Medicine noises are divided into organic, which indicate the presence of cardiac pathology, and functional, which are “innocent” noises. Organic heart murmurs are sounds that may have arisen due to congenital or acquired malformations, as well as other heart diseases.
In most cases, organic noise occurs due to a valve or septal defect (interventricular or atrial septal defect). Organic noises have a hard, coarse, persistent timbre; loud, sharp intensity; they are long, they are characterized by holding beyond the borders of the heart, axillary or in the interscapular region. After exercise, organic noise amplifies; their equal audibility in any position of the body is noted, they have a connection with heart sounds.
Functional murmurs in the heart are called “innocent”, since there is no connection with heart diseases, they can be heard in the presence of other diseases that are not related to heart pathologies. Functional noises have a soft, musical, inconstant timbre, weak intensity, they are short, are not carried out of the heart.
- Noise features: systolic murmur at the apex of the heart and in other parts
- Features of the structure of the heart of the child
- What is it talking about?
- Why does the noise appear in children?
- Subdivision of noise into species
- Why do systolic murmurs occur?
- 1-12 months
- 1-2 years
- 2-3 years
- 5-7 years
- 10-12 years
- Symptoms in children
Noise features: systolic murmur at the apex of the heart and in other parts
Systolic murmurs occur when blood flows through the affected valves or other structures of the heart. Soundness of noise depends on the speed of blood flow and pressure.
The reasons for such noise may be a narrowing of the aortic lumen, blood return in the area of the mitral or tricuspid valve, narrowing of the pulmonary artery, damage to the heart valves, the presence of pathological holes in the interatrial septum, damage to the apparatus that secures the valve.
All diseases that are characterized by this type of noise mainly have an innate character, but they can also be due to rheumatism and other diseases that occur in young children.
In general, what is noise, heart murmur is vibration, which occurs as a result of turbulent blood flow. They have several characteristics:
- the form;
On the example of aortic narrowing, noise occurs only during the expulsion of blood from the heart to the aorta. Noise reaches maximum sonority at a time when the speed of blood flow reaches its peak.
And during diastole – relaxation of the heart, the noise disappears. Over time, the noise can weaken or disappear altogether – this occurs with severe lesions of the valve and after a while the child may develop heart failure.
The noise, which takes all the time to reduce the heart, most often occurs with congenital defects of the heart walls.
The noise that occurs at the very end of the contraction of the heart is characteristic of the reverse flow of blood in the mitral valve during damage to the apparatus, which secures it.
The noise is heard in the area of the base of the sternum and can give off to the armpit or back and neck. Rough noise preceded by a click.
It is very difficult to determine the noise that occurs at the end of relaxation of the heart heart or in the middle during a rapid heartbeat.
With the return of blood in the area of the affected tricuspid valve, pulsation of the liver and pulsation to the right of the sternum are possible. With defects of the septum of the heart, the noise is rough with the effect of a kind of trembling.
When the aortic valve opening narrows, the noise is localized in the upper third of the sternum.
A slow pulse on the carotid arteries is noted. When the pulmonary artery narrows, the noise is best heard on the left at the upper edge of the sternum. Characterized by an increase in inspiration. Atrial septal defect is characterized by splitting of one of the heart beats.
- Noise can also occur during contraction of the heart due to the reverse flow of blood, such noise occurs from the very beginning of the expulsion of blood.
- In this case, the most common causes are the return of blood in the area of the mitral valve associated with the separation of the apparatus.
- The noise arising at the very end of the contraction of the heart is characterized by a rough character, before the noise, you can hear a click.
Diastolic noise is one of the most difficult to hear noises, for the reason that they are very low frequency and can easily be confused with noise or hum from the street.
Diastolic murmur is the murmur that occurs when the heart relaxes.
The causes of this noise are most often a narrowing of the mitral valve opening, endocarditis, exfoliating aneurysm or trauma. It is characterized by an increase if you put the child on his left side or after exercise.
- The best point for listening to noise is the 5th intercostal space along a line drawn from the middle of the left clavicle.
- When listening to diastolic murmur on the aortic valve, you can hear a soft, quiet murmur, but when the patient tilts forward, the sonority of the noise is amplified by approaching the heart to the chest.
- With severe prolonged return of blood and with diseases such as endocarditis, exfoliating aneurysm or trauma, a very loud and short noise is characteristic.
- Over time, this develops into an increase in heart contraction against a background of short noise, loss of consciousness and collapse.
- The treatment in this case is only a quick surgical treatment and correction of a valve defect.
Systolodiastolic murmurs– occur only in adults. They are characterized by the presence of noise, both during contraction of the heart, and during relaxation.
With untimely diagnosis in a child of diseases of the cardiovascular system, it can quickly lead to the death of the baby.
We recommend that at the slightest suspicion contact a cardiologist who, in the presence of a serious condition, will immediately send you to an echocardiography, where he will be confirmed or the diagnosis will be refuted, which will be just fine.
Studying the problem of pathological tones in children, cardiologists discovered several types of anomalies that explain why the failure occurs. Long studies have made it possible to compile a complete list of changes, which include abnormalities of the heart valves, heart muscle, holes. Anomalies, in turn, are represented by various localizations:
- heart valve abnormality: stenosis of the pulmonary artery, tricuspid valve, aortic and mitral, tricuspid valve insufficiency and aortic or mitral regurgitation (reverse blood flow);
- an abnormal opening occurs due to defects in the interchamber septum and in the open ductus arteriosus;
- an abnormality of the heart muscle is formed with congenital malformation and for acquired reasons (high blood pressure, myocardial infarction, heart failure).
However, only on anomalies does not end the list of all the causes of the disease. The following diseases are often culprits:
- congenital malformation associated with narrowing of the lumen of the aortic segmental nature (coarctation);
- hereditarily formed additional chord;
- hypoplasia of the departments (often left);
- cardiac myxoma (a benign tumor of the soft tissues of the heart, rarely diagnosed);
- tetralogy of Fallot.
Noises are also heard during hemodynamics when the blood flow velocity is impaired. However, all of these factors are associated with impaired blood flow, which produces noise effects. Cardiologists classify these sound phenomena according to localization, nature and origin. Affect deviations in the form of heart murmurs and age-related characteristics of the child’s body.
It is worth knowing that the characteristic of noise can vary depending on their location. For example, there is systolic murmur at the apex of the aorta.
- Mitral valve pathology and related acute failure. In this position, the noise is short-lived. Its manifestation occurs early. If this type of noise is fixed, then the following pathologies are revealed in the patient: hypokinesis, chord rupture, bacterial endocarditis, and so on.
- Systolic murmur on the left edge of the sternum.
- Chronic mitral valve insufficiency. This type of noise is characterized by the fact that they occupy the entire duration of ventricular contraction. The magnitude of the valve defect is proportional to the volume of blood returned and the nature of the noise. This noise is better heard if the person is in a horizontal position. With the progression of heart disease, the patient experiences vibration in the chest. There is also systolic murmur at the base of the heart. Vibration is felt during systole.
- Mitral insufficiency of a relative nature. This pathological process lends itself to therapy with proper treatment and adherence to recommendations.
- Systolic murmur with anemia.
- Pathological disorders of the papillary muscles. This pathology relates to myocardial infarction, as well as to ischemic disorders in the heart. Systolic murmur of this type is variable. It is diagnosed at the end of systole or in the middle. There is a short systolic murmur.
The heart is a muscular organ that has an internal cavity, which is divided by partitions into four chambers. Accordingly, two atria and two ventricles are formed. Between each pair of atria and ventricle there is one atrioventricular valve. In addition, between the left ventricle and the aorta, as well as between the right ventricle and the pulmonary artery, there are tricuspid septa called semilunar valves.
The heart has two phases of work: • Diastole is the process of relaxing the heart muscle and filling the heart with blood; • Systole is the phase of the expulsion of blood into the blood vessels. When the heart muscle contracts, two specific tones are formed. Everyone has the opportunity to hear them. First of all, they are associated with the closure of alternately atrioventricular and lunar valves.
Heart murmurs result from changes in blood flow in the vessels and heart. More than 85 percent of manifestations are registered in children and adolescents, less often in adults over 25 years of age. Many cardiologists are of the opinion that heart murmur in an adult is a striking symptom of a serious illness, so it is better for a sick person to undergo a full examination.
The danger of heart attacks is that they last for a long time asymptomatically and occasionally show noises. A detailed examination will show the cardiologist a complete picture of the heart and vascular system and, if necessary, help you choose the treatment methodology.
Systolic heart murmur is divided according to the phase of the cycle of its functioning. It is formed by compression of the ventricle of the heart muscle, which provokes a further exit of the blood flow from it into a tiny hole in size. Systolic abnormality is traditionally diagnosed with a thorough examination of the upper part of the main organ of life.
Responsible for its provocation and further development in the children’s body are septal and valvular anomalies of the septa located between the ventricles and atria. When organizing research, the noise of the type in question while listening to it by a specialist will be sharp, loud, harsh and at the same time long.
In most cases, the fact of the passage of the anomaly to the axillary and subscapular region, i.e. outside the heart muscle itself, is observed. It is advisable to emphasize that in the presence of systolic murmurs, unhealthy sounds in the work of the children’s heart will be heard more clearly after heavy physical exertion.
Features of the structure of the heart of the child
Systolic murmurs, quite often diagnosed in young children, are classified into:
- early systolic;
- middle systolic.
And by nature, depending on the situation requiring or not requiring treatment, to:
- functional (in most cases natural, not requiring treatment);
- pathological (involving mandatory medical intervention).
The circumstances that influenced the occurrence of the considered anomaly in the child may be functional or pathological. Functional noise is considered to be due to accelerated blood flow due to age-related changes, gender, lifestyle, and physical activity in a child’s life.
In the absence of other signs of deviations, for example, confused breathing, pulse surges or lack of oxygen in the blood of a growing person, such deviations are considered a normal variant and do not require treatment.
The reasons that caused functional abnormalities in the heart of a recently born child are traditionally attributed to:
- structural features of the cardiovascular system, which in most cases are self-correcting over time (open oval window, open Botallic duct; open venous duct, and so on);
- intensive growth of the body, ahead of the development of the cardiovascular system;
- changes in the hormonal system;
- endocrine disruption;
- the proximity of blood vessels to the chest;
- lean body constitution of a child.
Based on the above “stimulants” of the emergence of functional heart murmurs, their sudden diagnosis is quite justified in most cases, since it is observed at the moments of peculiar growth jumps in a growing person. It is about the age of 2 – 5 years and in the teenage period – 12 – 15 years.
Despite the external harmlessness of the type of cardiac abnormality under consideration, it is advisable for parents, when it is detected in a child, to contact a pediatrician or cardiologist for a proper examination of their daughter or son. Such measures can minimize the risk of complications in the event of an onset of the disease.
Is it worth recalling that the heart is one of the most important organs of man. It works without respite, ensuring the supply of oxygen and nutrients with the blood to other organs and tissues. It is no exaggeration to say that in his “hands” is the fate of the whole organism.
Unfortunately, in recent years, cases of the birth of children with congenital pathologies of the development of vital organs and systems have become more frequent. You can blame the ecology, the unhealthy lifestyle of parents, and blame doctors for negligence, but the fact remains: diseases of the cardiovascular system in the structure of childhood morbidity occupy one of the first places.
In addition, in recent years, the ratio, clinical symptoms and outcome of heart diseases in children have noticeably changed. For the current generation, non-rheumatic heart diseases of a bacterial nature come to the fore, there is a tendency to increase the frequency of congenital heart defects, rhythm and conduction disorders, as well as arterial hyper- and hypotension (high and low blood pressure).
Ultrasound examination of the fetus allows in utero to diagnose about 90% of various forms of heart defects. The first examination after birth, the babies go through the walls of the hospital: with the help of a stethoscope, an experienced pediatrician can listen to tones and noises not only in the heart, but also on the baby’s head (before closing a large fontanel).
If necessary, a neonatologist appoints an additional examination to exclude congenital pathology. At the age of 1 month, all children undergo an ultrasound examination of the abdominal cavity, brain, heart, hip joints, compulsory electrocardiographic examination to determine the state of conduction of the heart muscle and identify the risk group.
The next scheduled heart examination for babies will be a year. Further inspections are repeated with the involvement of additional specialists. Thus, the chance that the pathology of the heart of the child will be missed by doctors is practically absent. However, parents should not be vigilant. The problem is that parents miss dangerous symptoms, neglect the doctor’s examinations of the child, and meanwhile the disease progresses.
Some very vigilant mothers, in vain, sound the alarm, not knowing the physiological characteristics of the children’s cardiovascular system, and undergo a lot of examinations with the children, spending a lot of time and money on it. Unfortunately, such “trips” do not benefit the child, and unnecessary disturbances adversely affect the work of the heart of the parents.
The bookmark of the heart in a child begins in the second week of fetal development from two independent cardiac embryos, which then merge into one tube located in the neck. From the end of the second month of pregnancy, placental circulation is established, which persists until the birth of the baby (up to this age, the fetus feeds in a histotrophic manner).
The cardiovascular system of the fetus is distinguished by the functioning of the following three formations: oval opening, arterial and venous ducts. They are necessary to relieve excess blood and help the heart work in the absence of breathing and low pressure. In the right atrium, blood flows do not mix completely, since blood from the inferior vena cava is directed through the oval window into the left atrium, and then into the left ventricle, while blood from the superior vena cava flows through the right atrium into the right ventricle.
At birth, the lungs are straightened and filled with blood, fetal blood paths (Arantia and arterial ducts, oval window and the remains of the umbilical vessels) are closed. Extrauterine blood circulation is established in newborns, small and large circles of blood circulation begin to function. In the left atrium, blood pressure increases due to the receipt of a large amount of it, and the valve of the oval window is mechanically closed.
The closure of the ductus arteriosus occurs under the influence of nerve, muscle and torsion factors. Meanwhile, the heart of the newborn has a number of anatomical and physiological features. In newborns, the heart is relatively large and amounts to 0,8% of body weight (about 22 g), while in adults it is 0,4%. The right and left ventricles are approximately equal, their wall thickness is 5 mm.
With age, there is an increase in heart mass: by eight months, the mass doubles, by three years – triples, by six years it increases by 11 times. Anatomically, the heart of the newborn is located higher than that of older children, which is partially due to the higher standing of the diaphragm. Pulse in children of all ages is more frequent than in adults.
This is due to the faster contractility of the heart muscle due to the lesser influence of the vagus nerve and more intense metabolism. The normal heart rate of a newborn is 120-140 beats per minute, when feeding or crying increases to 160-200 beats. Then, the pulse rate in children gradually decreases with age.
Cry, anxiety, fever always cause children to increase heart rate. The respiratory arrhythmia is characteristic of the children’s pulse: when it is inhaled, it becomes more frequent, while on exhalation it thins. The increased needs of the tissues of the growing organism in the blood are satisfied by the relative increase in the cardiac output. Blood pressure in children is lower, the younger the child.
In a newborn baby, systolic pressure averages about 70 mm Hg. Art., by the year it increases to 90 mm RT. Art. Pressure increase in the future occurs most intensively in the first 2-3 years of life and in the puberty. An increase in pressure with age is parallel to an increase in the propagation velocity of the pulse wave through the vessels of the muscle type and is associated with an increase in their tone.
A network of small arteries is well developed in the heart of the child, which provide good blood supply to the heart muscle. Trunk vessels are relatively large. Up to 10-12 years in children, the pulmonary artery is wider than the aorta, then their lumens become the same, and after puberty, an inverse relationship is established.
The capillary system in children is relatively and absolutely wider than in adults, which causes difficulties in maintaining temperature homeostasis. Summing up all the above about the anatomical and physiological characteristics of the cardiovascular system in children, it can be said that a relatively large mass of the heart, relatively wider openings of the heart and vascular lumens are factors that facilitate blood circulation in children.
Young children are characterized by a small systolic blood volume and a high heart rate, and the minute blood volume per unit of body weight is relatively large. The relatively greater amount of blood and the features of energy metabolism in children cause the heart to perform work that is relatively larger than the work of the heart of an adult.
The reserve capabilities of the heart at an early age are limited due to greater rigidity of the heart muscle, short diastole and a high heart rate. The absence of negative effects on the heart muscle of a children’s heart of chronic and acute infections, various intoxications is its advantage.
The beginning of the formation of the heart is considered the second week of pregnancy. From the third month, it can work, and tissue nutrition is carried out by pumping blood from the placenta. The structure of the heart of the fetus is characterized by the presence of three features:
- oval window
- ductus arteriosus
- venous trunk.
Venous blood from the right atrium passes into the right ventricle through the superior vena cava, and its part (from the lower) through the opening in the septum flows into the left atrium, then into the ventricle and further through the arteries.
After childbirth, the lungs straighten, and a blood stream enters them, and all the auxiliary vessels and openings that were needed earlier are closed. This is facilitated by increased pressure in the left half of the heart, closing the window between the atria, as well as the work of the nervous and muscular systems.
What is it talking about?
If the patient has sounds inside the body, then this means that the blood flow in the heart vessels is disturbed. There is a widespread belief that systolic murmur is observed in adults.
This means that a pathological process occurs in the human body that indicates some kind of ailment. In this case, it is urgent to undergo a cardiological examination.
Systolic murmur implies its presence between the second heart tone and the first. Sound is recorded on the heart valves or blood flow.
Why does the noise appear in children?
The main reason for the appearance of noise in a child under six months of age is their physiological origin, associated with a change in the functional activity of the cardiovascular system after birth and the inclusion of a small circle of blood circulation, in particular, an oval window through which a part of the blood was discharged from the right to the left atrium during the prenatal period.
- Non-enlargement of the oval window, arterial or venous duct, which should normally close at the age of 1 year.
- A ventricular septal defect is a malformation in which there remains an opening connecting the right and left ventricles.
- Any congenital malformations accompanied by narrowing (stenosis) or valve insufficiency.
The development of noise in a child per year can often be unrelated to organic changes. So an increase in body temperature during infectious intoxication of the body or after exercise can be accompanied by the appearance of noise.
Why can there be a heart murmur in a child? There are many reasons. Below will be listed the most common. So, there may be heart murmurs in the child due to the following pathologies:
- Violation of the atrial septum. In this case, we are talking about the absence of tissue in it. This situation leads to the discharge of blood. The volume of blood discharged depends on the size of the defect and the compliance of the ventricles.
- An abnormal state of the venous return of the lungs of a child’s body. There are cases of abnormal formation of pulmonary veins. The essence of this is that the pulmonary veins do not communicate with the atrium on the right. They can grow together with the veins of a large circle.
- Coarctation aortic. In this case, we are talking about narrowing of the thoracic aorta. A child is diagnosed with heart disease. Segmental aortic lumen is smaller than expected. This pathology is treated through surgery. In case of failure to prov >
Subdivision of noise into species
There is a certain gradation in the separation of data from pathological processes:
- Functional systolic murmur. It refers to an innocent manifestation. There is no danger to the human body.
- Organic systolic murmur. Such a noise character indicates the presence of a pathological process in the body.
An innocent type of noise can indicate that there are other processes in the human body that are not related to heart disease. They are of a soft nature, not long, have a weakly expressed intensity. If a person reduces physical activity, then the noise will disappear. Data may vary depending on the posture of the patient.
Sound effects of a systolic nature occur due to septal disorders and valvular. Namely, in the human heart there is a dysfunction of the septa between the ventricles and atria. They differ in the nature of the sound. They are solid, tough and stable. There is a gross systolic murmur, its long duration is recorded.
These sound effects extend beyond the borders of the heart and are reflected in the axillary and interscapular zones. If a person subjected his body to exercises, then sound abnormalities persist after they are over. During physical activity, noise is amplified. Organic sound effects that are present in the heart are independent of body position. They are equally well heard in any position of the patient.
Why do systolic murmurs occur?
It is important for parents to know that in every childhood there is a chance of encountering an unpleasant phenomenon. After passing through several stages of development, the baby’s cardiovascular system changes, trying to reach the level of development of the adult body. The process is natural, but sometimes faced with the fact that the increase in the length of blood vessels and the volume of the heart does not coincide with the overall growth of the child’s body.
Examining a newborn, a neonatologist is required to listen to noise. Their easy manifestation is characteristic of all children and is associated with the restructuring of the circulatory system of the child. The direct blood flow characteristic of the fetus between the aorta and the pulmonary artery ends. The main task of the specialist is to correctly recognize the problem heard and in time to identify the defect. According to statistical estimates, about 1,5% of infants are born with a birth defect.
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If the examination of the child in the maternity hospital did not cause anxiety at the neonatologist, the pediatrician can listen to the noise after a month. A similar problem after a month of age, when the birth defects had to go away, translates into a serious diagnosis of 5-6 months. Cyanosis of the skin, shortness of breath, developmental delay noted in a one-year-old baby or during the first year indicate a heart defect. Noises without the symptoms described above are classified as functional, which disappear with the growth of the child.
A universal routine examination aimed at identifying heart ailments is performed for children aged 1 year. Extra tones detected at this time can be caused by increased child anxiety or rapid growth. Perhaps the doctor previously did not attach importance to the violation. As a rule, 95% of the noise established at this age is related to a safe functional appearance, because the defect is diagnosed with great accuracy much earlier.
The period in which every 3rd baby is observed by a cardiologist due to heart murmur. Suddenly arising additional tones can be explained by factors accompanying the examination. The child ran a lot before undergoing examination or his temperature jumped a little, or he was anxious and very worried before visiting the doctor.
If the child was running or playing actively before the examination, this may affect the results.
Cardiologists classify noise among preschoolers of 5-7 years of age as benign, not causing particular concern tones, indicating their external nature. Solid physical activity, a sense of anxiety, fever, hyperthyroidism can cause such manifestations in the heart. If parents eliminate the negative factors from their child’s life, pathological tones will disappear.
Adolescence 10-12 years and the onset of puberty are marked by small functional tones, even if they did not appear earlier. There is a growth of blood vessels in width and length, but it is uneven.
What are the causes of systolic murmur? There are several basic ones. These include:
Aortic stenosis. It can be either congenital or acquired in nature. This disease occurs due to narrowing of the aorta. With this pathology, the valve walls are fused. This situation complicates the flow of blood ins >
Doctors classify noise into innocent (functional) and pathological (organic).
An experienced doctor can already approximately determine the degree of heart damage by the nature of the noise, its volume, conductivity and time of occurrence.
Functional noise when listening:
- change their character when the child changes position, physical activity;
- listened mainly within the borders of the heart;
- occur with systole (heart contraction).
Functional noises are not reflected in the cardiogram, do not affect blood circulation and are not considered serious violations. Most often they are heard in infants and adolescents during the period of active growth. They can also be observed in infectious diseases with a rise in temperature, rickets, anemia, and a narrow chest.
Pathological noise when listening:
- have a high volume;
- listened outside the heart for tissues and blood vessels;
- arise both with contraction of the heart, and with its relaxation.
Pathological heart murmurs are a sign of serious disturbances in the work of the heart, as a rule, these are heart defects.
Children with congenital heart defects are divided into three groups:
- Children who are indicated for surgical treatment to prevent complications.
- Children with pathology that cannot be corrected or with concomitant diseases that make surgical treatment pointless (for example, with severe brain damage). Such patients undergo only supportive drug therapy.
- Children with minor circulatory disorders. They have a higher risk of surgery than a risk of complications. Such children should be registered with a pediatric cardiologist and periodically undergo examinations. If necessary, treat with diuretics and other means. If the disease progresses, then the question is about surgery.
To clarify the diagnosis, all children with heart murmurs must have an ECG, an ultrasound of the heart, and if necessary, a CT scan or magnetic resonance imaging. Cardiac catheterization with angiocardiography may also be required.
If even a slight noise in the heart is detected, it is necessary to undergo a full examination with a pediatric cardiologist to find out its cause. Only a specialist can give recommendations on the frequency of examinations, permitted physical exertion and decide on the need for medical or surgical treatment.
First of all, the doctors are faced with the task of determining whether there is a heart murmur or not. The patient undergoes an examination such as auscultation. During her, a person must first be in a horizontal position, and then in a vertical position. Also, listening is done after exercise in the position on the left side on the inhale and exhale.
For example, with mitral valve disease, it is necessary to listen to the apex of the heart. But with malformations of the tricuspid valve, it is better to examine the lower edge of the sternum.
An important point in this matter is the exclusion of other noises that may be present in the human body. For example, with a disease such as pericarditis, noise can also occur.
In order to diagnose noise effects in the human body, special technological tools are used, namely: FCG, ECG, radiography, echocardiography. Radiography of the heart is done in three projections.
There are patients to whom the above methods may be contraindicated, since they have other pathological processes in the body. In this case, invasive methods of examination are prescribed to the person. These include sensing and contrast methods.
Also, for accurate diagnosis of the patient’s condition, namely, to measure the intensity of noise, various tests are used. The following methods are used:
- Exercise patient load. Isometric, isotonic, carpal dynamometry.
- The patient’s breathing is heard. It is determined whether the noise exacerbates as the patient exhales.
- Change in the poses of the person being examined. Namely, raising legs when a person is standing, crouching and so on.
- Breath holding. This examination is called a Valsalva test.
It is worth saying that it is necessary to make timely diagnostics to detect noise in the human heart. An important point is to establish the cause of their occurrence. It should be remembered that systolic murmur may mean that a serious pathological process occurs in the human body. In this case, identifying the type of noise at an early stage will help to take all the necessary measures to treat the patient. However, they, too, may not have any serious deviations and will go through a certain time.
It is necessary that the doctor carefully diagnose the noise and determine the cause of its appearance in the body. It is also worth remembering that they accompany a person at different age periods. Do not be frivolous with these manifestations of the body. It is necessary to bring the diagnostic measures to the end.
It is recommended to check the work of the heart even if a person has no complaints about the work of this body. Systolic murmurs can be detected by chance. Diagnosing the body allows you to identify any pathological changes at an early stage and take the necessary treatment measures.
See more in the transfer of Dr. Komarovsky.
Doctors who observe the child should think about how to act and what treatment tactics to choose. The task of parents, according to Yevgeny Komarovsky, is not to interfere with them, but to contribute in every possible way. The action algorithm is quite simple:
- Primary noise detection. Usually this happens at the pediatrician’s appointment at the time of listening to the phonendoscope. A normal doctor will not make a diagnosis on the basis of only what he has heard, he will simply explain what changes he has heard and will give a direction for examination. Komarovsky advises not to panic and in no case refuse to diagnose. Parents should receive directions to an ECG, an ultrasound of the heart, an echocardiographic examination, and sometimes an MRI. After visiting these offices and specialists with the results of measurements and graphs, you need to go to the pediatric cardiologist.
- Confirmation of organic noise. If a cardiologist, on the basis of past studies, concludes that there is a pathological organic damage to the heart, he may prescribe medication or surgery. All recommendations should be followed again, without panic – the current level of cardiac surgery is at such a high level that even embryos in the womb are successfully operated on. Forecasts are most often very favorable.
- Confirmation of functional noise. If the cardiologist says that the noise is harmless, you can breathe a sigh of relief, return home and live as before, leaving the child alone. True, it is still advisable to see a cardiologist for some time, visiting him at least once every six months to monitor the dynamics – the noise may disappear, or may not disappear.
- Denial of noise. And this happens often. Studies show that everything is normal in the child, the cardiologist does not find noise on repeated listening. Parents in this situation do not have to scandal with the pediatrician who heard the noise for the first time. Examination is never superfluous.
Symptoms in children
The article provides basic data on heart murmurs in a child: the causes of what it is and the main types of noise. Symptoms of pathological noise, their diagnosis, and how to treat a child.
The author of the article: Yachnaya Alina, oncologist surgeon, higher medical education with a degree in General Medicine.
Heart murmur is a sound image of a violation of the movement of blood through the chambers of the muscle, which can be heard between heart tones.
On examination, the pediatrician evaluates the child’s heart by ear, using a stethophonendoscope. There are two main heart tones:
- The first, or systolic, is the sound of slamming valve flaps between the atria and ventricles during the contraction of the heart muscle (systole).
- The second, or diastolic, is the closure of valve flaps of the pulmonary artery and aorta at the beginning of cardiac relaxation (diastole).
A child is traditionally considered a person from birth to adolescence (about 12-13 years), although under the supervision of a pediatrician they are up to 18 years old. A feature of heart murmur in the childhood period is the presence of a “physiological” sound of muscle work. In the adult population, any sound changes in the work of the heart are evidence of a pathological process. There are no other differences in “noise” between age categories.
In the first year of life due to the restructuring of the circulatory system to work outside the mother’s body
May intensify or first appear during periods of active growth of the child (preschool – early school and adolescence), against the background of uneven growth of the heart muscle and its parts
No changes in the condition of the child, impaired development
No pathology with additional studies (ECG, sonography, x-ray)
To be monitored regularly
May be congenital or acquired due to other diseases
There are changes in additional studies
Not always accompanied by clinical manifestations.
In some cases, requires treatment, including surgical
Frequent inspection of specialists is required.
May be life threatening, leading to disability.
Given that physiological noise does not require treatment, does not affect the quality and life expectancy of the child, then we will only talk about pathological heart murmur (it can be more or less dangerous – depending on its cause).
Local pediatricians, pediatric cardiologists and cardiac surgeons are involved in monitoring and, if necessary, treating children with heart murmurs.
There are clinical cases where noise is the only sign of heart disease. This can be with a slight defect or good compensatory conditions. So, combined vices are known, one of which neutralizes the other.
Most children with congenital structural abnormalities show pallor or
Newborns refuse to breast, as they quickly lose strength when sucking, capricious and restless.
At an older age, children grow slowly, gain weight slightly, and lag behind their peers in physical development. Heart murmurs are often combined with tachycardia or more complex rhythm disturbances. With an increase in decompensation, there are swelling on the legs, coughing, asthma attacks, and the liver increases.
All treatment is aimed at restoring the anatomical structure of the heart or at normalizing blood circulation with the heart and blood vessels. The modern achievements of cardiac surgery make it possible to operate even on newborn children, which gives them a huge chance to live a full life. All children with congenital malformations are monitored for life in cardiology centers.
Surgical treatment for diagnosed noise of various etymologies in the children’s heart can be prescribed only as a last resort, when drug therapy is senseless or ineffective in a particular case.
The most common reasons for prescribing surgery to correct the described anomaly are:
- atrial septal defect;
- defect of interventricular septum;
- congenital heart defects;
- damage to the pulmonary valve;
- damage to the aortic, mitral, tricuspid valve of the heart muscle;
- myocardial dysfunction;
- excessive enlargement of the heart chambers;
- increase in myocardial wall density;
- infectious damage to the ins >
The key to the effectiveness of the operation to eliminate heart murmur in a child is his timely diagnosis. If there is a suspicion of a first preventive examination of a growing person by a pediatrician, parents should immediately be examined by a specialist to rule out possible problems with the vital system of the body.
Given the fact that there is a wide range of pathologies that require surgical intervention, qualified specialists are forced to carry out operations not only on vessels and functional valves, but also on individual sections of the heart tissue of the muscle itself.
Often diagnosed in children at different ages, heart murmurs should be the reason for an additional examination of the child by narrow specialists. If a pathological nature is identified, qualified doctors will take appropriate measures to minimize the risk of complications due to the existing disease in the child’s body.
more rare and deeper;
pauses between inhalation and exhalation;
when walking (sometimes even able to