Congenital ventricular septal defects in children. If the defect is small, it will not affect the child’s growth and development, and the small defect may heal naturally. If the defect is large, the child may experience rapid breathing and colds, and will need to be examined in detail at the hospital to choose the appropriate treatment plan based on the condition.
What is a ventricular septal defect?
Etiology
Defects in the septum separating the left and right ventricles
In the fifth to seventh week of embryonic life, the myocardial septum is formed from the apical part of the ventricle from bottom to top and from top to bottom at the crest of the heart bulb, respectively, and fuses with the membranous septum from the endocardial pad at the atrioventricular valve to form a complete ventricular septum, which completely separates the left and right ventricular chambers. The condition can now be detected by heart ultrasound as soon as the child is born or while in the mother’s womb.
Normally oxygenated blood, flows from the lungs to the left ventricle and then to the whole body. However, in the case of a defect in the ventricular diaphragm, the blood will leak out from the left ventricle to the right ventricle, causing the blood to flow back to the lungs instead of to the whole body, resulting in an increased burden on the heart and lungs. In addition, the location of the defect, if it is below the aorta, can cause deformation of the arterial valve.
The cause of ventricular septal defect is not yet fully elucidated. It is generally believed that any factor affecting the embryonic development of the heart during the fetal period may cause heart malformation, such as the mother suffering from the flu, rubella, mumps, coxsackie and other viral infections during the first trimester of pregnancy, or exposure to radiation and medication.
Symptoms
Shortness of breath after 1 month of life
If the caliber of defect is small and the fractional flow is small, there are usually no obvious symptoms. If the defect is larger and the fractional flow is more, there may be developmental disorders, fast breathing, shortness of breath after crying or activity, purple lips, etc. It may also be manifested as repeated colds, easy to develop pneumonia, and in severe cases, symptoms such as respiratory distress and left heart failure may occur. When mild to moderate pulmonary hypertension is produced and left-to-right shunt flow is correspondingly reduced, pulmonary infections and other conditions are seen to be reduced, but symptoms such as shortness of breath and limitation of activity are still present or more pronounced. In severe pulmonary hypertension, with bidirectional or reverse (right-to-left) shunts, there is cyanosis of the lips and mouth, known as Eisenmenger’s syndrome, which worsens with physical activity and pulmonary infections, and eventually heart failure.
During inspiration, intercostal depression occurs and a sound like a groan is produced. At the same time, breathing is difficult, and it is easy to feel tired, and drinking milk stops, making little weight gain. In addition, the baby sweats easily and cries weakly.
Suggestions for home treatment and therapy
Home care
Prevent anemia and take more iron supplements
Since you can’t drink too much milk at once, you should feed your baby in small quantities to replenish the insufficient amount.
In addition, the fetus can obtain iron from the mother when it is in her body, but after 6 months of life, the iron gradually decreases, which can easily cause anemia due to iron deficiency. Anemia tends to make the symptoms worse, so when starting to feed supplementary foods, give him foods with more iron.
When treating tooth decay, pay more attention to
In the case of ventricular septal defect, after the tooth is removed for the treatment of tooth decay, it is easy to be infected by bacteria and cause “endocarditis”. Endocarditis is an inflammation of the inner lining of the heart, which causes damage to the heart’s membrane, and requires hospitalization for 1-2 months even if the symptoms are mild. In order to prevent endocarditis, when tooth extraction is required for the treatment of tooth decay, please explain the situation to your dentist first in order to obtain the prescribed antibiotic medication for the treatment. There are also antibiotic medications that can be obtained from the doctor beforehand for treatment when the tooth is extracted or during the period of teething.
Treatment advice
Some young parents lack knowledge of congenital heart disease and often seem overwhelmed when they hear that their child has congenital heart disease. As long as early diagnosis and timely treatment are done, most congenital heart diseases can be completely cured through surgery and can live and work like normal people after surgery.
A baby with a ventricular septal defect does not show symptoms immediately after birth, and if the condition is not very serious, it is usually difficult for the mother to detect. The suspicion of a ventricular septal defect is usually raised during a health examination when a murmur is detected, so most cases are only known when the health examination report is available.
Small defects may heal on their own and have little effect on the child’s growth and development, so they can be followed up regularly at the hospital outpatient clinic until the age of 3. If they do not heal, surgical repair of the defect is an option, and if they are prone to colds or if the pulmonary artery pressure increases on ultrasound or the valve is affected during the follow-up, surgery should be performed in a timely manner; for large defects, which have a greater impact on the child’s development and cardiopulmonary function, especially if they still occur frequently after active medical treatment If the respiratory distress syndrome is delayed, the natural mortality rate is higher, and the opportunity for surgery is often lost because of the early and rapid development of secondary pulmonary vascular lesions, or the surgery is too late, resulting in too high a mortality rate, as well as poor recovery after surgery, so early surgery is advocated.
Special reminder: Nowadays, the treatment methods for heart diseases are becoming more and more advanced. When a child has a ventricular septal defect, it is important to listen to the advice of a specialist, learn more about the child’s symptoms and treatment options, and work together for the child’s health.