How to rehabilitate and care for children with congenital heart disease

  Congenital heart disease is a malformation caused by a defective or partially arrested development of the fetal heart within the mother’s body. There are many different types of congenital heart disease malformations, and the hemodynamic impact varies widely. With advances in medical technology, the survival rate of patients with congenital cardiovascular disease continues to improve, and many children with congenital malformations can self-regulate and compensate for their hemodynamic disorders and survive naturally into adulthood. Many scientific studies have reported the positive impact of sensible exercise on public health, especially cardiovascular health, and patients with congenital heart disease (CHD) should also benefit from sensible exercise. Parents of children with weak heart function are often concerned about over-exercising their children, and it is common to over-protect and restrict their children’s activities. A sedentary and inactive lifestyle leads to reduced physical fitness and work capacity in these children, putting them at potential risk for early disease in skeletal and muscular systems, which not only affects the physical development of the child, but also adds to the psychological burden on parents and children. Proper exercise is a necessary requirement for children’s growth and development, a catalyst for the development of emotional, mental and cognitive skills, promotes muscle and bone growth, reduces disease, is a major indicator of maintaining a healthy body, and effectively improves cardiovascular and respiratory function. The International Society of Cardiology promotes the concept that normal children should have at least 60 minutes of moderate to vigorous physical activity per day. Although not all children with CHD can participate in all physical activities, if children’s physical activity is restricted, it can produce many conditions that are detrimental to children’s growth and development, thus suggesting that children with CHD of all ages should be encouraged to intervene in reasonable physical activities that are beneficial to children’s physical and mental development and consistent with individual physical activity that is beneficial to the child’s physical and mental development and consistent with the individual’s physiological condition.  Due to the altered hemodynamics of congenital heart disease, the oxygen uptake capacity of the body and tissues is altered and decreased, and as a result, related dysfunctions occur, such as: cardiac dysfunction, psychological dysfunction, motor dysfunction, and dyspnea and cyanosis during activity, the weakening of exercise endurance and muscle strength, and the ability to perform daily life can be greatly affected. If the child’s condition is stable, no obvious symptoms such as chest tightness, dizziness, pallor, dyspnea, drop in blood pressure and serious cardiac arrhythmia occur during exercise, and the defect is naturally closed without obvious symptoms or successful repair, he or she can completely carry out reasonable rehabilitation and recreational sports under the guidance of a doctor, without restricting recreational activities and low-intensity sports that meet the individual’s physiological condition. The more suitable sports for them are shuttlecock, chess, ping pong, walking-slow walking-jogging sports, fixed or movable pedal bicycle and health care gymnastics, but they should not participate in strenuous sports, such as basketball, soccer, riding and other impact sports, to avoid excessive fatigue. Infants with weak heart function can have a short time of swimming, touch massage and health gymnastics under the supervision and help of their parents to enhance their physical fitness and increase the immune function of the body. Adolescents involved in sports need annual cardiac function assessments to guide training, and it is recommended to avoid high-intensity static and power sports. In the exercise program, training should follow a specific form, there should be a warm-up period before exercise, a low-intensity exercise to prevent sudden changes in peripheral resistance before the skeletal muscles produce maximum contraction during exercise, and a relaxation period after exercise, which can prevent hypotension and syncope.  Suggestions for the rehabilitation of children with congenital heart disease: 1. Exercise therapy: adolescents with congenital heart disease can perform self-exercise, such as qigong, taijiquan and medical gymnastics, according to their own conditions. And according to their personal interests, they can participate in various recreational activities, such as playing poker, ball, games, chess, etc.  2, warm water therapy: regulate vasodilation and contraction, increase cardiac output, improve blood circulation, water temperature 35 ° ~ 37 ° is appropriate.  3, massage and chiropractic therapy: can unblock meridians, regulate qi and blood, improve and adjust the function of the internal organs, and enhance the body’s ability to resist disease.  4, psychotherapy: through psychological support, de-escalation treatment methods, improve or eliminate children’s depression, anxiety, encourage children to correctly understand the disease, establish confidence in overcoming the disease, actively cooperate with treatment and eliminate psychological barriers. Psychological adjustment can also relax the muscles and body and mind, and soothe the anxiety.  5. Diet and living: Create a comfortable, affectionate, harmonious and harmonious living environment to help children eliminate fear, pessimism, anxiety and depression, so that they can build up confidence in life and speed up the recovery of heart function. Since children with CHD may eat less due to nausea, dyspnea or edema, small and frequent meals are recommended, and the intake of sodium should be limited when heart failure occurs.  6.Enhance autoimmunity: prevent respiratory infections to reduce the possibility of heart failure. Such as influenza vaccination and sunbathing, Chinese herbal formula to regulate qi and blood as adjuvant treatment for CHD.