What is congenital heart disease?
Congenital heart disease is the most common physical defect at birth and often develops within the mother. The fetal heart begins to develop after conception, but the first 8 weeks after conception are the most critical period for heart development. During this time, problems in some of the key steps of heart development can cause congenital heart disease to develop. Many people may think that only adults or older people have heart disease, but this is not the case – one in every 200-300 new babies born will have congenital cardiovascular disease. And many congenital heart diseases require medication or surgery to correct them in childhood, otherwise there is a high risk of missing valuable treatment.
Diagnosis and evaluation of congenital heart disease in childhood.
The diagnosis and evaluation of heart disease in children is a very complex task that requires a combination of physicians and professionals with clinical experience. Below we have listed and briefly described some of the main measures used in the diagnosis of pediatric heart disease.
Physical examination: Our physicians will perform a careful head-to-toe examination of your child, which is important to understand their condition and to develop appropriate treatment measures. For example, fluttering of the nose indicates possible respiratory distress; blue lips often indicate cyanotic heart disease; angry jugular veins or carotid arteries at rest indicate heart failure; abnormal precordial bulges, tremors, and murmurs almost certainly indicate heart disease; abdominal fullness, especially on the right side of the abdomen, is likely due to hepatomegaly caused by precordial disease; and abnormal pulses in the extremities often indicate aortic constriction. Abnormalities in the pulses of the extremities often indicate aortic constriction; nail bruising and deformation (pestle fingers) are typical signs of cyanotic preconditioning ……
Blood tests: blood tests are important in the diagnosis of congenital heart disease and include: complete blood count: increased red blood cells suggest tissue hypoxia and possible cyanotic heart disease; blood biochemistry; total protein and albumin; partial thromboplastin time (PTT), prothrombin time (PT).
Blood gas examination and fingerstick oxygen saturation.
Chest X-ray: Chest X-ray is a traditional, but at the same time very useful, test for chest diseases. With this we can know: changes in the morphology and size of the heart, the presence of pericardial or pleural effusions, the presence of congestion ischemia or infection in the lungs.
Electrocardiogram (ECG), 24-hour continuous ECG (Holter monitoring): both of these are very quick and effective methods of screening for heart disease, and many congenital heart diseases can be detected with ECG and Holter to provide a wealth of information to guide your child’s further diagnosis and treatment; also sometimes we may need to perform some exercise or drug stimulation as a way to observe changes in the ECG.
Echocardiography: There is no doubt that the advent of echocardiography has led to the development of cardiology as a whole, and echocardiography has become the most powerful weapon in the diagnosis of pediatric precardiac disease. When you suspect that your child may have a cardiac abnormality, the first thing that comes to mind after completing some of the simple tests above is to perform an ultrasound of the heart. Structural as well as functional abnormalities of the heart are well represented on ultrasound, provided that the cardiologist or sonographer is very experienced, as the diagnosis of complex precordial disease can be a very difficult task.
Cardiac catheterization: This is a special kind of examination. Simply put, a soft, thin tube is inserted into the patient’s heart through a vein or artery to perform a number of tests, such as measuring pressure, taking specimens, and showing structures; in addition, some simple treatments can be performed through cardiac catheterization, such as atrial septal windowing, outflow tract dilation, PDA, or blockage of the main pulmonary side branches; cardiac catheterization is relatively complex and expensive, but it is still essential for some complex congenital cardiac disease is still essential.
Heart murmur
A heart murmur is a sound produced by the flow of blood through the heart chambers, valves, or proximal vessels of the heart.
What conditions produce an abnormal heart murmur?
Abnormal heart murmurs can be produced by valve disease, holes in the heart, manifestations after surgical repair, fever, and anemia.
Do all murmurs indicate heart disease?
Not all heart murmurs are indicative of heart problems in your child. For example, your child may have a transient heart murmur when he has a fever or anemia, which will disappear after the disease is corrected. Some children may have an innocent murmur, which will disappear as they get older and will not affect their lives. If you are unsure, you can have other, such as ultrasound, tests performed.
Congestive heart failure
What is congestive heart failure?
Congestive heart failure is a pathological condition in which the heart is unable to pump enough oxygenated blood to meet the body’s needs, which often indicates an underlying heart condition.
What are the specific signs of congestive heart failure?
Swelling of the lower extremities, sometimes involving the eyelids, face or abdomen, shortness of breath at rest or during light exercise, shortness of breath, easy fatigue, need for frequent breaks to play with children, nausea, poor appetite or tendency to sleep, weight gain (edema) even though little is eaten, coughing, easy sweating.
The above manifestations do not occur in every child and are closely related to the severity and type of the condition.
Management of congestive heart failure
When you are diagnosed with congestive heart failure after a formal diagnosis, you should immediately undergo formal treatment, both medical and surgical.
Digoxin, cardiac strengthening therapy
Diuretic, to reduce the cardiopulmonary burden, but pay attention to potassium supplementation
ACEI-type antihypertensive drugs to reduce the afterload of the heart
When your child’s condition is clear and surgical treatment is needed, surgery should be performed as soon as possible
What causes precordial disease?
We do not yet know the cause of the vast majority of precardiac disease. Mothers often believe that something they did during pregnancy caused their child to develop the disease, but are actually exaggerating their responsibility. Precocious heart disease may have a certain genetic background, as it shows a slight familial onset. Certain medications taken during pregnancy may also cause preeclampsia, such as antiepileptic drugs. However, in 85-90% of cases of precocious heart disease, no direct cause can be found.
Classification of precardiac disease
Some congenital heart diseases are very simple, while others are very complex. For ease of understanding we have classified congenital heart disease into the following types.
Congenital heart disease that causes increased blood flow in the lungs
Pulmonary artery ductus arteriosus (PDA)
Atrial septal defect (ASD)
Ventricular septal defects (VSD)
Atrioventricular canal malformations
Congenital heart disease causing decreased intrapulmonary blood flow
Tricuspid atresia (TA)
Pulmonary artery atresia (PA)
Transposition of the great arteries (TGA)
Tetralogy of Fallot (TOF)
Aortic constriction
Aortic stenosis
Pulmonary artery stenosis
Permanent arterial trunk
Complete pulmonary vein ectopic lead
Left ventricular dysplasia syndrome