Heart disease is a disease of the heart valves, in which the organ begins to work improperly. As a result of a congenital or acquired change in the structure of the valvular apparatus, cardiac partitions, walls or large vessels extending from the heart, a violation of the blood flow of the heart occurs. Congenital heart defects are distinguished by a variety of anomalies in the development of the heart and blood vessels and usually appear in childhood. Acquired vices are formed in different age periods due to damage to the heart in rheumatism and some other diseases.
What is the difference between congenital heart disease and acquired?
Congenital heart defect
Congenital heart disease is detected in approximately 1% of newborns. The cause of the disease is the abnormal development of the organ inside the womb. Congenital heart disease affects the walls of the myocardium and large vessels adjacent to it. The disease may progress. If the operation is not performed, then the child may develop changes in the structure of the heart, in some cases a fatal outcome is possible. With timely surgical intervention, complete restoration of heart function is possible.
Prerequisites for the development of congenital heart disease:
- fetal development disorders under the influence of pathogenic factors in the first months of pregnancy (radiation, viral infections, vitamin deficiency, uncontrolled intake of medications, including some vitamins);
- parents smoking;
- alcohol consumption by parents.
Acquired heart disease
Acquired heart disease does not occur immediately after birth, but over time. It manifests itself as a malfunction of the valvular apparatus of the heart (narrowing of the walls or insufficiency of the heart valves).
Surgical treatment consists in replacing the heart valve with a prosthesis.
If two or more orifices of the heart or valves are simultaneously affected, they speak of a combined acquired defect. For the appointment of an operation of an acquired defect, it is classified according to the degree of anatomical changes and disorders.
Causes of acquired heart disease:
Treatment of heart defects
People with heart defects need complex treatment:
- organization of the regime of physical activity;
- drug therapy for heart failure and other complications;
- diet;
- physiotherapy.
Surgical treatment is the most effective. Surgical correction is applied to both acquired and congenital malformations, and operations are increasingly being performed on newborns and children from the first year of life.
An acquired defect requires surgical treatment in cases where therapeutic treatment is ineffective and ordinary physical activity causes fatigue, shortness of breath, palpitations, angina pectoris in patients. Operations with an acquired defect are done in order to preserve the patient's own heart valves and restore their function, including by valvuloplasty (suturing the leaflets, using animal heart valves, etc.). If a valve-preserving operation is not possible, the valves are replaced with mechanical or biological prostheses.
How is heart surgery going?
Most heart surgeries are performed under cardiopulmonary bypass. After operations, patients need long-term rehabilitation with a gradual restoration of their physical activity. The deterioration of the condition of the operated patient may be associated with the development of complications caused by surgical intervention, so patients should periodically undergo examinations in cardiological centers. For uncomplicated course postoperative period many patients can return to work 6-12 months after surgery.
* Heart valve - part of the heart, formed by the folds of its inner shell, provides unidirectional blood flow.
** Myocardium is the middle muscular layer of the heart, which makes up the bulk of its mass.
*** Heart valve insufficiency is a type of heart disease in which, due to incomplete closure of the valve, due to its defeat, part of the blood flows back into those parts of the heart from which it came.
**** Myocardial infarction is an acute form of coronary heart disease.
Heart disease is a collective name for a number of diseases that are associated with an incorrect position of the heart, its general underdevelopment, or with defects in the heart valves and / or abnormal vasoconstriction. The circulatory system, as you know, works in two directions: the arterial blood is saturated with oxygen and, when inhaled, makes a circle through the vessels, enriching the body, while the venous blood, when exhaled, takes out carbon monoxide and other by-products of vital activity. This mechanism is driven by the heart muscle, which is divided into four chambers, where blood is distributed. The valves isolate these chambers from each other so that the blood does not mix. There are five such barriers in the human body:
- aortic valve;
- tricuspid valve;
- pulmonic valve;
- eustachian valve.
With congenital underdevelopment of the valves or their destructuring due to illness, the blood freely fills the heart chambers, returning to the “compartment” from which it just left, disrupting the circulation - this is what heart disease is (it can be found in both babies and adults) .
Classification
Heart defects are classified by location, severity, causes, etc. They are:
- congenital - occur when the heart muscle is not formed by the time the child is born; these include: anatomical malformations, cellular and tissue metabolic disorders;
- acquired as a result of diseases: acute and chronic coronary artery disease, rheumatic heart disease, etc.
For reasons of dysfunction, there are:
- abnormal narrowing of arteries or veins;
- narrowing of the aorta;
- unformed heart as a whole or valves separately;
- hypoplasia - in this case, one side of the heart does not work intensively enough, and the other experiences a double load.
Depending on the scale of the problem, there are:
- simple violations in one of the valves (mitral heart disease, patent ductus arteriosus, etc.);
- complex - a combination of valve weakness with vasoconstriction (for example, Lautembacher's disease);
- combined - dysfunction of a number of valves, the most striking example is Fallot's tetrad.
It is important in this classification to determine how much the movement of blood has changed during the course of the disease: the slower the blood moves through the vessels, the worse. The last, 4th stage speaks of irreversible changes.
In addition, according to the movement of blood, there are:
- white defects - this is when arterial blood moves from the left half of the heart, where it is supposed to be, to the right and twice in one circle enters the lungs to be enriched with oxygen. Visually, the patient looks pale, as in anemia;
- blue defects - when venous blood moves to the left and enters the arterial vessels.
There is an opinion that acquired defects are easier to cure than congenital ones, but this is not always natural. For example, an open ductus duct in newborns is quickly eliminated with injections or a simple operation, while prolonged rheumatism, turning into rheumatic heart disease, is fraught with the appearance of rheumatic heart disease (HRHD), which can affect several valves at once. It is much more difficult to get rid of such violations.
congenital heart defects
Congenital heart defects include diseases such as:
- PDA - blood enters the pulmonary artery twice in one breath for oxygen saturation due to a functioning tubule between it and the main artery.
- Lautembacher's disease - weakness of the septum between the atria is combined with a narrow hole connecting the left chambers of the heart, which creates a risk of rupture.
- A secondary atrial septal defect is a gap at the top of the septum.
- A primary atrial septal defect is a gap at the bottom of the septum.
- A ventricular septal defect is a weak membrane that does not adequately isolate the ventricles.
- Tetralogy of Fallot is a congenital defect in which the functionality of four valves is impaired at the same time.
- The Eisenmenger complex is a combination of ventricular septal dysfunction, aortic malposition, and critical enlargement of the right ventricular muscle.
- Ebstein's anomaly is an abnormal development of the tricuspid valve.
- Stenosis (narrowing of the entrance) of the pulmonary artery.
- - narrowing of the entrance to the main vessel, slowing down the ingress of blood from the pulmonary artery.
- Atresia of the tricuspid valve - there is no access of blood from the right atrium to the ventricle, because a septum appears between them.
- Coarctation of the aorta is a narrowing of the main vessel, slowing down the flow of blood.
- Anomaly of the connection of the pulmonary veins - when they flow into the right atrium instead of the left. The defect may be partial or complete.
- Transposition of the great vessels - the wrong location of the aorta relative to the right ventricle, and the pulmonary trunk - relative to the left ventricle.
- Uhl's disease is the absence of myocardium.
Acquired heart disease
Almost all acquired heart defects are provoked by rheumatism or long-term cardiovascular diseases. These are violations such as:
- stenosis or narrowing of the valves, which slows down blood flow;
- insufficiency of valves - they are too weak to close or open at the right time, so the blood flows freely to where it just came from.
Causes of defects
Congenital heart defects occur under the following conditions:
- genetic predisposition;
- poor environmental conditions in which the embryo is formed (mother's illness, her alcohol abuse, living in highlands, radioactive damage, etc.)
Heart defects can be transmitted not only from the mother or father, but also from previous generations. Most often, girls suffer from such defects. The presence of relatives with cardiac problems worries parents who are expecting a baby, and makes them fear whether the acquired heart disease is inherited. Fortunately, this is not possible.
Acquired heart defects occur in almost all cases from rheumatism, less often from causes such as:
- injury;
- infection with pale treponema;
- hypertension;
Heart disease symptoms
Signs of congenital heart disease
The symptoms of a birth defect depend on its type and stage. There are times when it is completely invisible in infancy, and with age it begins to seriously disturb. Look out for signs such as:
- sluggish sucking reflex or respiratory failure when sucking breast, bottle;
- pallor or blueness of the extremities, the area around the mouth (especially noticeable when screaming, crying, deep breaths, hiccups);
- fainting;
- unwillingness to eat;
- fatigue;
- persistent cough;
- tendency to colds, flu, bronchitis, tonsillitis;
- thinness;
- failure of the heart and respiratory rhythms.
Symptoms of the acquired form
Acquired heart disease has the following symptoms:
- constant fatigue;
- pain in the temples;
- labored breathing;
- heartache;
- hoarse voice and "barking" cough (sometimes even doctors mistake this symptom for a sign of developing bronchitis and prescribe treatment incorrectly);
- blue extremities at the slightest respiratory load;
- high blood pressure;
- expressiveness of the pattern of veins.
If you are at risk, have rheumatism, or have been injured, pay close attention to these signs.
Diagnostics
The International Classification of Diseases (ICD 10) assigns code Q24 to congenital heart defects, and I 00-35 to acquired ones.
Some congenital heart defects are detected even during pregnancy, thanks to ultrasound. There are those who reveal themselves at a later age. If a heart defect is suspected, the doctor will do the following:
- listens to the complaints of the patient, or parents (if we are talking about a baby);
- appreciates it appearance(swelling of the fingers on the hands, pallor or blue skin, "heart hump" - deformation of the chest - all this may indicate a disease);
- listening to the heart with a stethoscope;
- taps the chest with fingers, trying to determine the location of the heart and its volume.
When the problem is established, the diagnosis is clarified with the help of:
- x-ray;
- electrocardiograms;
- analysis of internal fluids.
Treatment
With heart disease, treatment is prescribed purely individually, according to the development of the defect and the state of the body. Surgery or drugs are often offered that significantly alleviate symptoms, block seizures and prolong the patient's life:
- magnesium and potassium;
- glycosides;
- vitamin and mineral complexes;
- blood thinners;
- drugs that remove excess fluid from the body.
This list can be supplemented or, conversely, reduced. Support is often required in the form of a special diet, regular walks, exclusion of any type of activity, reduction of physical activity, periodic rest in sanatoriums, folk remedies.
A big problem is oxygen starvation that occurs in people with heart defects. To prevent this, it is necessary to periodically undergo treatment in cardio centers, use oxygen cocktails, and purchase a special inhaler.
Folk remedies
Help to stabilize the condition and strengthen the heart folk remedies, which are taken in parallel with the prescribed treatment, as well as for the prevention of acquired defects.
Hawthorn decoction
Boil 5 - 6 fruits for 20 minutes in 0.5 liters. water. After straining and cooling, you can drink as thirst arises. Of course, such a drink will soon get bored, then you can turn to hawthorn jam or pureed berries.
Lily of the valley infusion
A tablespoon of lily of the valley flowers is poured with boiling water and waited for 30 minutes. For accurate dosing, take a measuring spoon or syringe and measure out 25 mg. Drink three times a day in the indicated amount.
Operation
Surgery eliminates heart disease once and for all. The degree of complexity of the operation depends on the type of defect and its stage. For example, with an open aortic duct, a small hole is made in the chest and the tubule is closed with a special device.
Valve defects require more serious manipulations: targeted cardiac arrest, implantation of prostheses, resuscitation.
For people with multiple heart defects, surgery may be vital.
Forecast and prevention
How many live with heart disease, it is impossible to say for sure. It all depends on the dynamics of the development of the disease, its severity, as well as living conditions, nutrition of the patient, lack of stress, timely treatment.
It is quite difficult to anticipate congenital heart disease, especially if it is associated with genetics. Prevention of an acquired heart disease also does not guarantee that you will be able to avoid heart problems. However, you can reduce your risk of cardiac dysfunction by keeping the following in mind:
- during pregnancy, alcohol and tobacco should be excluded from consumption;
- if you live in a high-altitude area with rarefied air, it makes sense to leave it before the baby is born;
- closely related marriages (between cousins) increase the chances of getting heart disease;
- breathing exercises in any technique trains the heart, strengthening it;
- diseases caused by streptococcus should be treated immediately, because they can cause rheumatic heart disease;
- if there is hypertension, it is not enough just to reduce the pressure as it increases - you need a whole range of measures that the doctor prescribes.
Heart disease is a violation of blood flow in the myocardium, which occurs due to the detachment of enlarged vessels from the muscles located in the heart.
Today at clinical practice There are various classifications of heart defects. However, this pathology is formed either in the womb, or throughout life.
Heart disease: types
According to the etiology of origin, such pathologies of heart disease are distinguished:
1. Birth defects. The development of such a defect occurs even in the womb, or during childbirth due to the influence of any external or internal factors. External factors include the environment, viruses, medications and other reasons. To internal - a variety of disorders in the health of parents.
2. Acquired vices. Such defects are formed after the birth of a person, that is, throughout life due to any disease. For example, diseases such as rheumatism, atherosclerosis, ischemic disease, myocardial injury, syphilis and many other causes.
Heart disease: classification by localization
2. Aortic defect - changes occur in the vestibule of the aorta.
3. Tricuspid defect or tricuspid. This valve is responsible for blood flow right side from the atrium to the ventricle.
4. Pulmonary valve defect - this pathology is formed in the vestibule of the pulmonary artery.
5. Open ductus arteriosus - nonunion of the arterial duct in newborns. A similar defect is often observed in girls. However, in the first months of life, the ducts overgrow on their own.
Congenital heart defect
Predisposing factors for congenital heart disease.
Let's figure out why a child is born with a similar pathology.
Studies have shown that there is some unevenness in childbearing with heart disease. So, disruption of the heart valves is observed in girls who are born from the tenth to the first month of the year. Boys are most often born with a ductus arteriosus at the heart in March or April.
Such fluctuations most likely depend on viral epidemics and environmental changes. For example, the rubella virus, which infects a pregnant woman, has a negative effect on the fetus. In addition, if a woman carries the influenza virus in the first three months of gestation, then there is a predisposition of the fetus to the occurrence of heart disease.
Undoubtedly, one virulent agent is not yet enough for a child to begin to develop a heart defect. The impetus for the development of pathology can be given by the presence of additional factors - this is a hereditary predisposition, the severity of a viral illness.
A woman's alcoholism also plays a significant role in the appearance of heart disease in the fetus. Almost 50% of such women have children born with a defect.
Congenital coarctation of the aorta is also affected by lupus erythematosus disease and diabetes.
Acquired heart disease
How can you determine the acquired heart disease at home?
Disorders in the heart can be recognized independently by the following signs:
Frequent heartbeat, pain in the region of the heart.
Feeling of a certain bursting behind the chest.
Fainting, dizziness.
Swelling of the legs.
A little blush on the face.
Diagnosis of congenital and acquired heart defects
The standard method for detecting such pathologies is an ultrasound examination of the heart (ECHO). However, this method is only effective for early stages formation inflammatory processes in the valves of the heart.
Additional examination procedures:
- X-ray projection of the heart;
- phonocardiogram.
Mitral heart disease
The following causes affect the development of mitral valve disease:
— layering of calcium on the surface of the valve;
- atrial myxoma of the left side;
- rheumatic fever;
- Marfan's syndrome (connective tissue disorders).
With mitral stenosis, blood flow into the left ventricle is difficult and thus there is a risk of enlargement of the left atrium. After some time, the blood in the lungs is retained, which can cause an increase in the right side of the heart. So, heart failure begins.
Signs of heart disease
At the initial stages, mitral stenosis does not manifest itself at all, so a person can perform any physical activity. In the process of development of the defect, shortness of breath occurs. There may also be a cough, and sometimes bloody expectoration. There is weakness for no reason, fatigue, chest pains of a diffuse nature. In the chronic stage of the development of the disease, an enlarged heart can have a compressive effect on the larynx or esophagus - there is a change in voice and discomfort when swallowing.
Diagnosis and treatment
If a person is sick with mitral stenosis, he has a pale face with a pronounced blush on the cheeks with a bluish tint to the lips and nose. A tubercle protrudes on the human chest - this is an enlarged heart. Different pulses are felt on the hands.
A qualified doctor with a thorough examination and additional laboratory tests will be able to accurately diagnose.
The disease can be treated with medication at the initial stage of development. In the later stages of the progression of the disease, the treatment is carried out by surgical intervention: the fused valves are cut or changed to an artificial valve.
This disease occurs when the mitral valve is disturbed. Aortic defects are characterized by the following manifestations:
Aortic malaise is the incomplete closure of the aorta by the mitral valve.
Aortic stenosis is the compression of the opening of the aorta.
The combination of aortic malaise and stenosis of the aortic valve is incomplete compression of the mitral valve and compression of the aortic orifice.
Such defects can appear in newborns or appear during life.
Causes of aortic valve insufficiency
With congenital pathology, the following violations occur:
Lack of one damper valve.
One sash is enlarged unlike the others.
One of the valves has dystrophy.
Mouths are formed in the valves.
With age, the following factors can affect the appearance of heart disease:
Diseases caused by a particular infection (pneumonia, tonsillitis, syphilis, sepsis): virulent microorganisms infect the endocardium, as a result of which pathogenic bacteria form on the valve. These microbes stick together over time and disrupt the structure of the valve, thereby causing it to partially close.
Autoimmune pathologies - are characterized by the rapid reproduction of connective tissue, which in turn thins the valve flaps and contributes to its periodic closing.
Aortic heart disease: symptoms with malaise
The disease proceeds slowly, so the initial stage can be held for ten years and almost without any special signs.
If the reflux of blood from the aorta to the ventricle increases to 30%, then the following complaints from the patient are observed:
- dizziness when turning the body;
- frequent fatigue;
- cardiopalmus;
- frequent shortness of breath;
- swelling of the legs;
- shortness of breath with little activity;
- feeling of heaviness under the right rib;
- clouding of consciousness.
Aortic valve stenosis
With congenital stenosis, such injuries in humans are visible:
A tangle of muscle fibers forms over the aortic valve.
Lack of leaflet at the valve.
An orifice in the form of a membrane is formed under the valve.
Such violations can be observed up to ten years. With age, defects in the heart are transformed and change the symptoms. The following factors influence the acquisition of stenosis:
Diseases caused by a particular infection (pharyngitis, pneumonia, syphilis, tonsillitis).
Autoimmune diseases (rheumatism, scleroderma).
Age-related changes: atherosclerosis, deposition of calcium salts on the valve flaps and the accumulation of fatty plaques on them, which gradually block the aortic opening.
Symptoms
The manifestation of aortic stenosis is often not visible. This pathology can be detected during a preventive examination or during examination of other diseases. Over time, the following complaints appear:
- pain in the heart;
- heaviness in the chest;
- frequent fatigue;
- swelling of the legs;
- fainting states;
- dry cough.
Aortic heart disease: treatment and diagnosis
Assign such methods of examination:
1. Radiography.
2.Dopplerography.
4. Echocardiography.
5. Cardiac catheterization.
The complex of drug treatment consists of the following drugs:
Antianginal drugs: neutralize the feeling of heaviness in the chest and pain in the heart.
Diuretics: taken to restore normal blood circulation in the pulmonary joints.
Antibiotics: taken to prevent infection with infective endocarditis.
The choice of drugs and their dosage is determined only by the doctor.
Rheumatic heart disease
Rheumatism is a lesion of the connective tissue of various body systems.
Rheumatic heart disease: causes
1. The formation of streptococcus infection in the nose and larynx (sinusitis, tonsillitis, pharyngitis, scarlet fever). The risk of rheumatism appears only after suffering similar infectious diseases.
2. Hereditary predisposition.
It is streptococcal infection that produces substances that release toxic substances that enter the bloodstream and affect the functioning of the heart.
The effect of streptococcus on the work of the heart:
Promotes the formation of inflammatory processes on the membrane of the heart - diseases of rheumatic heart disease.
Promotes the formation of inflammatory processes of the muscular membrane of the heart - myocarditis.
It promotes the formation of inflammatory processes on the outer shell of the heart - pericarditis.
Promotes the formation of inflammatory processes on the inner lining of the heart - endocarditis.
Promotes the formation of inflammatory processes of all membranes of the heart - pancarditis.
Streptococcus causes an increase and gluing of the valves of the heart, as a result of which a failure occurs in the structure of the heart, and there is a risk of malformations.
Symptoms of rheumatic heart disease:
- general malaise;
- tachycardia;
- an increase in body temperature;
- possible arrhythmia;
- increased sweating;
- shortness of breath even at rest;
- enlargement of the liver;
- swelling of the legs;
- the volume of the heart increases;
- cough that worsens with any physical activity.
Complaints that are observed in myocarditis:
- rapid heartbeat;
- discomfort in the heart area;
- shortness of breath with little physical exertion.
With endocarditis, an increase and fusion of the valve flaps leads to its incomplete closure or stenosis.
With pancaditis, the work of the heart is completely disrupted, which can even cause cardiac arrest.
Acquired heart defects
General information
Acquired heart defects- a group of diseases (stenosis, valve insufficiency, combined and associated defects), accompanied by a violation of the structure and functions of the valvular apparatus of the heart, and leading to changes in intracardiac circulation. Compensated heart defects can be secretive, decompensated ones are manifested by shortness of breath, palpitations, fatigue, pain in the heart, and a tendency to faint. If conservative treatment fails, surgery is performed. Dangerous development of heart failure, disability and death.
With heart defects, morphological changes in the structures of the heart and blood vessels cause a violation of cardiac function and hemodynamics. There are congenital and acquired heart defects.
In the stage of compensation with slight or moderate insufficiency of the mitral valve, patients do not complain and do not differ externally from healthy people; BP and pulse are not changed. Compensated mitral heart disease can remain for a long time, however, with a weakening of the contractility of the myocardium of the left heart, stagnation increases first in the small and then in the systemic circulation. In the decompensated stage, cyanosis, shortness of breath, palpitations appear, later on - swelling in the lower extremities, a painful, enlarged liver, acrocyanosis, swelling of the neck veins.
Narrowing of the left atrioventricular orifice (mitral stenosis)
Of the laboratory studies, rheumatoid tests, the determination of sugar, cholesterol, and general clinical blood and urine tests are of the greatest diagnostic value for heart defects. Such diagnostics is carried out both during the initial examination of patients with suspected heart disease, and in dispensary groups of patients with an established diagnosis.
Treatment of acquired heart defects
Conservative treatment for heart defects concerns the prevention of complications and relapses of the primary disease (rheumatism, infective endocarditis, etc.), the correction of rhythm disturbances and heart failure. All patients with identified heart defects should consult a cardiac surgeon to determine the timing of timely surgical treatment.
With mitral stenosis, mitral commissurotomy is performed with separation of the fused valve leaflets and expansion of the atrioventricular orifice, as a result of which the stenosis is partially or completely eliminated and severe hemodynamic disorders are eliminated. In case of insufficiency, mitral valve replacement is performed.
In case of aortic stenosis, an aortic commissurotomy is performed, in case of insufficiency, aortic valve replacement is performed. With combined defects (stenosis of the orifice and valve insufficiency), the destroyed valve is usually replaced with an artificial one, sometimes prosthetics are combined with commissurotomy. With combined defects, operations are currently being carried out for their simultaneous prosthetics.
Forecast
Minor changes in the valvular apparatus of the heart, not accompanied by myocardial damage, can remain in the compensation phase for a long time and not impair the patient's ability to work. The development of decompensation with heart defects and their further prognosis is determined by a number of factors: repeated rheumatic attacks, intoxications, infections, physical overload, nervous strain, in women - pregnancy and childbirth. Progressive damage to the valvular apparatus and the heart muscle leads to the development of heart failure, acute decompensation leads to the death of the patient.
The course of mitral stenosis is unfavorable prognostically, since the myocardium of the left atrium is unable to maintain the compensated stage for a long time. With mitral stenosis, there is an early development of stagnation of the small circle and circulatory failure.
The prospects for working capacity with heart defects are individual and are determined by the value physical activity, fitness of the patient and his condition. In the absence of signs of decompensation, work capacity may not be impaired; with the development of circulatory failure, light work or termination is indicated. labor activity. For heart defects, moderate physical activity, quitting smoking and alcohol, doing physiotherapy exercises, sanatorium treatment at cardiological resorts (Matsesta, Kislovodsk) are important.
Prevention
Measures to prevent the development of acquired heart defects include the prevention of rheumatism, septic conditions, syphilis. For this, sanitation of infectious foci, hardening, and an increase in the fitness of the body are carried out.
With a formed heart disease, in order to prevent heart failure, patients are advised to follow a rational motor regimen (hiking, therapeutic exercises), a complete protein diet, limiting the intake of table salt, refrain from sudden climate changes (especially high mountains) and active sports training.
In order to control the activity of the rheumatic process and compensate for cardiac activity in case of heart defects, dispensary observation by a cardiologist is necessary.
Heart disease refers to many diseases. Due to the fact that the structure of the heart, for one reason or another, does not correspond to the norm, blood through the blood vessels cannot flow as it would in a healthy person, as a result of which there is insufficiency from the circulatory system.
Consider the main classification of congenital and acquired in children and adults: what they are and how they differ.
Heart defects are classified according to the following parameters:
- By the time of occurrence ( , );
- By etiology (due to chromosomal abnormalities, due to diseases, unclear etiology);
- By the location of the anomaly (septal, valvular, vascular);
- By the number of affected structures;
- According to the peculiarities of hemodynamics (with cyanosis, without cyanosis);
- In relation to the circles of blood circulation;
- By phase (adaptation phase, compensation phase, terminal phase);
- By type of shunt (simple with a left-to-right shunt, simple with a right-to-left shunt, complex, obstructive);
- By type (stenosis, coarctation, obstruction, atresia, defect (hole), hypoplasia);
- By the effect on the blood flow velocity (minor, moderate, pronounced effect).
Classification of birth defects
The clinical division of defects into white and blue is based on the predominant external manifestations of the disease. This classification is to some extent conditional, since most of the defects simultaneously belong to both groups.
The conditional division of congenital malformations into "white" and "blue" is associated with a change in skin color in these diseases. With "white" heart defects in newborns and children, due to a lack of arterial blood supply, the skin becomes pale in color. With the "blue" type of defects due to hypoxemia, hypoxia and venous stasis, the skin becomes cyanotic (bluish).
Currently, the total number of congenital cardiac anomalies has not been identified. This is due to the fact that many malformations of the heart and cardiac structures are components of systemic genetic syndromes (trisomy, Down's syndrome, etc.) and cannot be distinguished into independent diseases.
White UPU
White heart defects, when there is no mixing between arterial and venous blood, there are signs of blood discharge from left to right, are divided into:
- With saturation of the pulmonary circulation (in other words - pulmonary). For example, when the foramen ovale is open, when there are changes in the interventricular septum.
- With deprivation of a small circle. This form is present in isolated pulmonary artery stenosis.
- With saturation of the systemic circulation. This form takes place in isolated aortic stenosis.
- Conditions when there are no noticeable signs of hemodynamic disturbances.
| Hemodynamics Group | The name of the vice | ICD-10 code | Frequency per 1000 children born | Causes |
| With small circle enrichment | Q21.0 | 1.2-2.5 | Exposure to teratogenic substances | |
| Q21.1 | 0.53 | Embryotoxic effect of drugs | ||
| Q25.0 | 0.14-0.3 | Genetic disorder in the structure of vascular wall proteins | ||
| Atrioventricular communication | Q20.5 | 0.021 | Chromosomal anomaly due to exposure to adverse factors in the 1st trimester | |
| With the impoverishment of the small circle | Isolated pulmonary stenosis | Q25.6 | 0.2-1.4 | Diseases of the pregnant mother, pathology of the placenta |
| With great circle impoverishment | Isolated aortic stenosis | Q25.3 | 0.1-1.9 | Toxic effects of infectious agents, especially viral ones |
| Q25.1 | 0.2-0.6 | Rubella in a pregnant woman, injuries during pregnancy | ||
| No significant hemodynamic disturbances | Q24.0 | 0.001 | Deep toxic effects (alcohol, smoking, drugs) in the first days of embryonic development | |
| Dextroposition of the aorta | Q25.8 | 0.00012 | Exposure to the fetus of drugs prohibited during pregnancy | |
| Double aortic arch | Q25.4 | 0.0007 | Rubella, viral infections |
Blue
Blue heart defects occur when venous blood is thrown into the arterial one, they have several subspecies:
- Those that contribute to the enrichment of the pulmonary circulation;
- Those that deprive the pulmonary circle.
| Hemodynamic groups | Name | ICD-10 code | Frequency | Causes |
| With small circle enrichment | Q21.8 | 0.6 | Chromosomal abnormalities | |
| Q20.4 | 0.001-0.002 | Anomaly of the genes responsible for the development of the myocardium | ||
| common truncus arteriosus | Q20.0 | 0.07 | Infectious-toxic diseases of the mother | |
| Q25.8 | 0.01-0.034 | Spontaneous chromosomal abnormalities | ||
| Main pulmonary trunk | Q25.7 | 0.0023 | Chromosomal abnormalities, deletions of structural protein genes | |
| With the impoverishment of the small circle | , | Q21.3 | 0.5-1.6 | Multiple toxic exposure in the 1st trimester |
| Tricuspid valve atresia | Q22.4 | 0.34 | Pregnant woman taking antibiotics, viral infections, influenza | |
| Common false truncus arteriosus | Q25.8 | 0.008 | Occupational factors in a pregnant woman (toxic production) | |
| Q22.5 | 0.1 | Multiple toxic effects | ||
| aortic atresia | Q25.2 | 0.0045 | Medicinal effects on the fetus in the 1st trimester | |
| Aneurysm of the sinus of Valsalva | Q25.4 | 0.007 | Pathology of the yolk sac of the embryo | |
| accessory pulmonary artery | Q25.7 | 0.00004 | Taking certain antibiotics while pregnant (tetracyclines) | |
| Pulmonary arteriovenous aneurysm | Q25.7 | 0.002-0.0068 | Glomerulonephritis, influenza in a pregnant woman |
hypoplasia
Hypoplasia is an anatomical underdevelopment of the heart or individual cardiac structures. Pathology often affects only one chamber and is manifested by progressive functional heart failure with hypoxemia and venous congestion. The blue variety of the UPU.
obstruction defects
Obstruction is the complete closure of the anatomical opening (aorta, pulmonary trunk, exit chambers). The essence of the pathology is expressed in the inability to pump blood through a closed hole, which causes hypertension in the adjacent ventricle. Obstructive defects are white or blue, depending on which side of the heart the obstruction is located.
Septal defects
Septal defects are open openings between the atria or ventricles. The defect causes blood to be shunted from left to right and the heart to be overloaded with volume. Subsequent pulmonary hypertension causes hypoxemia in the blood (white malformations) or venous stasis (blue).
Congenital valve defects
Heart valve defects are represented by narrowing or complete absence of valvular orifices. Stenotic defects are white (due to a significant violation of blood flow and arterial insufficiency), atresia - blue (the absence of a hole leads to a decrease in oxygen saturation of the blood).
Types of VPS according to Fridley
The classification is based on the most pronounced syndromes characteristic of each CHD group.
| Lead Syndrome | Types of violations | Vice |
| Arterial hypoxemia, hypoxemic status | Mixing of arterial and venous blood | Fallot disease |
| Decreased pulmonary blood flow | Pulmonary stenosis | |
| Complete separation of small and large circles of blood circulation | Aplasia, ventricular hypoplasia | |
| Closure of the ductus arteriosus | ||
| Heart failure (acute, congestive), cardiogenic shock | Overload with a large volume of blood | Aortic stenosis |
| Increased resistance | Stenosis or atresia of the cardiac vessels | |
| Myocardial damage | Hypoplasia of the myocardium of the right ventricle | |
| Closure of an open ductus arteriosus | Underdevelopment of the cardiac chambers, three-chambered heart | |
| Arrhythmia | Atrioventricular blocks | Fallot's malformations, Eisenmenger's syndrome |
| Paroxysms of tachycardia | Arteriovenous aneurysm | |
| fibrillation | single ventricle of the heart | |
| Flutter | Inversion of the heart, sinus venosus defect |
Classification of acquired defects
By etiology:
- Due to atherosclerosis;
- syphilitic;
- Due to;
- Due to systemic autoimmune processes (scleroderma, dermatomyositis, lupus).
By severity:
- Lungs (compensated);
- Moderate (subcompensated);
- Severe (decompensated).
According to the state of hemodynamics:
- A defect with a weak effect on blood circulation;
- A defect with a moderate effect on blood circulation;
- A defect with a pronounced effect on blood circulation.
By localization:
- With the involvement of one valve;
- With the involvement of several valves ().
Functional form:
- simple;
- Combined.
List of all teaching staff
- : , a combination of stenosis and insufficiency;
- : , combination of stenosis with insufficiency;
- Tricuspid: stenosis, combination of stenosis with insufficiency;
- Narrowing of the pulmonary valve;
- Pulmonary valve insufficiency;
- Combined two-valve defects: mitral-aortic, mitral-tricuspid, aortic-tricuspid;
- Combined three-valve defects: aortic-mitral-tricuspid.
Prevalence
| Age group | Pathologies, % of cases from all diseases |
| newborns | Septal defects - 47.3%. Open ductus arteriosus - 10%. |
| Children | Fallot's disease - 56%. Isolated stenoses of large heart vessels - 23.5-35.7%. |
| Teenagers | Tetralogy of Fallot - 37%. Stenosis of the pulmonary trunk - 12.4%. |
| Young people | Eisenmenger's syndrome - 45.2%. Isolated defects of the pulmonary trunk - 34%. |
| adults | Rheumatic mitral stenosis - 84-87%. Rheumatic aortic defects - 13-16%. |
| Elderly | Women - rheumatic mitral insufficiency - 70-80%. Men - rheumatic aortic stenosis - 67-70%. |
Symptoms and diagnosis
Among the most common complaints are:
- Shortness of breath
- Cyanosis of various parts of the skin;
- Frequent edematous phenomena;
- Cardiopalmus;
- Discomfort or pain in the heart area;
- Cough;
- Noises in the cardiac region.
To establish cardiac pathology, specialists use the following examinations:
- ECHOCG (to detect a defect in the interatrial and interventricular septum, open ductus arteriosus, coarctation of the aorta, Fallot's tetralogy);
- Cardiac catheterization (you can detect changes in the interventricular septum, coarctation of the aorta);
- MRI of the pulmonary artery;
- transesophageal echocardiography;
- X-ray examination of the chest organs together with contrast illumination;
Used as drug treatment and the use of operational methods. Drug therapy is aimed at eliminating inflammation in the heart, eliminating symptoms, preparing for radical treatment - surgical operation, which is performed by minimally invasive methods or on an open heart.
Only the side effects of the defect are conservatively resolved, for example, heart rhythm disturbance, circulatory failure.
Also, cardiologists prescribe preventive measures that are aimed at preventing the occurrence of heart rheumatism and subsequent ones.
Early treatment of the patient and timely appropriate treatment increase the chances of a favorable outcome. It must be remembered that any kind of heart disease is an extremely life-threatening phenomenon that requires urgent intervention from specialists.
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