Cardiopathy can be acquired or received due to improper intrauterine development:
- Congenital pathologies are diagnosed shortly after birth as heart defects. This is the most common form of cardiopathy.
- Acquired, as a rule, more often appear at the age of 7-12 years and after 15 years. In the first case, this is facilitated by the rapid growth of the body, in the second – hormonal changes.
Cardiopathy is divided into types depending on the cause of occurrence:
- Functional. Violation appears after excessive physical and psycho-emotional stress. Often it occurs during active sports, when the child is not ready for such intense exercises.
- Secondary It is associated with diseases of other organs, chronic infectious diseases, the presence of foci of inflammation in the body. The secondary form appears with asthma, pneumonia, myocarditis, endocarditis.
- Dysplastic. The work of other organs is not disturbed, and in the myocardium tissue is replaced by inelastic fibers. It mainly affects children with rheumatism. Dysplastic cardiopathy is an independent pathological process.
- Dilatation. With it, the heart cavities expand due to poor tissue elasticity.
Several factors for the occurrence of cardiopathy can be identified:
- viral, bacterial, fungal pathogens;
- autoimmune disorders;
Cardiomyopathy also varies in the factors that cause it:
- Hypertrophic. With it, the myocardium pathologically increases.
- Associated with stenosis of the aortic orifice. The narrowing occurs on the left side of the heart.
- Stagnant. With this form of cardiomyopathy, the heart muscles are too thin and cannot support the blood flow properly, there is an acute circulatory disturbance.
As a rule, these anomalies are congenital. They are detected early, at the first myocardial studies, but can be detected at a more mature age.
Congenital cardiopathy can be detected in the first months of the baby’s life, but more often the child has no complaints up to 6-7 years. Sometimes during outdoor games, he can get tired faster than his peers, make stops for rest.
The child may complain of chest pain, shortness of breath with minor physical activity. Increased heart rate and excess weight are noted.
Functional cardiopathy in children occurs due to physical overload (improperly organized physical education lessons, professional sports). Myocardium is trying to quickly adapt to a new mode of operation, less oxygen enters the bloodstream. With a functional type of pathology, the following symptoms are noted:
- fatigue and weakness;
- shortness of breath even at standard walking speed;
- poor stamina;
- attacks of tachycardia, manifested by pallor or blueness of the skin;
- sweating, swelling.
The dysplastic form of the disease occurs as an independent pathology and is not the result of malfunctions of the body or other diseases. It is characterized by the replacement of a separate section of the heart muscle with connective tissue, because of which the electrical pulses are not fast enough. Dysplastic cardiopathy in children manifests itself:
- pallor of the skin;
- lack of oxygen;
- heart rhythm disturbance;
- heavy sweating.
Primary cardiopathy from secondary is often difficult to distinguish – the determination of one type or another is carried out after a detailed and comprehensive examination of the child. The reasons for their occurrence differ:
- primary is most often a consequence of a congenital disease and manifests itself in the first years of life;
- secondary cardiopathy in children is a disease that develops as a result of any ailment (diabetes, asthma, HIV, cancer, prolonged colds, etc.).
The secondary form of pathology is easier to suspect, because with its development, the child is already under the supervision of a pediatrician and is undergoing treatment for the underlying disease. Symptoms are varied and most children do not talk about heart problems, but depend on the primary disease. If there are suspicions of myocardial changes, the baby is sent to a cardiologist.
Knowing what functional cardiopathy is, it is recommended that the child be monitored. For an accurate diagnosis, the changes are divided into groups in accordance with the classification as follows:
- Mitral valve prolapse.
- Extra one or more papillary muscles.
- Wrong location.
- Greater mobility of the chords in the cavities of the heart due to the increase in length.
- Bifurcation of the papillary muscles.
- Attaching chords outside the front or back cusps.
- Extension of the ring at the site of attachment of the tricuspid valve.
- Displacement of the septum.
- Increase or decrease in aortic lumen.
- Change in the number of tricuspid valves in a child or adult.
- Valve prolapse in the inferior vena cava.
- Aneurysm of various sizes located in the interventricular or interatrial septum.
- Non-oval window.
If the listed functional changes do not disappear in adolescence, then the pathology is called connective tissue dysplasia.
The most common among all ILCs
For cardiomyopathies in children, not one, but several classifications have been proposed. However, they are not different from those used for diagnosis among the adult population. From the point of view of pathophysiology, there are:
- Dilated cardiomyopathy. Its main characteristic is the “stretching” of the chambers of the heart. They increase in size, while losing their functions.
- Hypertrophic cardiomyopathy. Its main characteristic is the predominance of processes of hypertrophy (quenching) of the walls of the heart. In this case, the size of the heart may not be changed.
- Restrictive cardiomyopathy. With this disease, the heart is not able to adequately relax in the phase of diastole (filling).
- Arrhythmogenic cardiomyopathy of the right ventricle. Myocardial cells are replaced by adipose or fibrous-adipose tissue, undergo atrophy. The walls of the chamber are thinned and stretched, the disease is characterized by the occurrence of various rhythm disturbances.
According to another classification, all cardiomyopathies are divided into genetic (hereditary), non-genetic and mixed.
All cardiomyopathies can also be divided into primary and secondary.
- The primary group includes cardiomyopathies, where the myocardium is damaged in isolation. The cause of the disease is unknown. An example of primary cardiomyopathy is dilated congestive cardiomyopathy, hypertrophic constrictive, etc.
- In secondary cardiomyopathies, damage to the heart muscle occurs due to some primary pathological process (systemic disease, the use of toxic substances, etc.). In this case, the disease is symptomatic. An example of this group can be cardiomyopathies against the background of gout, amyloidosis, diabetes mellitus and other diseases.
Let’s talk about some variants of cardiomyopathies in children and adolescents.
Functional cardiopathy in a child
Cardiopathy most often appears under the influence of unknown factors. The reasons that are considered the main in the development of the disease are the following:
- hereditary predisposition;
- previous heart attack;
- persistent increase in blood pressure;
- valve dysfunction;
- persistent tachycardia;
- deficiency of vitamins and minerals;
- metabolic disorders – diabetes, obesity;
- complicated pregnancy;
- radiation treatment or chemotherapy;
- drug use;
- transferred infectious diseases;
- accumulation in the myocardium of iron – hemochromatosis;
- the formation of granulomas in the wall of the heart due to inflammation;
- accumulation of abnormal protein in the myocardium;
Almost all patients have a combination of several reasons.
A special place is occupied by a persistent increase in blood pressure. When FKP attach great importance to attach numbers over 140/90 mm Hg. If the cause of such manifestations is not cardiac pathology, then the development of other forms is possible. Often there are signs of hypertrophic cardiomyopathy or dilated.
With a significant increase in pressure, the load on the myocardium and blood vessels increases. The walls lose their former elasticity, and over time, the process of blood circulation becomes complicated.
All heart cells are rich in various proteins. If there is a defect in any of them, the work of the muscle walls changes. If during the examination it is not possible to establish the subtle cause of the symptoms, then they are inclined to a genetic predisposition to cardiomyopathy.
With oxygen deficiency, ischemia gradually develops in the tissues. In most patients, a violation occurs with pathology of the arteries of the heart. Older people are prone to atherosclerosis. The lumen of the vascular walls narrows due to the deposition of cholesterol.
Pathology becomes a predisposing factor for the development of functional cardiopathy. Important age of more than 50 years, smoking, obesity, diabetes, high blood pressure.
Pathology appears not only in babies and older people. Pregnant women who are in the third period, or in the first months after childbirth, are at risk of getting sick too. This is due to hormonal changes and a temporary change in hemodynamics.
Normally, in women, the volume of circulating blood increases. Additionally, stress and blood pressure act on the body. When a newborn baby appears, secondary cardiopathy occurs. They are reversible. Timely treatment of diseases, against which the symptoms appeared, leads to the restoration of health.
Symptoms of different types of pathology and features of the disease in children
The treatment regimen for cardiopathy depends on the type of pathology. The functional form of the disease is treated using physiotherapeutic methods, for example, interference therapy. The use of a special apparatus helps to accelerate metabolic processes and improve blood circulation, reduce pain. The procedure is considered more preventive than therapeutic. For some patients, drugs are prescribed:
- B vitamins, potassium, L-carnitine, nicotinic acid – to strengthen the body;
- tablets Metoprolol, Nebivolol – with severe arrhythmia.
The use of other drugs should have clear indications. Surgery for functional cardiopathy is extremely rare.
Dysplastic cardiopathy does not require specific treatment. Most often, the child is prescribed prophylactic drugs and it is recommended not to overload the heart muscle. According to the indications for dysplastic type of the disease are used:
- Anaprilin, Verapamil;
- hormone therapy;
- magnesium preparations (Panangin);
- amino acids (carnivit);
- sedative medicines (Persen).
There is no specific treatment for primary cardiopathy – the therapy is aimed at preventing complications. Patients need to reduce physical activity, follow a diet with limited intake of salt and fat. In the secondary type of disease, agents are prescribed to stimulate heart activity, or surgery is performed on the affected area of the organ. The newest and extremely rarely used treatment methods are the use of stem cells and heart transplantation.
With cardiopathy, the following symptoms are observed:
- aching pain in the region of the heart (see also: pain in the child’s heart: causes of complaints);
- the nasolabial triangle turns blue;
- slowdown of metabolic processes;
- functional cardiopathy – increased fatigue, apathy, weakness and shortness of breath;
- dysplastic cardiopathy or heart failure – pallor of the skin, fatigue, lack of air;
- secondary cardiopathy in children (pulmonary insufficiency) – frequent coughing, sweating, swelling, shortness of breath, feeling of heaviness in the region of the heart.
With pathology, the child is constantly lethargic, tired and complains of pain in the heart
It is quite difficult to determine cardiomyopathy due to many different symptoms, which include:
- intrauterine growth retardation;
- lag in physical development;
- feeling of lack of air, suffocation;
- blue parts of the body;
- myocardial hypertrophy and liver;
- swelling of the extremities;
- loss of consciousness;
- rapid pulse.
At the initial stage, the disease may not manifest itself in any way. This is the main problem of the correct and timely diagnosis of cardiomyopathy.
Before prescribing treatment, competent diagnosis is important. Its purpose is to assess the patient’s condition, search for the cause and possible risks of complications. The examination includes the following procedures:
- blood tests – general and biochemical;
- ECG (electrocardiography);
- Echocardiography (echocardiography);
- CT (computed tomography);
- genetic analysis.
During the survey, it is necessary to collect the maximum amount of information. The data obtained will help to diagnose and find the cause of the manifestations of cardiopathy. Before starting treatment, you need to take blood for analysis. This is the first stage of diagnosis.
Evaluation of the results makes it possible to suspect atherosclerosis, renal pathology, or other probable causes. One of the main studies is echocardiography. It gives a complete picture of the myocardium, which is displayed on the monitor.
The most effective method is considered when confirming the prolapse of one of the valves. In the presence of reverse blood flow (regurgitation) or changes, it is one of the decisive. Difficulties arise with the diagnosis of the abnormal location of the chords.
An obligatory step for each patient is an ECG. It is especially important when arrhythmia joins, cardiac muscle conduction is impaired. If doubts about the diagnosis remain, then they write out a referral for computed tomography.
The monitor will best detect changes in soft tissue compared to magnetic resonance imaging (MRI). For this reason, this research option is most appropriate. In rare cases, blood is taken for genetic analysis. One disease of the cardiovascular system that has a family predisposition is enough.
Complications and Predictions
If cardiopathy is detected, the doctor imposes serious restrictions on the child’s lifestyle:
- You can not play active, sports games;
- expose the baby to strong physical and psychological stress.
If all doctor’s prescriptions are followed and the right lifestyle is conducted, the prognosis of the disease is favorable. Some types of cardiopathy do not even require medical treatment.
With cardiomyopathy, a complete recovery, unfortunately, is impossible. That is why the heart will need to protect all subsequent life, otherwise the development of the disease can lead to acute heart failure and death.
Parents need to teach their child to follow preventative measures:
- sleep 7-8 hours;
- walk a lot in the fresh air;
- avoid stress;
- do sport;
- eat right.
Any diseases (infectious, chronic, etc.) must be treated in a timely manner, following the recommendations of the doctor. Parents are required to monitor the condition of the child and undergo examinations at the pediatrician – this will allow you to identify such pathology as cardiopathy in time.
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