns.

Coarctation of the aorta

This congenital pathology is associated with a narrowing of the main artery of the body - the aorta. In this case, a certain obstacle to blood flow is created, which forms a specific clinical picture.

Happening! A 13-year-old girl complained of increased blood pressure. When measuring pressure on the legs with a tonometer, it was significantly lower than on the arms. The pulse in the arteries of the lower extremities was barely palpable. Cardiac ultrasound revealed coarctation of the aorta. For 13 years, the child has never been examined for congenital defects.

Usually, narrowing of the aorta is detected at birth, but may occur later. Such children even have their own peculiarity in appearance. Due to poor blood supply to the lower part of the body, they have a fairly developed shoulder girdle and puny legs.

It occurs more often in boys. As a rule, coarctation of the aorta is accompanied by a defect in the interventricular septum.

Bicuspid aortic valve

Normally, the aortic valve should have three cusps, but it so happens that there are two of them from birth.

Tricuspid and bicuspid aortic valve

Children with a bicuspid aortic valve do not particularly complain. The problem may be that such a valve will wear out faster, which will cause the development of aortic insufficiency.

When grade 3 insufficiency develops, surgical valve replacement is required, but this can happen by the age of 40-50.

Children with a bicuspid aortic valve should be monitored twice a year and endocarditis should be prevented.

Sports heart

Regular physical activity leads to changes in the cardiovascular system, which are referred to as “athletic heart.”

An athletic heart is characterized by an increase in the cavities of the cardiac chambers and myocardial mass, but cardiac function remains within the age-related norm.

Changes in the heart appear 2 years after regular training 4 hours a day, 5 days a week. Athletic heart is more common among hockey players, sprinters, and dancers.

Changes during intense physical activity occur due to the economical work of the myocardium at rest and the achievement of maximum capabilities during sports activities.

Sports heart does not require treatment. Children should be examined twice a year.

Acquired heart defects in children

The most common acquired heart defect is a valve defect.

• rheumatism;
• previous bacterial and viral infections;
• infective endocarditis;
• frequent sore throats, previous scarlet fever.

Of course, children with an unoperated acquired defect must be observed by a cardiologist or therapist throughout their lives. Congenital heart defects in adults are an important problem that should be reported to your physician.

Diagnosis of congenital heart defects

1. Clinical examination by a neonatologist of the child after birth.
2. Fetal ultrasound of the heart. Conducted at 22-24 weeks of pregnancy, where the anatomical structures of the fetal heart are assessed
3. At 1 month after birth, ultrasound heart screening, ECG.

The most important examination in diagnosing the health of the fetus is ultrasound screening in the second trimester of pregnancy.

In modern medicine, if you have the necessary equipment, diagnosing a congenital defect is not difficult.

Treatment of congenital heart defects

Heart disease in children can be cured surgically. But, it should be remembered that not all heart defects need to be operated on, since they can heal spontaneously and take time.

The determining tactics of treatment will be:

• type of defect;
• presence or worsening heart failure;
• age, weight of the child;
• associated developmental defects;
• the likelihood of spontaneous elimination of the defect.

Surgical intervention can be minimally invasive, or endovascular, when access occurs not through the chest, but through the femoral vein. This is how small defects, coarctation of the aorta, are closed.

Prevention of congenital heart defects

Since this is a congenital problem, prevention should begin in the prenatal period.

1. Elimination of smoking and toxic effects during pregnancy.
2. Consultation with a geneticist if there are congenital defects in the family.
3. Proper nutrition for the expectant mother.
4. Treatment of chronic foci of infection is mandatory.
5. Physical inactivity worsens the functioning of the heart muscle. Daily gymnastics, massages, and work with a physical therapy doctor are required.
6. Pregnant women should definitely undergo ultrasound screening. Heart defects in newborns should be monitored by a cardiologist. If necessary, it is necessary to promptly refer to a cardiac surgeon.
7. Mandatory rehabilitation of operated children, both psychological and physical, in sanatorium-resort conditions. Every year the child must be examined in a cardiology hospital.

Heart defects and vaccinations

It should be remembered that it is better to refuse vaccinations if:

• development of heart failure of the 3rd degree;
• in case of endocarditis;
• for complex defects.

Graduated from South State Medical University, internship in pediatrics, residency in pediatric cardiology, since 2012 she has worked at the Lotos MC, Chelyabinsk.

Heart disease: what is it?

Heart disease is a change in the anatomical structures of the heart (chambers, valves, septa) and the vessels extending from it, which lead to hemodynamic disturbances. All heart defects are divided into two groups: congenital and acquired. In childhood, congenital heart defects (CHD) are usually detected. They come in two types:

• “Blue”, in which venous blood enters the arteries, so the skin acquires a bluish tint. This group of congenital heart diseases is the most dangerous, since the child’s organs and tissues do not receive enough oxygen due to the mixing of arterial and venous blood saturated with carbon dioxide. The most common “blue” congenital heart defects are pulmonary atresia, tetralogy of Falo, and transposition of the vessels.
• “White”, characterized by the discharge of blood to the right side of the heart and pale skin. Defects of this type are easier for patients to tolerate, but over time they lead to the development of heart failure and lung problems. Examples are atrial septal defect, patent ductus arteriosus, etc.

Congenital heart disease in children develops in the womb, and this happens when the heart is formed - during the first 2 months of pregnancy. If negative factors influence the female body during this period, the risk of congenital heart disease in the child increases significantly. Factors leading to the development of heart defects in the fetus include:

• Alcohol, nicotine, drugs.
• Radiation.
• Certain medications (including sulfonamides, aspirin, antibiotics).
• Rubella virus.
• Unfavorable ecology.

In addition, genetics plays a large role in the formation of heart defects. Mutation of certain genes causes a disruption in the synthesis of proteins that form the septum of the heart. Genetic mutations can be inherited, or they can appear due to a woman’s use of drugs, alcohol, exposure to radiation, etc.

How to determine a heart defect?

An experienced ultrasound doctor can diagnose heart defects even in utero. Therefore, gynecologists strongly recommend that all expectant mothers undergo routine ultrasound examinations. Prenatal detection of serious congenital heart disease in the fetus gives a woman the right to choose: to give birth or not to give birth to a seriously ill child. If a woman wants to carry the pregnancy to term, organize the birth in such a way that the newborn is immediately provided with the necessary medical care (as a rule, these are resuscitation measures) and the operation is performed as soon as possible.

It often happens that heart defects are not detected in utero, the child is born, at first glance, completely healthy, and problems arise later. Therefore, in order not to miss congenital heart disease, to prevent the progression of pathology and the development of complications, each newborn is carefully examined in the maternity hospital. The first thing that indicates a possible defect is a murmur detected by listening to the heart. If this is detected, the child is immediately sent to a specialized clinic for further examination (echocardiography, ECG and other studies).

However, it is not always possible to detect a heart defect in a newborn in the first days of life (murmurs may simply not be heard), so it is important for parents to know what symptoms indicate that something is wrong with the child’s heart in order to consult a doctor in a timely manner. These signs include the following:

• Pale or bluish skin (especially around the lips, on the arms, on the heels).
• Poor weight gain.
• Sluggish sucking, frequent breaks during feeding.
• Rapid heartbeat (the norm in newborns is 150 – 160 beats per minute).

With some congenital heart disease, pronounced symptoms of the pathology appear not in the first year of life, but later. In such cases, the presence of heart pathology can be suspected based on the following signs:

• Lagging behind peers in physical development.

In addition, parents should regularly take the child to a pediatrician or family doctor (every month in the first year of life, annually thereafter), since only a doctor can hear heart murmurs and notice what fathers and mothers do not pay attention to.

If someone in the family has congenital heart disease or the pregnancy occurred against the background of aggravating factors (endocrine and autoimmune diseases of the woman, severe toxicosis, threat of miscarriage, infectious diseases, taking medications, smoking and alcohol abuse, etc.), the child It is advisable to examine the heart using echocardiography even in the absence of any pathological symptoms.

Treatment and prognosis

The approach to treatment of congenital heart disease is always individual. For some patients, surgery is performed immediately after birth, for others – after six months, and for others, doctors treat them conservatively, without any surgical interventions. Congenital defects that are well tolerated by patients and do not always require surgical correction (since they often close spontaneously) include the following:

• Small defects in the septa between the ventricles and atria.
• Patent ductus arteriosus.
• Minor deformations of the heart valves.

The prognosis for these congenital heart defects is usually favorable, even if surgical treatment is required.
The situation is much worse with most “blue” vices. These vices are more complex and more dangerous. The most severe congenital heart diseases include:

• Transposition (change of places) of the aorta and pulmonary artery.
• The origin of both the aorta and pulmonary artery is from the right ventricle.
• Tetralogy of Falo (includes 4 anomalies of the development of the heart and great vessels).
• Severe valve defects.
• Hypoplasia (underdevelopment) of the heart. A particularly dangerous defect is the underdevelopment of the left sections. The question of how long people live with it can be answered with statistical data - with this defect there is almost 100% mortality.
• Atresia (fusion) of the pulmonary artery.

With severe congenital heart disease, heart failure rapidly increases; children immediately after birth go into a very serious condition, requiring immediate surgical intervention. The success of such treatment directly depends on how quickly the newborn is delivered to a specialized cardiac surgery clinic and how the correct treatment tactics are chosen. Compliance with these two conditions is possible only in one case - if the defect is identified before the birth of the child. Intrauterine diagnosis of congenital heart disease allows doctors of all levels (both obstetricians-gynecologists and cardiac surgeons) to prepare for the upcoming birth and plan surgical intervention on the newborn’s heart.

While still in the mother’s tummy, the baby’s cardiac system is formed. Every parent worries about the health of the little person, but no one is immune from heart defects. Today, every second child born can be diagnosed with this pathology.

Every mother needs to know what heart disease means in newborns, why it is dangerous, its causes, signs of pathology and methods of treatment. Give up bad habits, follow a proper diet - this is important not only for you, but also for your baby.

Description of the pathology

Heart disease in newborns

Congenital heart disease is an anatomical defect that occurs in utero (during pregnancy, in the early stages), a violation of the correct structure of the heart, or the valve apparatus, or the blood vessels of the child’s heart. Among heart diseases in children, congenital defects firmly occupy a leading place.

Every year, out of every 1,000 babies born, 7 to 17 have heart anomalies or malformations. Moreover, without the provision of qualified cardiac, intensive care and cardiac surgery care, up to 75% of babies may die in the first months of life.

There are about two dozen CHDs in total, and the frequency of occurrence varies. The most common defects, according to pediatric cardiologists, are: ventricular septal defect, in second place is atrial septal defect, in third place is patent ductus arteriosus.

Of particular social importance to congenital diseases are the high mortality and disability of children, from a very early age, which undoubtedly has serious implications for the health of the nation as a whole. Children require detailed and highly qualified treatment; we need trained specialists in the regions and specialized clinics.

Sometimes the treatment of a child is long and expensive, and most parents are simply not able to pay for the treatment, which makes it much more difficult to provide assistance. With the current level of progress in cardiac surgery, it is possible to surgically cure 97% of children with defects, and in the future the children will completely get rid of the disease. The main thing is a timely diagnosis!

Congenital heart defects are anomalies in the structure of large vessels and the heart that form between 2 and 8 weeks of pregnancy. According to statistics, 1 child out of a thousand is diagnosed with such a pathology, and in one or two, the diagnosis can be fatal.

Why does heart disease occur in newborns?

A congenital defect occurs if any harmful factor affects the development of the cardiovascular system in the fetus. During these periods, the most severe defects are formed, because the formation of the chambers and partitions of the heart occurs, and the main vessels are formed.

Often the causes of congenital heart disease are viral diseases that a pregnant woman suffers in the first three months; viruses are able to penetrate to the fetus through the developing placenta and have a damaging effect. The harmful effects of ARVI, influenza and herpes simplex have been proven.

The rubella virus poses the greatest danger to a pregnant woman, especially if there are children in the family. Rubella, contracted by the mother up to 8-12 weeks, in 60-80% of cases causes Gregg's triad - a classic symptom complex of rubella: congenital heart disease with congenital cataracts (clouding of the lens) and deafness.

There may also be malformations of the nervous system. An important role in the formation of congenital heart disease is played by occupational hazards, intoxication, and unfavorable environmental conditions of the place of residence - for mothers who drank alcohol in the early stages of pregnancy, the likelihood of the defect increases by 30%, and in combination with nicotine - up to 60%.

In 15% of children with heart defects, there is an indication of the expectant mother’s contact with paint and varnish materials, and in 30% of children, the fathers were drivers of vehicles, often in contact with gasoline and exhaust gases.

There is a connection between the development of the defect and the mother taking medications shortly before pregnancy, in the early stages - papaverine, quinine, barbiturates, narcotic analgesics and antibiotics, hormonal substances that can negatively affect the formation of the heart.

Chromosomal and gene mutations are detected in 10% of children with heart defects, and a connection with toxicosis of pregnancy and many other factors has been noted.

How does the disease develop and how dangerous is it?

By the end of the first trimester of pregnancy, the fetal heart is already well formed, and by the 16-20th week of pregnancy, it is possible to identify many severe defects using ultrasound. With subsequent studies, the diagnosis can be definitively established.

The blood circulation of the fetus is designed in such a way that most defects do not affect intrauterine development - with the exception of extremely severe ones, in which the death of the baby occurs in the first weeks of intrauterine development.

After birth, the baby’s blood circulation is rearranged into two circles of blood circulation, the vessels and openings that worked intrauterinely are closed, and the circulatory system is adjusted to an adult way.

The clinical picture of congenital heart disease is varied and is determined by three characteristic factors:

• depends on the type of defect;
• from the capabilities of the baby’s body to compensating for violations, using adaptive reserve capabilities;
• complications arising from the defect.

Taken together, the signs give a different picture of the defect in different babies; in some it is recognized immediately, or it can be asymptomatic for a long time. Babies often experience cyanosis (blue color), while others may have a blue appearance in both their limbs and body. The second dangerous sign is shortness of breath and heavy breathing of the baby, he cannot suckle, gets tired quickly, and is lethargic.

It is possible that the baby is not gaining weight well, despite all efforts to feed, there may be delays in psychomotor development, frequent respiratory illnesses, recurring pneumonia in early childhood, disturbances in the structure of the chest with the formation of a protrusion (heart hump) in the area of ​​​​the projection of the heart.

We will talk about the manifestations, specific complaints and clinical picture of each type of congenital heart disease in the future, the main thing that is worth noting for parents is that if the baby has the slightest alarming symptoms, seek advice from a pediatrician or cardiologist.

Classification

There are a large number of classifications of heart defects in newborns, and among them there are about 100 types. Most researchers divide them into white and blue:

• white: baby's skin becomes pale;
• blue: the baby’s skin takes on a bluish tint.

White heart defects include:

• ventricular septal defect: part of the septum is lost between the ventricles, venous and arterial blood mixes (observed in 10-40% of cases);
• atrial septal defect: formed when the closure of the oval window is disrupted, as a result, a “gap” is formed between the atria (observed in 5-15% of cases);
• coarctation of the aorta: in the area where the aorta exits the left ventricle, narrowing of the aortic trunk occurs (observed in 7-16% of cases);
• stenosis of the aortic mouth: often combined with other heart defects, a narrowing or deformation is formed in the area of ​​the valve ring (observed in 2-11% of cases, more often in girls);
• patent ductus arteriosus: normally, closure of the aortic duct occurs 15-20 hours after birth; if this process does not occur, then blood is discharged from the aorta into the vessels of the lungs (observed in 6-18% of cases, more often in boys);
• pulmonary artery stenosis: the pulmonary artery narrows (this can be observed in different parts of it) and this hemodynamic disturbance leads to heart failure (observed in 9-12% of cases).

Blue heart defects include:

• tetralogy of Fallot: accompanied by a combination of pulmonary artery stenosis, displacement of the aorta to the right and ventricular septal defect, leading to insufficient blood flow into the pulmonary artery from the right ventricle (observed in 11-15% of cases);
• atresia of the tricuspid valve: accompanied by a lack of communication between the right ventricle and the atrium (observed in 2.5-5% of cases);
• anomalous drainage (ie drainage) of the pulmonary veins: the pulmonary veins drain into the vessels leading to the right atrium (observed in 1.5-4% of cases);
• transposition of large vessels: the aorta and pulmonary artery change places (observed in 2.5-6.2% of cases);
• common arterial trunk: instead of the aorta and pulmonary artery, only one vascular trunk (truncus) branches off from the heart, this leads to mixing of venous and arterial blood (observed in 1.7-4% of cases);
• MARS syndrome: manifested by mitral valve prolapse, false chordae in the left ventricle, patent foramen ovale, etc.

Congenital valvular heart defects include anomalies associated with stenosis or insufficiency of the mitral, aortic or tricuspid valve.

Although congenital defects are detected in the womb, in most cases they do not pose a threat to the fetus, since its circulatory system is slightly different from that of an adult. Below are the main heart defects.

1. Ventricular septal defect.

The most common pathology. Arterial blood enters through the opening from the left ventricle to the right. This increases the load on the small circle and on the left side of the heart.

When the hole is microscopic and causes minimal changes in blood circulation, surgery is not performed. For large holes, suturing is done. Patients live to old age.

A condition where the interventricular septum is severely damaged or absent altogether. In the ventricles, a mixture of arterial and venous blood occurs, the oxygen level drops, and cyanosis of the skin is pronounced.

Children of preschool and school age are typically forced to squat (this reduces shortness of breath). An ultrasound scan reveals an enlarged spherical heart and a noticeable cardiac hump (protrusion).

The operation must be done without delaying for long, since without appropriate treatment, patients, at best, live up to 30 years.

The operation involves installing a graft on the damaged area. After the measures taken, the functioning of the heart and blood vessels is restored and the patient lives a long time.

General symptoms of the disease in newborns

Within the group of diseases called Congenital Heart Disease, symptoms are divided into specific and general. Specific ones, as a rule, are not assessed immediately at the time the child is born, because the first goal is to stabilize the functioning of the cardiovascular system.

Specific symptoms are often identified during functional tests and instrumental research methods. The general symptoms include the first characteristic signs. This is tachypnea, tachycardia or bradycardia, skin coloring characteristic of two groups of defects (white and blue defects).

These violations are fundamental. At the same time, the task of the circulatory and respiratory system is to supply the remaining tissues with oxygen and a substrate for oxidation, from which energy is synthesized.

Under conditions of blood mixing in the cavity of the atria or ventricles, this function is disrupted, and therefore peripheral tissues suffer from hypoxia, which also applies to nervous tissue. These features also characterize heart valve defects, vascular malformations in the heart, dysplasia of the aorta and pulmonary veins, transposition of the aorta and pulmonary trunk, coarctation of the aorta.

As a result, muscle tone decreases and the intensity of the manifestation of basic and specific reflexes decreases. These signs are included in the Apgar scale, which allows you to determine the degree of full term of the child.

At the same time, congenital heart disease in newborns can often be accompanied by early or premature birth. This can be explained by many reasons, although often, when congenital heart disease is not detected in newborns, this indicates prematurity due to:

• Metabolic;
• Hormonal;
• Physiological and other reasons.

Some birth defects are accompanied by changes in skin color. There are blue defects and white defects, accompanied by cyanosis and pallor of the skin, respectively. White defects include pathologies accompanied by the discharge of arterial blood or the presence of an obstacle to its release into the aorta.

These vices include:

1. Coarctation of the aorta.
2. Aortic stenosis.
3. Atrial or ventricular septal defect.

For blue defects, the development mechanism is associated with other reasons. Here the main component is stagnation of blood in a large circle due to poor outflow into the pulmonary aorta, lungs or left parts of the heart. These are disorders such as mitral, aortic, tricuspid congenital heart disease.

The causes of this disorder also lie in genetic factors, as well as in diseases of the mother before and during pregnancy. Mitral valve prolapse in children: symptoms and diagnosis Mitral valve prolapse (MVP) in children is one of the types of congenital heart defects, which became known only half a century ago.

Let us remember the anatomical structure of the heart to understand the essence of this disease. It is known that the heart has two atria and two ventricles, between which there are valves, a kind of gate that allows blood to flow in one direction and prevents blood from flowing back into the atria during contraction of the ventricles.

Between the right atrium and the ventricle, the locking function is performed by the tricuspid valve, and between the left ones - by the bicuspid, or mitral, valve. Mitral valve prolapse is manifested by the bowing of one or both valve leaflets into the atrium during contraction of the left ventricle.

Mitral valve prolapse in a child is usually diagnosed in older preschool or school age, when, unexpectedly for the mother, the doctor discovers a heart murmur in a practically healthy child and suggests being examined by a cardiologist. An ultrasound examination of the heart will confirm the doctor’s suspicions and allow us to speak with confidence about mitral valve prolapse.

Regular monitoring by a cardiologist is the only indispensable condition that a child will have to comply with before starting activities associated with physical overexertion. Most people with mitral valve prolapse lead normal lives without knowing they have the disease.

Severe complications of mitral valve prolapse are rare. This is mainly divergence of the leaflets, leading to mitral valve insufficiency, or infective endocarditis.

Heart disease in newborns - causes

In 90% of cases, congenital heart disease in a newborn develops due to exposure to unfavorable environmental factors. The reasons for the development of this pathology include:

• genetic factor;
• intrauterine infection;
• age of parents (mother over 35 years old, father over 50 years old);
• environmental factor (radiation, mutagenic substances, soil and water pollution);
• toxic effects (heavy metals, alcohol, acids and spirits, contact with paints and varnishes);
• taking certain medications (antibiotics, barbiturates, narcotic analgesics, hormonal contraceptives, lithium preparations, quinine, papaverine, etc.);
• maternal diseases (severe toxicosis during pregnancy, diabetes mellitus, metabolic disorders, rubella, etc.)

Children at risk for developing congenital heart defects include:

• with genetic diseases and Down syndrome;
• premature;
• with other developmental defects (i.e., with disturbances in the functioning and structure of other organs).

Symptoms and signs of congenital heart disease in children can vary. The degree of their manifestation largely depends on the type of pathology and its impact on the general condition of the newborn. If a baby has a compensated heart defect, it is almost impossible to notice any signs of the disease externally.

If the newborn has a decompensated heart defect, then the main signs of the disease will be noted after birth. Congenital heart defects in children are manifested by the following symptoms:

1. Blue skin. This is the first sign that the child has congenital heart disease.

It occurs against the background of a deficiency of oxygen in the body. Limbs, the nasolabial triangle, or the entire body may turn blue. However, blue discoloration of the skin can also occur with the development of other diseases, for example, the central nervous system.

A doctor can assume that a newborn child has this pathology based on the following signs:

• Bluishness of the limbs.
• Pallor of the skin.
• On cold hands, feet and nose (to the touch).
• Heart murmurs during auscultation (listening).
• Presence of symptoms of heart failure.

If the baby exhibits all these signs, the doctor gives a referral for a full examination of the child to clarify the diagnosis.

As a rule, the following diagnostic methods are used to confirm or refute the diagnosis:

1. Ultrasound of all internal organs and assessment of their functioning.
2. Phonocardiogram.
3. X-ray of the heart.
4. Cardiac catheterization (to clarify the type of defect).
5. MRI of the heart.
6. Blood tests.

It should be noted that external signs of congenital heart disease may initially be completely absent, and appear only as the baby grows older. Therefore, it is very important that every parent thoroughly examines their child in the first few months.

This will allow timely identification of the development of congenital heart disease and take all necessary measures. It’s just that if this pathology is not detected in a timely manner and its treatment is not started, this can lead to dire consequences.

Signs of the disease

A newborn baby with a heart defect is restless and does not gain weight well. The main signs of congenital heart disease may include the following symptoms:

• cyanosis or pallor of the outer skin (usually in the area of ​​the nasolabial triangle, on the fingers and toes), which is especially pronounced during breastfeeding, crying and straining;
• lethargy or restlessness when attaching to the breast;
• slow weight gain;
• frequent regurgitation during breastfeeding;
• causeless screaming;
• attacks of shortness of breath (sometimes combined with cyanosis) or constantly rapid and difficult breathing;
• causeless tachycardia or bradycardia;
• sweating;
• swelling of the limbs;
• bulging in the area of ​​the heart.

If such signs are detected, the child’s parents should immediately consult a doctor to have the child examined. During the examination, the pediatrician can detect heart murmurs and recommend further treatment by a cardiologist.

Diagnostics

If congenital heart disease is suspected, the child is urgently sent for consultation to a cardiologist, and in case of emergency measures, to a cardiac surgery hospital.

There they will pay attention to the presence of cyanosis that changes when breathing under an oxygen mask, shortness of breath involving the ribs and intercostal muscles, assess the nature of the pulse and pressure, conduct blood tests, assess the condition of organs and systems, especially the brain, listen to the heart, noting the presence of various noises, and will conduct additional research.

An ultrasound of the heart and blood vessels will be performed. Diagnostics, goals:

• clarify whether there really is a vice;
• determine the main circulatory disorders caused by congenital heart disease, recognize the anatomy of the defect;
• to clarify the phase of the defect, the possibility of surgical and conservative treatment at this stage;
• determine the presence or absence of complications, the feasibility of their treatment;
• choose the tactics of surgical correction and timing of the operation.

At the present stage, with the introduction into practice of almost universal ultrasound examination of the fetus during pregnancy, there is actually a possibility of making a diagnosis of congenital heart disease at a period of pregnancy up to 18-20 weeks, when the question of the advisability of continuing pregnancy can be decided.

Unfortunately, there are few such highly specialized hospitals in the country, and most mothers are forced to go to large centers in advance for hospitalization and childbirth. If an ultrasound reveals abnormalities in the baby’s heart, do not become despondent.

The defect is not always detected in utero, but from the moment of birth the clinical picture of the defect begins to increase - then emergency assistance may be required, the baby will be transferred to a cardiac surgery hospital in an intensive care unit and everything possible will be done to save his life, including open-heart surgery.

To diagnose children with suspected congenital heart disease, a complex of the following research methods is used:

• Echo-CG;
• radiography;
• general blood analysis.

If necessary, additional diagnostic methods such as cardiac catheterization and angiography are prescribed.

All newborns with congenital heart defects are subject to mandatory monitoring by a local pediatrician and cardiologist. A child in the first year of life should be examined every 3 months. For severe heart defects, examination is carried out every month.

Parents must be made aware of the mandatory conditions that must be created for such children:

• preference for natural feeding with mother's or donor milk;
• increasing the number of feedings by 2-3 doses with a decrease in the amount of food per meal;
• frequent walks in the fresh air;
• feasible physical activity;
• contraindications for being in severe frost or open sun;
• timely prevention of infectious diseases;
• rational nutrition with a reduction in the amount of liquid drunk, table salt and the inclusion of foods rich in potassium in the diet (baked potatoes, dried apricots, prunes, raisins).

Surgical and therapeutic techniques are used to treat a child with congenital heart disease. As a rule, medications are used to prepare a child for surgery and treatment after it.

For severe congenital heart defects, surgical treatment is recommended, which, depending on the type of heart defect, can be performed using a minimally invasive technique or using an open heart with the child connected to a heart-lung machine.

After the operation, the child is under the supervision of a cardiologist. In some cases, surgical treatment is carried out in several stages, i.e. the first operation is performed to alleviate the patient’s condition, and subsequent operations are performed to completely eliminate the heart defect.

The prognosis for timely surgery to eliminate congenital heart disease in newborns is favorable in most cases.

Medications

Taking medications during pregnancy is of particular importance. Currently, they have completely stopped taking thalidomide - this drug caused numerous congenital deformities during pregnancy (including congenital heart defects).

In addition, the following have a teratogenic effect: