The incidence of congenital heart disease in children has been high, concern was: every year about more than 100,000 newborn babies born with congenital heart disease.
What causes children with congenital heart disease is? How to prevent? How early detection? How to grasp the treatment opportunities? Young parents to pay attention to what issues? In order to enable more parents understand this knowledge, we invited Professor Pediatrics hospital affiliated to Fudan University in Shanghai Zhang Shantong cardiovascular Center wrote a set of articles, detailed answers to these questions of young parents.
Heart Murmur? Heart Murmur!
Early detection of congenital heart disease
I often met young father at specialist outpatient clinics and also in confinement\'s mother as well as Grandpa, Grandma, Grandpa, and Grandma holding newborn infants has not been a full moon, with anxious feelings came to visit, because the doctor in the maternity homes found that their babies have a heart murmur, may be suffering from congenital heart disease.
Is a common disease in children with congenital heart disease, high incidence. According to the foreign literature reports, its incidence approximately 0.4~0.8% per cent of infant survival. China under Shanghai\'s districts on the incidence of congenital heart disease findings confirmed that the Yangpu district as per cent of live births of neonatal 0.67%;, xuhui district, 0.72%, meaning that newborns every year, about 100,000 more suffering from congenital heart disease.
About the exact cause of congenital heart disease has not been any final conclusions, mainly because of the heart, great vessels in the early embryo developmental disorders or developmental disorder caused by abnormal cardiovascular Anatomy structure of a group of congenital malformation of disease. From simple to complex includes dozens of anomalies of the heart or great vessels.
Prevention of congenital heart disease in children, from the beginning of pregnancy
Etiology of congenital heart disease, internal and external causes two broad categories.
Intrinsic factor is genetic factors, such as chromosome abnormalities and genetic aberrations, about 4%~5% of congenital heart disease is caused by a chromosomal disorders.
External factors more important factors in indoor, especially viruses such as rubella, mumps, epidemic and Ke Saji virus. Critical period of embryonic development of the heart is in the di2~8 pregnancy weeks, resulting in congenital cardiovascular malformations are also mainly occurs at this stage, if the mother during pregnancy 3 months internal troubles when a severe viral infection, especially the risk of rubella virus born after high incidence of neonatal congenital heart disease.
Fetal and maternal factors of the environment, including fetal local mechanical pressure around, mother of nutrient or vitamin deficiency and other factors will affect fetal heart development.
Other factors such as Highlands, PDA high incidence, explains plateau environment possible factors for the onset of the disease.
And if the mother during pregnancy exposure to high-dose x rays or the use of certain drugs, risk of chronic disease, hypoxia, mothers age pregnancy, abortion strengthening mucle and multiple births are risk factors.
Early detection of babies suffering from congenital heart disease
Baby with congenital heart disease, due to the presence of single or complex of different clinical manifestations vary, some in the new-born neonatal cyanosis identify skin, Mucosa, short of breath, heart failure, if not timely diagnosis and treatment, will die. Usually no symptoms in children, normal growth and development, activity is also very strong, as with normal children, doctor only once in a while in a cold, respiratory infection, doctors discovered heart murmur is found in physical examination and patient with congenital heart disease.
In order for parents to learn how to early detection of congenital heart disease, timely treatment of knowledge, on the basis of various types of congenital heart disease hemodynamics and Anatomy characteristics and shunt is divided into three categories, and describe its main symptoms and manifestations.
A: first left ventricular cardiac shunt to the right groups often have the following on the clinical symptoms and manifestations:
1. short of breath: in a newborn or infant, found that hunger can\'t wait to find children with food, but found weak suck, shallow breathing, sucking milk unfinished abandoned milk due to shortness of breath, many stop sucking, feeling very tired, sweat.
2. recurrent respiratory infections or pneumonia: this is the most common presenting symptoms and found heart murmur, pulmonary congestion, mild respiratory infections will easily cause bronchial pneumonia, causing qiangke, tachypnea, and some when the baby is crying hoarse, congruent and even heart failure symptoms.
3. growth retardation due to inadequate systemic blood flow and oxygen supply, growth and development than the same age retardation in children, its weight behind than a body length behind more obvious.
4. edema: when it finds a congenital heart disease in children, have the above symptoms and manifestations, if less urine, appear when pitting edema of lower extremity, it means that from the function is not compensation caused by congestive heart failure in children, this is a very important warning!
5. cyanosis: cyanosis General diseases in this group will not appear, but if not treated in time, causing pulmonary hypertension complications, resulting in heart blood flow right to left shunt cyanosis can occur, treatment of chance has been lost.
B. second right to left shunt group, as a complex malformation congenital heart disease. Common clinical symptoms and manifestations are:
1. purple velvet or said cyanotic: is complex congenital heart disease of important symptoms, performance in skin, Mucosa (especially mouth lip) purple velvet, especially in cry noisy, and activities Hou increased, as in newborn period appears purple velvet, common of has full sexual arteries dislocation, pulmonary atresia,; in 6 months ~1 aged gradually appears purple velvet increased of has method music four joint syndrome,.
2. squat: is a common manifestation of tetralogy of fallot, in addition to cyanosis with age and increase, when he would walk, you will find activities for children with small, weak sense of not far away, automatically getting chest and knee squat position lying position
, After a short rest and then stand up activities, the squat process enables increased systemic resistance, promoting increased venous blood into the heart and oxygenation, to improve the symptoms of hypoxia.3. blackout: also known as the hypoxic seizures, often occurring in breastfeeding, crying, from lack of oxygen when defecating, baby sudden breathing difficulties, increased cyanosis, loss of consciousness or even cramping.
4. finger clubbing (toe): tetralogy of fallot, baby long-term hypoxia means (toe) end of soft tissue hyperplasia, the fingers and toes drumstick-like changes, clinical often appears after 2~3sui.
5. massive hemoptysis: tetralogy of fallot in children\'s cases, oxygen for a long time, formation of collateral circulation in lung blood vessel rupture can cause hemoptysis.
C: third: no shunt group in the left, right in the heart or great vessels without abnormal traffic, so no pulmonary congestion is often caused by performance of the respiratory tract, pneumonia, or arterial and venous blood and the existence of, so there is no cyanosis, common diseases of simple pulmonary stenosis; coarctation of the aorta.
All the above three groups of diseases there is a heart murmur, according to the different degree of heart murmur, doctor for further analysis, combined with a variety of detection methods, final diagnosis, adopting different methods of treatment.
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