What is heart disease – Treatment in children and adults

Heart disease is defects in septa, walls, valves, and blood vessels. Congenital heart anomaly manifests itself in childhood.

The defect is dangerous – if the operation is not done, irreversible changes in the myocardium with a fatal outcome develop. Surgical treatment completely restores the function of the heart.

The defect in adults develops slowly, disrupting its work. Ultimately complicated by heart failure. Timely replacement of a valve with a prosthesis saves a person’s life.

What is heart disease

This disease means a change in the structure of the valves, myocardium or vessels. Defects of its departments are accompanied by dysfunction. Defects are divided into 2 main groups – congenital and acquired.

The danger of the defect is that it leads to impaired blood flow in the heart muscle and lungs. As a result, all organs suffer from a lack of oxygen. Shortness of breath appears, legs swell. The quality of human life decreases.

Classification of vices

There are 3 types of cardiac abnormalities:

  • Simple defects mean damage to one valve.
  • With combined defects, there is both insufficiency and narrowing of the same hole.
  • Combined defects are the pathology of different valves or openings.

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There is a classification based on several criteria shown in the table.

pulmonary valve;

non-closure of the oval opening;

stenosis of the vessels or atrioventricular ring; failure or incomplete closure of the valves;

atresia – absence of a vessel;

Fallot’s tetrad – an anomaly of three valves in various combinations; Fallot’s pentad;

without hemodynamic disturbance in the disposition of the heart; white defects, in which there is no blue skin. With this anomaly, arterial and venous blood do not mix;

at grade 1, there are mild changes; at grade 2, moderate;

Congenital defects

In Russia, 1% of babies are born with various cardiac pathologies. Congenital heart defects (CHD) are formed in the prenatal period at 2-8 weeks of pregnancy. These changes occur due to improper organ laying in the embryonic period. The anomaly is characterized mainly by a violation of the structure of the walls and blood vessels of the heart.

Causes of congenital malformations of a child during a woman’s pregnancy:

  • viral diseases – hepatitis, rubella, influenza,
  • hormonal changes
  • overweight mother
  • the use of medicinal substances of teratogenic action,
  • hereditary predisposition,
  • exposure to radiation.

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The formation of a congenital defect is influenced by the mother’s lifestyle. The anomaly happens from bad habits – smoking, alcoholism, drug use. In women with obesity, in 40% of cases, children are born with heart disease.

The most common types of CHD:

  • A defect of the interventricular septum is often detected in children. In the prenatal period, it is the norm and is eliminated by itself after birth.
  • A septal defect between the ventricles is often found in infants. With this defect, arterial and venous blood is mixed in the ventricles due to a violation of the left-right blood flow.
  • Fallot’s tetrad is a complex vice. The most likely treatment is surgery for children.
  • Pulmonary artery stenosis.
  • Narrowing of the aortic isthmus.

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By the way! Congenital malformations are not always detected after the birth of a child. In most cases, they are found throughout life, especially after 50 years of age.

CHD symptoms

To determine heart abnormalities in childhood, it is enough to observe the child. Signs of the disease are caused by a lack of oxygen, which is manifested by a blue discoloration of the skin, lips and nails. More often this symptom occurs with physical effort, sucking. CHD is also manifested by increased fatigue, tachycardia, and leg edema.

Acquired vices

Heart abnormalities in adults are also called valvular defects. Violation of the organ is associated with organic diseases or functional insufficiency of the valves. In general, the pathology is a failure of the valves or narrowing of the opening. Combined and concomitant heart defects are formed. The left sections are affected more often than the right.

Insufficiency of a bicuspid valve develops due to incomplete closure of its valves. Through the open valve, during the contraction of the heart, blood from the left ventricle flows back into the atrium. This occurs when the valves are shortened, the chords and papillary muscles are torn off or deformed.

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Stenosis of the mitral foramen is formed as a result of the fusion of its valves. In addition, the valve undergoes fibrous degeneration. This obstructs blood flow from the atrium to the ventricle.

Aortic valve insufficiency is often found in humans. The cause of aortic insufficiency is a congenital bicuspid valve structure. Gradually, the valves undergo sclerodegenerative changes, calcium salts are deposited on them. Loss of elasticity leads to a violation of intracardiac hemodynamics.

Aortic valve stenosis occurs due to sclerosis and fusion of the leaflets after myocarditis. Myocardial inflammation is caused by streptococcus. The narrowing of the opening makes it difficult for blood fluid to drain from the left ventricle into the aorta.

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Insufficiency of the tricuspid valve is formed with the expansion of the right ventricle. Incomplete closure of the leaflets leads to a return of blood flow to the atrium. The severity of the defect is determined by the degree of regurgitation.

Tricuspid stenosis is a narrowing of the atrioventricular opening due to fusion of the valves in rheumatism or syphilis. This fact makes it difficult for the atrium to empty, causing it to first increase in size to push blood. When the compensatory capacity of the atrial muscle dries up, it stretches.

This leads to the fact that the blood from the portal vein does not have time to pump out. Therefore, fluid accumulates in the pleural and abdominal cavities (ascites), the liver enlarges.

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Causes of acquired defects

Abnormal valves are formed at 10–20 years of age, and are detected at any age period. The reasons for the acquired defect:

  • in 90% of cases, the disease is caused by endocarditis of rheumatic origin,
  • contributes to the development of myocardial infarction,
  • atherosclerosis,
  • injury.

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Although in most cases of acquired defects rheumatism is to blame, syphilis is often found.

Signs of acquired defects

Valve defects in humans are recognizable, although initially no symptoms are evident.

With the progression of the disease, similar signs of defects develop:

  • shortness of breath when walking up stairs
  • dizziness,
  • swelling of the ankles
  • stitching pains in the chest,
  • dry cough.

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Specific symptoms of acquired defects:

  • For stenosis of the bicuspid valve, pain in the heart, increased fatigue,

Note! A feature of stenosis is periodic hemoptysis.

  • insufficiency of the tricuspid valve, in addition to general symptoms, is manifested by swelling of the veins of the neck,
  • tricuspid stenosis is characterized by cold skin, which is associated with a reduced release of blood with each heartbeat,
  • aortic valve stenosis does not appear for a long time. Symptoms become noticeable when the aortic duct is severely narrowed. Chest pains are characteristic,

An important sign! Dizziness with loss of consciousness appears.

  • Insufficiency of the aortic valve is characterized by pulsation behind the breastbone, palpitations, fainting.

Symptoms of defects depend not only on the nature of the pathology. Signs change with a combined or combined defect. The clinical picture of the disease consists of the severity of the anomaly, the degree of hemodynamic disturbance.

Consequences of vices

While progressing, the disease threatens with irreversible morphological changes in the heart.

Complications of the defect:

  • heart failure develops over time,
  • violation of conductivity,
  • the consequence is pulmonary edema.

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One of the early signs of complications of the defect is dyspnea on exertion. At night, patients experience suffocation due to increased blood flow to the heart from the lower extremities. Before an attack, bronchospasm, coughing and hemoptysis sometimes appear.

A harbinger of pulmonary edema is swelling of the cervical veins, edema of the face and an enlarged liver. Overloading the right ventricle causes fluid retention. In excess, it also collects in the pleural and abdominal cavity (ascites).

In newborns and infants, heart failure occurs in the form of shortness of breath. At the same time, at rest, the frequency of respiration and heart rate increases. Sucking is difficult, the wings of the nose swell. Edema appears on the face, ankles.

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Treatment of vices

For patients with these diseases, complex therapy is required. First of all, it is necessary to adjust the work and rest regime. Medicines are used – diuretics, anticoagulants, antirheumatic agents, ACE inhibitors, β-blockers. Is it possible to cure the defect with medicines? Medication is used in the compensation stage to alleviate the patient’s condition. But it is impossible to cure heart disease with pills.

Drug therapy is used for complications and heart failure. In critical cases, empty heart syndrome can develop when blood pressure drops sharply. When treating shock, doctors know that to prevent shock, a glucose or saline solution must be injected immediately.

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The surgical method is used for complex defects in infants, when it is impossible to cure without surgery. An invasive method of treating acquired defects is resorted to if conservative therapy is ineffective. In such cases, one of the heart surgeries is performed.

Modern treatment:

  • valve replacement with a mechanical or biological prosthesis,
  • coronary artery bypass grafting,
  • reconstruction of the aorta.

Most of the operations are done when the patient is connected to a heart-lung machine. Long-term rehabilitation is required after surgical treatment.

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Attention! Surgery is not shown to all patients. Most require supervision.


Already at the initial examination, a cardiologist can establish a heart defect by auscultation (listening) and percussion (tapping) of the heart.

But the diagnosis is confirmed by instrumental methods:

  • ECG (electrocardiogram) determines the overload, hypertrophy of the departments.
  • an overview X-ray can check the configuration of the heart.
  • ECHO-KG reveals the structure of the valves, changes in the walls of the heart.
  • Doppler echocardiogram allows you to see the direction of blood flow in a heart defect.
  • Contrast angiography of vessels and ventricles.

If necessary, do computed tomography (CT) or magnetic resonance imaging (MRI). In addition to instrumental methods, general and biochemical blood tests are done to determine inflammation.

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Some vices do not make themselves felt for a long time. A doctor should be consulted if shortness of breath occurs when walking quickly or climbing stairs. Defects of any origin, sooner or later lead to impaired blood circulation with shortness of breath, edema of the extremities. Timely surgery will restore heart function.

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Tatyana Jakowenko

Editor-in-chief of the Detonic online magazine, cardiologist Yakovenko-Plahotnaya Tatyana. Author of more than 950 scientific articles, including in foreign medical journals. He has been working as a cardiologist in a clinical hospital for over 12 years. He owns modern methods of diagnosis and treatment of cardiovascular diseases and implements them in his professional activities. For example, it uses methods of resuscitation of the heart, decoding of ECG, functional tests, cyclic ergometry and knows echocardiography very well.

For 10 years, she has been an active participant in numerous medical symposia and workshops for doctors - families, therapists and cardiologists. He has many publications on a healthy lifestyle, diagnosis and treatment of heart and vascular diseases.

He regularly monitors new publications of European and American cardiology journals, writes scientific articles, prepares reports at scientific conferences and participates in European cardiology congresses.