The incidence of pediatric congenital heart disease has always been high, and it is a matter of concern that about 100,000 or more babies born every year have congenital heart disease.
The specialist clinic on how to detect congenital heart disease early often meets young fathers and mothers who are still sitting on their baby, as well as grandfathers, grandmothers, grandparents holding their newborn babies who are not yet full term and come to the clinic with anxious hearts because the doctors in the maternity hospital found that their babies have heart murmurs and may have congenital heart disease during the examination.
Congenital heart disease is a common pediatric disease with a high incidence. According to foreign literature, its incidence accounts for about 0,4 to 0,8% of surviving infants. In other words, there are about 100,000 or more newborns suffering from congenital heart disease in China every year.
The exact cause of congenital heart disease has not yet been determined, but it is mainly a group of congenital malformations of cardiovascular anatomical structure abnormalities caused by malfunction or developmental disorders of the heart and large blood vessels in early embryonic development. It includes dozens of developmental abnormalities of the heart or large blood vessels ranging from simple to complex.
Prevention of congenital heart disease in children starts from pregnancy The causes of congenital heart disease are broadly divided into two categories: endogenous and exogenous.
The internal factors are genetic factors, such as chromosomal abnormalities and genetic aberrations, and about 4% to 5% of congenital heart disease is caused by chromosomal disorders.
The more important of the external factors are indoor, especially viruses such as rubella, mumps, epidemic and coxsackie virus. The critical period of heart embryonic development is between the 2nd and 8th week of gestation, causing congenital cardiovascular malformations also occurs mainly at this stage, such as the incidence of congenital heart disease is higher in newborns born after severe viral infection of the mother during the 3rd month of gestation, especially after rubella virus.
Fetal environmental and maternal factors, including local mechanical compression around the fetus and nutritional or vitamin deficiencies of the mother, can affect the development of the fetal heart.
Other factors such as highland areas, where the incidence of ductus arteriosus is higher, suggest that the highland environment may be a factor in the development of the disease.
Other factors such as exposure of the mother to high doses of x-rays or use of certain drugs during pregnancy, chronic diseases, hypoxia, advanced maternal age pregnancy, abortion preservation and multiple births are all high risk factors.
How to early detection of congenital heart disease babies with congenital heart disease, due to the existence of a single or complex disease, clinical manifestations also vary, some in the newborn baby found skin, mucous membrane cyanosis, shortness of breath, heart failure, if not timely diagnosis and treatment, will be a premature death. Some children are usually asymptomatic, with normal growth and activity, like normal children, and are only found to have congenital heart disease when the doctor finds a heart murmur on physical examination during occasional visits for colds and whistling infections.
In order to facilitate parents’ understanding of how to detect congenital heart disease at an early stage and how to treat it in time and other scientific knowledge, we now classify congenital heart diseases into three categories according to their hemodynamic and anatomical characteristics and shunt directions, and describe their main symptoms and performance respectively.
The first left-to-right heart shunt group often has the following symptoms and manifestations in clinical practice.
1, shortness of breath: in the newborn or infant, the child is found to be impatient for food due to hunger, but is found to be weak in sucking, shallow into the whistle, abandoning the milk and gasping due to shortness of breath before finishing sucking, stopping after a few sips, feeling tired and sweating profusely.
2, repeated whistling infection or pneumonia: this is the most common symptom and consultation found heart murmur, because the lungs are congested, a mild whistling infection can easily cause bronchopneumonia, resulting in choking and coughing, shortness of breath, some babies are hoarse when crying, and even symptoms such as cardiac insufficiency.
3, growth retardation: due to insufficient circulation flow and blood oxygen supply, growth and development than the same age children delayed, its weight behind than the length of the backward more obvious.
4.Oedema: When congenital heart disease children are found to have various symptoms and manifestations mentioned above, if little urine is found and sunken edema appears in the lower limbs, it means that the children are unable to compensate from the function and cause heart failure, which is a very important warning!
5. Cyanosis: Generally, cyanosis does not occur in this group of diseases, but if it is not treated in time, it causes complications of pulmonary hypertension, resulting in a shunt of blood flow from the right heart to the left heart, cyanosis can occur, which also indicates that the opportunity for treatment has been lost.
The second right-to-left heart shunt group is a complex malformation of congenital heart disease. The common clinical symptoms and manifestations are
1, cyanosis or cyanosis: it is an important symptom of complex congenital heart disease, manifested in skin, mucous membrane (especially mouth and lips) cyanosis, especially intensified after crying and noise and activity, such as cyanosis in neonatal period, common ones are complete aortic dislocation, pulmonary atresia, etc.; in 6 months to 1 year old gradually appearing cyanosis aggravated by Fara tetralogy of Fallot, etc.
2. Squatting: It is a common manifestation of tetralogy of Fallot. In addition to cyanosis aggravated with age, when he can walk, you will find that the child does not have much activity and feels weak after walking a short distance, so he will automatically take a squatting position or take a chest and knee position, and then stand up again after resting for a moment.
3, fainting: also known as hypoxic seizures, often occurs when nursing, crying, defecation due to lack of oxygen, the baby suddenly whistling difficulty, increased cyanosis, loss of consciousness and even cramps.
4, pestle-like fingers (toes): in Fallux tetralogy, due to long-term hypoxia in babies, soft tissue hyperplasia at the end of the fingers (toes), so that the fingers and toes are drumstick-like changes, often appear clinically after 2 to 3 years of age.
5. Hemoptysis: In cases of children with tetralogy of Fallot, the rupture of blood vessels forming the collateral circulation in the lungs can cause hemoptysis due to long-term hypoxia.
The third type: no shunt group has no abnormal traffic in the left, right heart or great vessels, so there is no pulmonary congestion often leading to manifestations of whistling and pneumonia, and there is no presence of mixed arterial and venous blood, so there is also no cyanosis manifestations, and common diseases include simple pulmonary stenosis; aortic constriction, etc.
The above three groups of diseases all have heart murmur, according to the different degree of heart murmur and so on, doctors make further analysis, with a variety of examination means, finally clear diagnosis, take different methods of treatment.