Heart disease is a kind of a series of structural abnormalities and deformations of valves, partitions, openings between the heart chambers and blood vessels, which disrupt blood circulation through the internal cardiac vessels and predispose to the formation of an acute and chronic form of insufficient circulatory function.
As a result, a condition develops, which in medicine is called "hypoxia" or "oxygen hunger". Heart failure will gradually increase. If qualified medical assistance is not provided in a timely manner, this will lead to disability or even death.
What is heart disease?
Heart disease is a group of diseases associated with congenital or acquired dysfunctions and anatomical structure of the heart and coronary vessels (large vessels that supply blood to the heart), due to which various hemodynamic deficiencies develop (blood flow through the vessels).
If the usual (normal) structure of the heart and its large vessels is disturbed - either even before birth, or after birth as a complication of the disease, then we can talk about a defect. That is, a heart defect is a deviation from the norm that interferes with the movement of blood, or alters its filling with oxygen and carbon dioxide.
The degree of heart disease varies. In moderate cases there may be no symptoms, while with the pronounced development of the disease, heart disease can lead to congestive heart failure and other complications. Treatment for heart disease depends on the severity of the disease.
Causes
Changes in the structural structure of the valves, atria, ventricles or cardiac vessels that cause disruption of the movement of blood in the large and small circle, as well as inside the heart, is defined as a defect. It is diagnosed in both adults and newborns. This is a dangerous pathological process that leads to the development of other myocardial disorders, from which the patient can die. Therefore, timely detection of defects ensures a positive outcome of the disease.
In 90% of cases in adults and children acquired defects are the result of acute rheumatic fever (rheumatism). This is a serious chronic disease that develops in response to the introduction of group A hemolytic streptococcus into the body (as a result, scarlet fever,), and manifests itself as damage to the heart, joints, skin and nervous system.
The etiology of the disease depends onwhat kind of pathology is: congenital, or arising in the process of life.
The reasons for the appearance of acquired defects:
- Infectious or rheumatic endocarditis (75%);
- Rheumatism;
- (5–7%);
- Systemic connective tissue diseases (collagenosis);
- Injuries;
- Sepsis (general damage to the body, purulent infection);
- Infectious diseases (syphilis) and malignant neoplasms.
Causes of congenital heart disease:
- external - poor environmental conditions, mother's illness during pregnancy (viral and other infections), the use of drugs that have a toxic effect on the fetus;
- internal - associated with a hereditary predisposition on the line of the father and mother, hormonal changes.
Classification
The classification divides heart defects into two large groups according to the mechanism of occurrence: acquired and congenital.
- Acquired - occur at any age. The cause of heart disease is most often rheumatism, syphilis, hypertension and ischemic disease, severe vascular atherosclerosis, cardiosclerosis, and trauma to the heart muscle.
- Congenital - are formed in the fetus as a result of improper development of organs and systems at the stage of laying down groups of cells.
According to the localization of defects, the following types of defects are distinguished:
- Mitral are the most commonly diagnosed.
- Aortic.
- Tricuspid.
Also distinguish:
- Isolated and combined - changes are either single or multiple.
- With cyanosis (the so-called "blue") - the skin changes its normal color to a bluish tint, or without cyanosis. Distinguish between generalized cyanosis (general) and acrocyanosis (fingers and toes, lips and tip of the nose, ears).
Congenital heart defects
Congenital defects are abnormal development of the heart, a violation in the formation of the main blood vessels during the prenatal period.
If it speaks of congenital defects, then most often among them there are problems of the interventricular septum, in this case the blood from the left ventricle enters the right, and thus the load on the small circle increases. When conducting an X-ray, this pathology looks like a ball, which is associated with an increase in the muscle wall.
If such a hole is small, then the operation is not required. If the hole is large, then such a defect is sutured, after which the patients live normally until old age, disability in such cases is usually not given.
Acquired heart disease
Heart defects are acquired, while there are violations of the structure of the heart and blood vessels, their effect is manifested by a violation of the functional ability of the heart and blood circulation. Among acquired heart defects, the most common lesion is the mitral valve and the semilunar valve of the aorta.
Acquired heart defects are rarely subject to timely diagnosis, which distinguishes them from CHD. Very often people carry many infectious diseases "on their feet", and this can cause rheumatism or myocarditis. Acquired heart defects can also be caused by inappropriate treatment.
This disease is the most common cause of disability and death at a young age. According to primary diseases, defects are distributed:
- about 90% - rheumatism;
- 5.7% - atherosclerosis;
- about 5% - syphilitic lesions.
Other possible diseases leading to a violation of the structure of the heart - trauma, tumors.
Heart disease symptoms
The resulting defect in most cases can not cause any disturbances from the cardiovascular system for a long period of time. Patients can engage in physical activity for quite a long time without feeling any complaints. All this wakes up to depend on which part of the heart has suffered as a result of congenital or acquired defect.
The main first clinical sign of a developed defect is the presence of pathological murmurs in the tones of the heart.
The patient presents the following complaints in the initial stages:
- shortness of breath;
- constant weakness;
- developmental delay is characteristic of children;
- fast fatiguability;
- reduced resistance to physical stress;
- palpitations;
- chest discomfort.
As the defect progresses (days, weeks, months, years), other symptoms join:
- swelling of the legs, arms, face;
- cough, sometimes streaked with blood;
- heart rhythm disturbances;
- dizziness.
Signs of a congenital heart disease
Congenital pathology is characterized by the following symptoms, which can manifest itself in both older children and adults:
- Constant shortness of breath.
- Heart murmurs are heard.
- The person often loses consciousness.
- Observed atypically frequent.
- No appetite.
- Slowdown in growth and weight gain (a feature typical for children).
- The appearance of such a symptom as blue discoloration of certain areas (ears, nose, mouth).
- A state of constant lethargy and exhaustion.
Acquired form symptoms
- fatigue, fainting, headaches;
- difficulty breathing, feeling short of breath, coughing, even pulmonary edema;
- rapid heartbeat, disturbance of its rhythm and change in the place of pulsation;
- pain in the region of the heart - sharp or pressing;
- blue skin due to blood stasis;
- enlargement of the carotid and subclavian arteries, swelling of the veins in the neck;
- the development of hypertension;
- swelling, enlarged liver and a feeling of heaviness in the abdomen.
The manifestations of the defect will directly depend on the severity, as well as the type of ailment. Thus, the definition of symptoms will depend on the location of the lesion and the number of valves affected. In addition, the symptom complex depends on the functional form of the pathology (more on this in the table).
| Functional form of the defect | Typical symptoms |
| Mitral stenosis | Complaints of shortness of breath with relatively light exertion, coughing, hemoptysis are characteristic. However, sometimes quite pronounced mitral stenosis proceeds for a long time without complaints.
|
| Mitral insufficiency | As in the above case, shortness of breath in the initial stages only on the fact of exertion, and after that it is characteristic in a calm state. The symptoms are as follows:
|
| Aortic insufficiency | This defect most often develops as a result. However, other causes are also possible: septic endocarditis, syphilis, etc. One of the earliest symptoms of this defect is:
With severe aortic insufficiency, the following are noted:
You may experience pain in the heart area that resembles angina pectoris. |
| Aortic stenosis | Narrowing of the aortic valve (stenosis) is the most common birth defect. Inadequate blood outflow or inflow, low oxygen supply cause the following symptoms with aortic heart disease:
|
| Tricuspid Insufficiency | This defect is expressed in venous stasis of blood, which causes the following symptoms:
Signs common to all heart defects include blue skin, shortness of breath and severe weakness. |
Diagnostics
If, after reading the list of symptoms, you find matches with your own situation, it is better to play it safe and go to a clinic where an accurate diagnosis will reveal a heart defect.
The initial diagnosis can be determined using the pulse (measured while at rest). The patient is examined by palpation, the heartbeat is listened to to detect noise and tone changes. The lungs are also checked, the size of the liver is determined.
There are several effective methods that allow you to identify heart defects and, based on the data obtained, prescribe the appropriate treatment:
- physical methods;
- ECG is performed to diagnose blockade, arrhythmia, aortic insufficiency;
- Phonocardiography;
- X-ray of the heart;
- Echocardiography;
- MRI of the heart;
- laboratory methods: rheumatoid tests, KLA and OAM, determination of blood sugar and cholesterol levels.
Treatment
With heart defects, conservative treatment is to prevent complications. Also, all efforts of therapeutic therapy are aimed at preventing relapse of the primary disease, for example, rheumatism, infective endocarditis. Correction of rhythm disturbances and heart failure under the supervision of a cardiac surgeon is mandatory. Based on the shape of the heart defect, treatment is prescribed.
Conservative methods are not effective for congenital pathologies. The goal of treatment is to help the patient and prevent the onset of attacks of heart failure. Only the doctor determines which pills to drink for heart disease.
The following drugs are usually indicated:
- cardiac glycosides;
- diuretics;
- vitamins D, C, E are used to support immunity and antioxidant effect;
- potassium and magnesium preparations;
- anabolic hormonal agents;
- in the event of acute attacks, oxygen inhalation is carried out;
- in some cases, antiarrhythmic drugs;
- in some cases, medications may be prescribed to reduce blood clotting.
Folk remedies
- Beet juice. Combined with honey 2: 1, it helps support heart function.
- Mother and Stepmother Blend can be prepared by pouring 20 g of leaves with 1 liter of boiling water. You need to insist the product for several days in a dry, dark place. Then the infusion is filtered and taken after meals 2 times a day. A single dose is 10 to 20 ml. The entire course of treatment should last about a month.
Operation
Surgical treatment of congenital or acquired heart defects is carried out in the same way. The difference lies only in the age of the patients: most children with severe pathologies operate in the first year of life in order to prevent the development of fatal complications.
Patients with acquired defects are usually operated on after 40 years of age, at the stages when the condition becomes threatening (stenosis of valves or passages by more than 50%).
There are a lot of options for surgical intervention for congenital and acquired defects. These include:
- repair of defects with a patch;
- artificial valve prosthetics;
- excision of the stenotic opening;
- in severe cases, heart-lung complex transplantation.
What kind of operation will be performed, is decided by a cardiac surgeon on an individual basis. The patient is monitored after surgery for 2-3 years.
After any surgical operation for heart defects, patients are in rehabilitation centers until they have completed the entire course of medical rehabilitation therapy with the prevention of thrombosis, improvement of myocardial nutrition and treatment of atherosclerosis.
Forecast
Despite the fact that the stage of compensation (without clinical manifestations) of some heart defects is calculated for decades, the total life expectancy can be reduced, since the heart inevitably "wears out", heart failure develops with impaired blood supply and nutrition to all organs and tissues, which leads to lethal the outcome.
With the surgical correction of the defect, the prognosis for life is favorable, provided that medications are taken as prescribed by a doctor and the development of complications is prevented.
How long do you live with a heart defect?
Many people who hear such a terrible diagnosis immediately ask the question - “ How many live with such vices?". There is no unequivocal answer to this question, since all people are different and clinical situations are also different. They live as long as their heart can work after conservative or surgical treatment.
If heart defects develop, prevention and rehabilitation measures include a system of exercises that increase the level of the functional state of the body. The system of recreational physical education is aimed at increasing the level of the patient's physical condition to safe values. It is prescribed for the prevention of cardiovascular diseases.
The cardiovascular system consists of the heart, which pushes the blood, and the vessels, through which the blood carries nutrition and oxygen to the cells. This system is closed, and blood flows in only one direction thanks to the four valves of the heart, which open and close, allowing the next portion of blood to pass through. Changes in the structure of the valves is called a defect, which can lead to disruption of the heart and the movement of blood in the circulatory system.
What is heart disease?
In order to understand, you need to know how the heart valves work. Normally, the heart has two atria at the top and two ventricles at the bottom. The right and left halves of the heart are separated by a septum, and the valves are located as follows:
- Mitral valve (bicuspid) - Located between the left atrium and the ventricle, its function is to prevent backflow of blood from the ventricle to the atrium.
- Tricuspid valve - located between the right atrium and ventricle. Its function is to prevent the reverse flow of blood from the right ventricle into the right atrium.
- Aortic valve - located at the exit from the left ventricle to the aorta. Its function is to prevent the flow of blood from the aorta into the ventricle.
- Pulmonary valve - located at the exit from the right ventricle to the pulmonary artery. Its function is to prevent blood from flowing back from the artery to the right ventricle.
The most common mitral valve defect (50-75% of cases), less common aortic valve defect (up to 20% of all cases). Malformations of the pulmonary valve and tricuspid valve occur less frequently than all others (up to 5% of all cases). Heart disease can be isolated (malformation of 1 valve) and multiple (malformation of 2 or more valves).
In addition to these defects, there are also defects of the atrial and interventricular septa, as well as defects in which blood is thrown from the right half of the heart to the left and vice versa (open Botallo duct, Fallot's tetrad and others). The defect can be manifested by insufficiency of the valve walls or narrowing of the lumen (stenosis), as a result of which circulatory disorders also occur.
In rare cases, it occurs mitral valve prolapsecharacterized by bulging of the valve walls. Bulging of the leaflets prevents the normal flow of blood from the left atrium into the left ventricle, and can be either congenital or acquired.
All heart defects are divided into congenital and acquired. Congenital heart disease Is a defect in any of the valves from the moment of birth. Children born with heart defects do not live long, and congenital heart disease is the main cause of early infant mortality.
Acquired heart disease Is a defect resulting from various diseases or disorders of the heart. In this case, heart disease is, as a rule, a secondary process after the underlying disease.
Causes of heart defects
The causes of congenital malformations in children are not fully understood. But it has been proven that the formation of the heart occurs between 5 and 8 weeks of pregnancy. Any factor that can have a harmful effect can cause congenital heart disease.
These can be infections (viruses, fungi, bacteria), as well as radiation exposure, medication, large doses of alcohol or drugs. Most often, such diseases of the mother as rubella, viral hepatitis, and influenza lead to a malformation of the valves. Heart disease in children occurs in 5-8 newborns per 1000 children.
The following diseases can become the causes of acquired heart defects:
- Rheumatism (long-term illness and ineffective treatment).
- Atherosclerosis of the vessels, leading to an increased load on the heart.
- Infectious diseases of the heart (infective endocarditis).
- Syphilis.
- Connective tissue diseases (systemic scleroderma, ankylosing spondylitis).
- Various injuries in the area of \u200b\u200bthe heart.
- Myocardial infarction.
As a result of various diseases, the valve leaflets first become inflamed, then collapse, and at the end they are covered with scar tissue, which is deformed and cannot hold back blood flow. Deformation and damage to the valves cannot pass without leaving a trace for the heart itself, which operates under increased stress.
If at this stage of the disease the necessary treatment is not carried out, then as a result of increased work of the heart, hypertrophy (thickening) of the walls of the heart, expansion of its cavities, a decrease in the contractility of the heart and the phenomenon of heart failure occur.
Heart disease symptoms
Children with a congenital defect usually lag behind in development and growth, they have severe shortness of breath during physical exertion, pallor or cyanosis (cyanosis) of the skin. Less common symptoms such as anxiety, headaches, dizziness, pain in the heart.
Congenital heart disease in newborns usually appears immediately after birth. A characteristic sign of severe congenital heart disease in a baby is a bluish skin color. On the second or third day, you can notice how the child quickly gets tired when feeding, he is lethargic or restless, and while listening to the heart, a heart murmur is clearly heard.
It is much more difficult to detect an acquired heart defect, since the body, when the first signs of heart failure appear, tries to compensate for this on its own. Symptoms of heart defects vary somewhat and depend on the lesion of a particular valve.
In most cases, patients are worried about shortness of breath during exertion and pain in the heart, as well as general weakness, heart palpitations, swelling in the legs and other various manifestations of heart failure.
Depending on the course of the disease, the following manifestations of acquired heart defects are distinguished:
- Compensated defects. In this case, the heart muscle completely copes with its function, and the symptoms are weakly or not at all.
- Subcompensated defects. With this form of the disease, the symptoms of heart disease may be mild, since this form is transitional between compensated and decompensated defects.
- Decompensated defects. Moreover, all the symptoms of heart failure are pronounced. This happens due to the fact that the increased work of the heart muscle leads to its weakening.
Treatment and prevention of heart defects
Treatment of congenital defects in children is mainly surgical, since according to statistics, without surgery, more than half of children diagnosed with heart disease die in the first year of life. If, for some reason, the operation is not performed, then the child must be given various medications to maintain cardiac activity.
Medications are prescribed only by a doctor after a complete clinical examination, which it is advisable to use strictly at a certain time and in a dosage prescribed by the doctor. In addition, the child needs walks in the fresh air, and the feeding regime should be increased by 2-3 times, while reducing the number of one-time meals. Of course, it is better to feed children with heart defects with mother's (or donor's) milk.
Patients with compensated defects do not need special treatment, since it is enough to observe the diet, work and rest. In this case, it is necessary to eliminate all those causes that could cause heart disease (rheumatism, chronic infections).
In this case, patients should engage in light physical labor to maintain normal blood circulation (heavy loads are contraindicated). In order to prevent the appearance of complications, it is better to give up overeating, drinking alcohol and smoking.
Currently, the cardiological service is well developed, which can offer modern methods of diagnosis and treatment. This is especially true for patients with acquired subcompensated and decompensated heart defects. With the help of surgery, valve replacement or mitral commissurotomy can be performed, after which the patient can lead a normal life.
There are no traditional preventive measures for acquired heart defects, but the risk of their occurrence can be significantly reduced if the underlying disease is treated promptly.
Heart disease is a violation of blood flow in the myocardium, which occurs due to the disconnection of enlarged vessels from the muscles in the heart.
Today in clinical practice, there are various classifications of heart defects. However, this pathology is formed either still in the womb, or throughout life.
Heart disease: types
According to the etiology of origin, such pathologies of heart disease are distinguished:
1. Congenital defects. The development of such a defect occurs even in the womb, or during childbirth due to the influence of any external or internal factors. External factors include ecology, viruses, drugs, and other causes. Internal - various disorders in the health of parents.
2. Acquired defects. Such vices are formed after a person is born, that is, throughout life as a result of any disease. For example, diseases such as rheumatism, atherosclerosis, coronary artery disease, myocardial injury, syphilis and many other reasons can cause the formation of heart defects.
Heart disease: classification by location
2. Aortic defect - changes occur on the eve of the aorta.
3. Tricuspid or tricuspid defect. This valve is responsible for blood flow from the right side from the atrium to the ventricle.
4. Pulmonary valve disease - this pathology is formed on the eve of the pulmonary artery.
5. Patent ductus arteriosus - non-union of the duct of arteries in newborns. A similar defect is often observed in girls. However, in the first months of life, the ducts overgrow on their own.
Congenital heart disease
Predisposing factors of congenital heart disease.
Let's figure out why a child is born with a similar pathology.
Studies have shown that there is some unevenness in childbirth with heart defects. So, dysfunction of the heart valves is observed in girls who are born from the tenth to the first month of the year. Boys are most often born with a violation of the ductus arteriosus in the heart in March or April.
Such fluctuations are most likely due to viral epidemics and environmental changes. For example, the rubella virus, which infects a pregnant woman, has a negative effect on the fetus. In addition, if in the first three months of gestation a woman carries the flu virus, then there is a predisposition of the fetus to the occurrence of a heart defect.
Undoubtedly, a virulent agent alone is not enough for a heart defect to begin to form in a child. The impetus for the development of pathology can be given by the presence of additional factors - this is a hereditary predisposition, the severity of a viral disease.
Alcoholism of a woman also plays a significant role in the appearance of a heart defect in the fetus. Almost 50% of these women have children born with a defect.
Lupus erythematosus and diabetes also affect congenital coarctation of the aorta.
Acquired heart disease
How can acquired heart disease be identified at home?
Disorders in the heart can be independently recognized by the following signs:
Frequent heartbeat, pain in the region of the heart.
Feeling of some kind of fullness behind the chest.
Fainting, dizziness.
Swelling of the legs.
Slight blush on the face.
Diagnosis of congenital and acquired heart defects
The standard method for detecting such pathologies is considered to be an ultrasound examination of the heart (ECHO). However, this method is effective only in the early stages of the formation of inflammatory processes in the heart valves.
Additional examination procedures:
- radiography of the projection of the heart;
- phonocardiogram.
Mitral heart disease
The following reasons affect the development of mitral valve defect:
- layering of calcium on the valve surface;
- myxoma of the atrium of the left side;
- rheumatic fever;
- Marfan syndrome (connective tissue disorders).
With mitral stenosis, blood flow into the left ventricle is difficult and thus there is a risk of enlargement of the left atrium. After a while, the blood in the lungs is retained, which can cause an increase in the right side of the heart. So, heart malaise begins.
Signs of heart disease
At the initial stages, mitral stenosis does not manifest itself at all, so a person can perform any physical activity. In the process of development of the defect, shortness of breath occurs. There may also be a cough, sometimes bloody coughing up. There is weakness for no reason, rapid fatigue, chest pains of a diffuse nature. In the chronic stage of the development of the disease, an enlarged heart can exert a squeezing effect on the larynx or esophagus - there is a change in voice and discomfort when swallowing.
Diagnostics and treatment
If a person is sick with mitral stenosis, he has a pale face with a pronounced blush on the cheeks with a bluish tint to the lips and nose. A bump protrudes on the chest in a person - this is an enlarged heart. A different pulse is felt on the hands.
A qualified doctor, with a thorough examination and additional laboratory tests, will be able to accurately diagnose.
The disease is amenable to drug treatment at the initial stage of development. In the later stages of the progression of the disease, the treatment is carried out by surgery: the fused valves are cut or replaced with an unnatural valve.
This disease occurs with a disorder of the mitral valve. Aortic defects are characterized by the following manifestations:
Aortic malaise is incomplete closure of the aorta by the mitral valve.
Aortic stenosis is compression of the aortic opening.
The combination of aortic malaise and stenosis of the aortic valve is incomplete compression of the mitral leaflets and compression of the aortic opening.
Such defects can appear in newborns or appear during life.
Causes of aortic valve insufficiency
With congenital pathology, such violations occur:
Lack of one damper valve.
One sash is enlarged in contrast to the others.
Dystrophy is observed in one of the valves.
The mouths are formed in the valves.
With age, the following factors can affect the appearance of heart disease:
Diseases caused by a particular infection (pneumonia, tonsillitis, syphilis, sepsis): virulent microorganisms infect the endocardium, as a result of which pathogenic bacteria form on the valve. These microbes stick together over time and disrupt the structure of the valve, thereby causing it to partially close.
Autoimmune pathologies - characterized by the rapid multiplication of connective tissue, which in turn thinns the valve flaps and contributes to its periodic closure.
Aortic heart disease: symptoms in case of malaise
The disease progresses slowly, so the initial stage can be kept for ten years and almost without any special signs.
If the flow of blood from the aorta into the ventricle increases to 30%, then the following complaints from the patient are observed:
- dizziness when turning the body;
- frequent fatigue;
- heart palpitations;
- frequent shortness of breath;
- swelling of the legs;
- shortness of breath with little activity;
- a feeling of heaviness under the right rib;
- clouding of consciousness.
Aortic valve stenosis
With congenital stenosis, such injuries are visible in humans:
A tangle of muscle fibers forms above the aortic valve.
Lack of flap at the valve.
A mouth in the form of a membrane is formed under the valve.
Such violations can be observed up to ten years. With age, defects in the heart transform and change symptoms. The following factors affect the acquisition of stenosis:
Diseases caused by this or that infection (pharyngitis, pneumonia, syphilis, tonsillitis).
Autoimmune diseases (rheumatism, scleroderma).
Changes associated with age: atherosclerosis, calcium salt deposition on the valve flaps and the accumulation of fatty plaques on them, which gradually block the aortic opening.
Symptoms
The manifestation of aortic stenosis is often not visible. This pathology can be detected during a routine examination or when examining other diseases. Over time, the following complaints appear:
- painful sensations in the heart;
- heaviness in the chest;
- frequent fatigue;
- swelling of the legs;
- fainting;
- dry cough.
Aortic heart disease: treatment and diagnosis
The following methods of examination are prescribed:
1.Radiography.
2. Doppler sonography.
4. Echocardiography.
5. Cardiac catheterization.
The complex of drug treatment consists of the following drugs:
Antianginal drugs: neutralize the feeling of heaviness in the chest and pain in the heart.
Diuretics: taken to restore normal blood circulation in the pulmonary joints.
Antibiotics: taken to prevent infection with infective endocarditis.
The choice of drugs and their dosage is determined only by the doctor.
Rheumatic heart disease
Rheumatism is a lesion of the connective tissue of various body systems.
Rheumatic heart disease: causes
1. Formation of streptococcus infection in the nose and larynx (sinusitis, tonsillitis, pharyngitis, scarlet fever). The risk of rheumatism appears only after suffering similar infectious diseases.
2. Hereditary predisposition.
It is the streptococcal infection that produces substances that release toxic substances that enter the bloodstream and affect the work of the heart.
The effect of streptococcus on the heart:
Promotes the formation of inflammatory processes on the membrane of the heart - rheumatic heart disease.
Promotes the formation of inflammatory processes of the muscular membrane of the heart - myocarditis.
Promotes the formation of inflammatory processes in the outer shell of the heart - pericarditis.
Promotes the formation of inflammatory processes in the inner lining of the heart - endocarditis.
Promotes the formation of inflammatory processes in all membranes of the heart - pancarditis.
Streptococcus causes enlargement and sticking of the heart valves, as a result of which there is a failure in the structure of the heart, and there is a risk of malformations.
Symptoms of rheumatic heart disease:
- general malaise;
- tachycardia;
- an increase in body temperature;
- possible arrhythmia;
- increased sweating;
- shortness of breath even at rest;
- an enlarged liver;
- swelling of the legs;
- the volume of the heart increases;
- a cough that worsens with any physical exertion.
Complaints that are observed with myocarditis:
- rapid heartbeat;
- discomfort in the region of the heart;
- shortness of breath with little physical exertion.
With endocarditis, enlargement and fusion of the valve closures leads to incomplete closure or stenosis.
With pankaditis, the work of the heart is completely disrupted, which can even cause cardiac arrest.
The unknown is always, at least, alarming or begin to be afraid of it, and fear paralyzes a person. On a negative wave, wrong and hasty decisions are made, their consequences worsen the state of affairs. Then again fear and - again wrong decisions. In medicine, such a "loopback" situation is called circulus mortum, a vicious circle. How to get out of it? Let shallow, but correct knowledge of the fundamentals of the problem, will help to solve it adequately and on time.
What is heart disease?
Every organ in our body is designed to function rationally in the system for which it is designed. The heart belongs to circulatory system, helps the movement of blood and its saturation with oxygen (O2) and carbon dioxide (CO2). Filling and contracting, it "pushes" the blood further, into large and then small vessels. If the usual (normal) structure of the heart and its large vessels is disturbed - either even before birth, or after birth as a complication of the disease, then we can talk about a defect. That is, a heart defect is a deviation from the norm that interferes with the movement of blood, or alters its filling with oxygen and carbon dioxide. Of course, as a result, problems arise for the whole organism, more or less pronounced and of varying degrees of danger.
A little about the physiology of blood circulation
The human heart, like all mammals, is divided into two parts by a dense partition. The left one pumps arterial blood, it is bright red and rich in oxygen. The right one is venous blood, it is darker and saturated with carbon dioxide. The septum is normal (it is called interventricular) has no holes, and blood in the cavities of the heart ( atria and ventricles) does not mix.
Venous blood from the whole body enters the right atrium and ventricle, then into the lungs, where it gives off CO2 and receives O2. There she turns into arterial, the left atrium and ventricle pass, through the vascular system it reaches the organs, gives them oxygen and takes carbon dioxide, turning into venous. Further - again to the right side of the heart and so on.
The circulatory system is closed, therefore it is called " circle of blood circulation". There are two such circles, both of which involve the heart. The circle "right ventricle - lungs - left atrium" is called small, or pulmonary: in the lungs, venous blood becomes arterial and is transmitted further. The circle "left ventricle - organs - right atrium" is called bigpassing along its route, blood from arterial again turns into venous.
Functionally left atrium and ventricle experience high stress, because the large circle is "longer" than the small one. Therefore, on the left, the normal muscular wall of the heart is always somewhat thicker than on the right. Large vessels entering the heart are called veins... Outgoing - arteries... Normally, they do not communicate at all with each other, isolating the flows of venous and arterial blood.
Valveshearts are located between atria and ventriclesand on the border of the entrance and exit of large vessels. The most common problems are with mitralvalve (bicuspid, between the left atrium and ventricle), in second place - aortic (at the exit of the aorta from the left ventricle), then tricuspid (tricuspid, between the right atrium and ventricle), and in the "outsiders" - pulmonary valve, at its exit from the right ventricle. The valves are mainly involved in the manifestations of acquired heart defects.
Video: principles of blood circulation and heart function. (Important for understanding hemodynamics for defects)
What are the types of heart defects?
Consider a classification adapted for patients.
- Congenital and acquired - changes in normal structure and position heart and his large vessels appeared either before or after birth.
- Isolated and combined - changes are either single or multiple.
- C (so-called "blue") - the skin changes its normal color to a bluish tint, or without cyanosis. Distinguish generalized cyanosis (general) and acrocyanosis (fingers and toes, lips and tip of the nose, ears).
I. Congenital heart defects (CHD)
Violations in the anatomical structure of the child's heart are formed more in utero (during pregnancy), but only appear after birth. To get a more complete picture of the problem - see pictures of heart defects.
For convenience, they were classified based on the blood flow through the lungs, that is small circle.
- CHD with increased pulmonary blood flow - with cyanosis and without it;
- CHD with normal pulmonary blood flow;
- CHD with reduced blood flow through the lungs - with cyanosisand without it.
Ventricular septal defect (VSD)
Depending on the degree of defect and disturbance of blood flow, the concepts were introduced compensated(due to the thickening of the walls of the heart and increased contractions, blood passes in normal volumes) and decompensated(the heart enlarges too much, the muscle fibers do not receive the necessary nutrition, the strength of the contractions falls) acquired defects.
Insufficiency of the mitral valve
The work of a healthy (top) and affected (bottom) valves
Incomplete closure of the valves is the result of their inflammation and consequences in the form sclerosis (replacing "working" elastic tissues with rigid connective fibers). Blood on contraction left ventriclethrown in the opposite direction, in left atrium... As a result, more force of contractions is needed to "return" the blood flow to the side aortaand hypertrophied(thickens) the entire left side of the heart. Develops gradually failurein a small circle, and then - outflow disturbance venousblood from the systemic circulation, the so-called.
Signs: mitral blush (pinkish-blue color of lips and cheeks). Trembling of the chest, even felt by the hand - it is called cat purrand acrocyanosis (bluish shade of hands and toes, nose, ears and lips). Such picturesque symptoms are possible only with decompensated vice, and if compensatedthey don't exist.
Treatment and prognosis: in advanced cases, for prevention is required. Patients live a long time, many do not even know about the disease, if it is in compensation stage... It is important to treat all inflammatory diseases on time.
drawing: mitral valve replacement
Mitral stenosis (narrowing of a valve between the left atrium and ventricle)
Signs: if vice decompensated, when measuring blood pressure lower digit ( diastolic pressure) can drop to almost zero. Patients complain of dizziness, if the position of the body changes quickly (lay down - got up), attacks of suffocation at night. The skin is pale, pulsation of the arteries in the neck is visible ( dance carotid) and shaking the head. Pupils eyes and capillaries under the nails (visible when pressing on nail plate) also pulsate.
Treatment: preventive - with compensated vice, radical - artificial aortic valve.
Forecast: isolated vice in about 30% they are found by chance, during a routine examination. If the defect valve small and not pronounced, people are not even aware of the vice and live a full life.
The consequence of aortic defect - heart failure, stagnation of blood in the ventricle
Aortic stenosis, isolated defect
Difficulty getting blood out of left ventricle in aorta: This requires more effort and the muscle walls of the heart thicken. The less aortic opening, the more pronounced hypertrophy left ventricle.
Signs: associated with a decrease in income arterial blood to the brain and other organs. Pallor, dizziness and fainting heart hump (if the defect developed in childhood), bouts of pain in the heart ().
Treatment: we reduce physical activity, we carry out restorative treatment - if there is no pronounced circulatory failure... In severe cases, only surgery, valve replacement or dissection of its leaflets ( commissurotomy).
Combined aortic defect
Two in one: failure valves + narrowing aortic opening... Such aortic defect heart is much more common than isolated. The signs are the same as for aortic stenosis, only less noticeable. In severe cases, stagnation begins in small circleaccompanied by cardiac asthma and pulmonary edema.
Treatment: symptomatic and prophylactic - in mild cases, in severe cases - surgery, replacement aortic valve or dissection of its "fused" valves. The prognosis for life is favorable, with adequate and timely treatment.
Video: causes, diagnosis and treatment of aortic stenosis
Insufficiency of the tricuspid (tricuspid) valve
Due to loose closure valve, blood from right ventricle thrown back into right atrium... His ability make up for a vicelow, so it starts quickly venous stasis in big circle.
Signs: cyanosis, veins the necks are full and throbbing blood pressure slightly lowered. In severe cases, edema and ascites (accumulation of fluid in abdominal). Treatment is conservative, mainly for elimination venous stasis... The prognosis depends on the severity of the condition.
Stenosis of the right atrioventricular (between the right atrium and ventricle) opening
The outflow of blood from right atrium in right ventricle. Venous congestion quickly spreading to liver, it increases, then develops cardiac fibrosis of the liver - active tissue is replaced connective (cicatricial). Appears ascites, are common edema.
Signs: pain and feeling of heaviness in hypochondrium on right, cyanosis with a yellow tint, always - ripple cervical veins. Blood pressure reduced; liver increased, pulsating.
Treatment: is aimed at reducing edema, but it is better not to delay the operation.
Forecast: normal health is possible with moderate physical. activity. If appeared and cyanosis - quickly to a cardiac surgeon.
Summary: acquired- basically rheumatic heart defects. Their treatment is aimed both at the underlying disease and at reducing the consequences of the defect. In the case of severe circulatory decompensation, only operations are effective.
Important!Heart disease treatment may have a better chance of success if people see their doctor on time. Moreover, malaise, as a reason for going to the Aesculapius, is completely optional: you can simply ask for advice and, if necessary, undergo basic examinations. A smart doctor doesn't allow his patients to get sick. An important note: the age of the doctor does not really matter. What are really important are his professional level, ability to analyze and synthesize, intuition.
Defects of the valves of the heart, aorta, pulmonary trunk, atrial and interventricular septum. These changes cause disruption of the normal functioning of the heart, which leads to an increase in chronic heart failure and oxygen starvation of body tissues.
The incidence of heart defects is about 25% of the rest of the cardiac pathology. Some authors (D. Romberg) give personal data with higher values \u200b\u200b- 30%.
Video "Heart defects":
What are the types of heart defects, classification
Among the many classifications of defects according to signs, there are:
- acquired - the main reason is rheumatism, syphilis, atherosclerosis;
- congenital - there is no unambiguous answer to the question about the causes of their occurrence, the problem is still under study. Most scientists agree that the pathological process is triggered by changes in the human genome.
Valve defects:
- bicuspid (mitral);
- tricuspid (tricuspid);
- aortic;
- pulmonary trunk.
Septal defects:
- interventricular;
- interatrial.
By the type of lesion of the valve apparatus, heart defects can proceed in the form of:
- failure (incomplete closure of the valves);
- stenosis (narrowing of the holes through which blood passes).
Depending on the degree of existing chronic circulatory failure, the following may appear:
- compensated defects (the patient is able to live, study and work, but with limitations);
- decompensated pathologies (the patient is sharply limited in the ability to move).
The form of severity provides for defects:
- lungs;
- medium;
- heavy.
By the number of defects formed, defects are distinguished:
- simple (with a single process available);
- complex (a combination of two or more defects, for example, the simultaneous presence of insufficiency and narrowing of the hole)
- combined (the problem is in several anatomical formations).
Important: some physicians in their practice drew attention to the fact that men and women have their own characteristics of the course of disease processes.
Women (girls) are more often characterized by:
- non-closure of the botallov duct. As a result of the pathological process, a relatively free communication is formed between the aorta and the pulmonary trunk. As a rule, this non-closure exists normally before the birth of the child, then closes;
- a defect in the septum between the atria (an opening remains, allowing blood to flow from one chamber to another);
- defect of the septum, designed to separate the ventricles, and non-closure of the aortic (botallic) duct;
- fallot's triad - a pathological change in the septum between the atria, combined with a narrowing of the opening of the pulmonary trunk and augmented (hypertrophic) enlargement of the right ventricle.
Men (boys) usually have:
- narrowing of the aortic opening (aortic stenosis) in the area of \u200b\u200bthe aortic valve cusps;
- defects in the connection of the pulmonary veins;
- narrowing of the isthmus of the aorta (coarctation), with an open botallic duct;
- atypical location of the main (main) vessels, the so-called transposition.
Some types of defects occur with the same frequency in both men and women.
Congenital malformations can develop in the early intrauterine period (simple) and late (complex).
With the formation of fetal pathologies at the beginning of a woman's pregnancy, a defect remains between the aorta and the artery of the lung, the opening of the existing opening between the two atria, as well as the formation of narrowing (stenosis) of the pulmonary trunk.
In the second, the atrioventricular septum may remain open, a defect of the tricuspid (tricuspid) valve with its deformation, complete absence, atypical attachment of the valves, "Ebstein's anomaly" also occurs.
Note: a very important classification criterion is the division of defects into "white" and "blue".
White vices - pathologies with a calmer course of the disease and a rather favorable prognosis, With them, the venous and arterial blood flow in their own channel, without mixing and without causing tissue hypoxia with sufficiently measured loads. The name "white" is given by the appearance of the patients' skin - a characteristic pallor.
Among them are:
- defects with stagnation of oxygen-rich blood in the pulmonary circulation. Pathology occurs in the presence of an open arterial duct, a defect of the interventricular or interatrial septum (enrichment of the small circle of blood circulation);
- defects with insufficient blood flow to the lung tissue (depletion of the small circle of blood circulation) caused by narrowing (stenosis) of the pulmonary artery (trunk);
- defects with a decrease in the supply of arterial blood, causing oxygen starvation of the organs of the human body (depletion of the systemic circulation). This defect is characteristic of narrowing (stenosis) of the aorta at the location of the valve, as well as narrowing of the aorta (coarctation) at the isthmus;
- defects without dynamic disorders of the circulatory system. This group includes pathologies with an atypical location of the heart: on the right (dextrocardia), on the left (sinistrocardia), in the middle, in the cervical region, in the pleural cavity, in the abdominal cavity.
Blue vices flow with a mixture of venous and arterial blood, which leads to hypoxia even at rest, they are characteristic of more complex pathologies. Patients with bluish skin color. In these painful conditions, venous blood is mixed with arterial blood, which leads to a lack of oxygen supply to the tissues (hypoxia).
This type of painful processes includes:
- defects with blood retention in the lung tissue (enrichment of the small circle of blood circulation). Transposition of the aorta, pulmonary trunk;
- defects with insufficient blood supply to the lung tissue (depletion of the pulmonary circulation). One of the most severe heart defects of this group is Fallot's tetrad, characterized by the presence of a narrowing of the pulmonary artery (stenosis) to which a septal defect between the ventricles joins and the right (dextraposition) position of the aorta, combined with an increase in the size of the right ventricle (hypertrophy).
Why do heart defects occur?
The causes of pathology have been studied for a long time and are well tracked in each case.
Reasons for the appearance of acquired defects
They arise in 90% of cases due to the transferred rheumatism, which gives a complication to the structure of the valves, causing their damage and the development of the disease. For a long time the doctors who treated this disease had a saying: "rheumatism licks the joints and gnaws at the heart."
Also, acquired defects can cause:
- atherosclerotic processes (after 60 years);
- untreated syphilis (by the age of 50-60);
- septic processes;
- chest trauma;
- benign and malignant neoplasms.
note: most often acquired valvular defects occur before the age of 30.
Causes of congenital defects
Factors causing the development of congenital malformations include:
- genetic causes... Hereditary predisposition to the disease was noted. A gap in the genome or chromosomal mutations cause a violation of the correct development of heart structures in the prenatal period;
- harmful effects of the external environment... Effects on a pregnant woman, poisons of cigarette smoke (benzpyrene), nitrates contained in fruits and vegetables, alcoholic beverages, drugs (antibiotics, anti-tumor drugs);
- diseases: rubella, diabetes mellitus, amino acid metabolism disorder - phenylketonuria, lupus.
These factors can cause heart problems in a developing child.
What happens to the heart and blood circulation with acquired defects
Acquired defects develop slowly. The heart includes compensatory mechanisms and tries to adapt to pathological changes. At the beginning of the process, hypertrophy of the heart muscle occurs, the chamber cavity increases in size, but then decompensation slowly forms and the muscle becomes flabby and loses its ability to function as a "pump".
Normally, during the contraction of the heart, blood is "pushed" from one chamber to another through the opening with a valve. Immediately after the passage of the blood portion, the valve leaflets normally close. If the valve is insufficient, a certain gap is formed through which the blood is partially thrown back, where it merges with the new "portion" that has already come up. Stagnation and compensatory expansion of the chamber occurs.
When the opening is narrowed, the blood cannot pass in full, and the rest of it complements the arriving "portion". Just as with insufficiency, congestion and stretching of the chamber occur with stenosis. Over time, compensatory mechanisms are weakened, and chronic heart failure is formed.
Acquired heart defects include:
- mitral valve insufficiency - due to the development of cicatricial processes after rheumatic endocarditis;
- mitral stenosis (narrowing of the left atrioventricular opening) - fusion of the valve leaflets and a decrease in the opening between the atrium and ventricle;
- aortic valve insufficiency - incomplete closure during the period of relaxation (diastole);
- narrowing of the aortic opening - the blood at the time of contraction of the left ventricle cannot all come out into the aorta and accumulates in it;
- tricuspid (tricuspid) valve insufficiency - blood during contraction of the right ventricle is thrown back into the right atrium;
- right atrioventricular stenosis - the blood from the right atrium cannot go all into the right ventricle and accumulates in the atrial cavity;
- pulmonary valve insufficiency - blood during contraction of the right ventricle is thrown back into the pulmonary artery, causing an increase in pressure in it.
Video "Mitral stenosis":
What happens to the heart with congenital defects
The exact cause of birth defects is unclear. In some cases, the development of these pathologies is facilitated by some infectious diseases that the expectant mother is ill with. Most often - measles, which has a teratogenic (damaging the fetus) effect. Less commonly, flu, syphilis and hepatitis. The effects of radiation and malnutrition have also been noted.
Sick children die without surgery with a number of defects. The earlier the treatment is carried out, the better the prognosis. There are many types of congenital heart defects. Combined defects are often observed. Let's consider the main, common diseases.
Congenital heart defects can be:
- defect (non-closure) of the interventricular septum - the most common type of pathology. Through the existing hole, blood from the left ventricle enters the right one and causes an increase in pressure in the pulmonary circulation;
- defect (non-closure) of the atrial septum - also a frequently noted type of disease, it is more often observed in women. Causes an increase in the amount of blood and increases pressure in the pulmonary circulation;
- patent arterial (botall) duct - non-closure of the duct connecting the aorta and the pulmonary artery, which leads to the discharge of arterial blood into the pulmonary circulation;
- coarctation of the aorta - narrowing of the isthmus with an open arterial (botallic) duct.
General principles of diagnosing heart defects
Determining the presence of a defect is a fairly understandable procedure, but requires special care from the doctor.
To make a diagnosis, it is necessary to carry out:
- careful questioning of the patient;
- examination to identify "heart" symptoms "
- listening (auscultation of the heart) in order to detect specific murmurs;
- tapping (percussion) to determine the boundaries of the heart and its shape.
