Heart failure in a child - what is this disease, what are its symptoms and how to treat it? Read about all this in the article.
The disease often leads to disability, poor quality of life, and death of the child. However, it should be noted that with timely complex treatment, the prognosis for recovery is very good, since it is possible to completely cure the existing disease. In order to recognize the presence of the disease in time, it is important to know exactly what symptoms are characteristic of it. When the first signs appear, you should immediately consult a doctor for diagnosis and treatment.
Features of the disease
If heart pathology is detected in time in newborns and older children, they can be saved and prevent complications. However, in most cases, dangerous symptoms go unnoticed for a long period of time, and then heart failure can develop in a child. This is a condition in which, as a result of reduced contractileability, blood circulation is disturbed inside the heart itself and beyond. In the presence of such a pathology, the whole organism suffers.
Often found in children is a chronic form of insufficiency, which develops as a result of the presence of various pathologies of the heart and blood vessels. The main danger of such a pathological condition is that it can be hidden, therefore, without timely diagnosis, heart failure in a child goes into a particularly severe, life-threatening stage.
In newborns, it is mainly provoked by congenital heart defects, especially if they are severe and combined. In older children, this problem often occurs as a result of various injuries in which damage to the heart muscle occurs.
Classification
According to the classification, heart failure in a child can be acute or chronic. Acute is characterized by the fact that it develops rapidly as a result of a violation of myocardial contractility and a simultaneous decrease in minute and systolic blood volume. Clinically, the symptoms are extremely severe: acute renal failure, pulmonary edema, cardiogenic shock.
The chronic form of the disease, as a rule, develops as a result of a disease of the cardiovascular system, which leads to a decrease in the pumping function of the human heart. Manifested by fatigue and shortness of breath.
In addition, there are diastolic and systolic forms of the disease.
Also, the pathology is left ventricular andright ventricular. The left ventricular form is characterized by the fact that it affects the pulmonary circulation and is often called pulmonary. It manifests itself in the form of cyanosis, shortness of breath and cough, and in more dangerous cases, there is pulmonary edema.
With the right ventricular form, the right side of the heart and the systemic circulation suffer, which is why it is called cardiovascular insufficiency. In children with this pathology, the spleen and liver increase, and swelling occurs.
Right-sided insufficiency
In children, cardiovascular insufficiency of the right atrium is associated with stagnation of blood in the systemic circulation. Among the main manifestations of the disease, the following should be highlighted:
- puffiness;
- disruption of the liver, intestines and stomach;
- blood stasis;
- nausea and vomiting.
External puffiness is mainly manifested on the legs, and it increases significantly in the evening. At the same time, edema does not affect the shoulders, face and arms, and in bedridden children it is concentrated in the lumbar region. In a newborn child, the swelling is not very pronounced, but his illness may manifest as cyanosis on the back of the feet and hands.
Left sided insufficiency
Heart failure in a young child, and especially in newborns, is mainly caused by dysfunction of the left ventricle of the heart. With this type of pathology, there are signs such as:
- rapid heart rate;
- shortness of breath;
- sweating and fatigue;
- wet rales in the chest.
It is worth noting that many children complain about the lack of air. Parents should definitely pay attention to such rather characteristic signs as intermittent and rapid breathing, as well as shortness of breath even with slight exertion.
In addition, among the main signs of illness in newborns, one can note sleep disturbance, attempts to sit or lie down so that the chest is slightly elevated. In this position, the wheezing subsides, and the asthma attack weakens. Blood stasis provokes cough without sputum production. Without timely treatment, a prolonged increase in pressure provokes pulmonary edema. This condition is very dangerous and requires urgent medical attention.
Chronic form
Chronic heart failure in children is a syndrome that is complicated by many diseases and affects other organs. Pathology develops slowly: over several weeks or maybe even years.
Now there are two types of chronic insufficiency. This form is much more common in disorders of the cardiovascular system.
Sharp shape
Acute cardiovascular insufficiency in children is a syndrome that develops rapidly. It is accompanied by cardiac asthma, pulmonary edema.
Acute insufficiency in children often develops due to rupture or injury of the walls of the left ventricle, as well as mitral and aortic valve insufficiency.
Degrees of disease
Doctors distinguish 3 degrees of heart failure in children, which are characterized by different signs. The first degree is considered the easiest. Among the main signs of pathology, nervousness, weakness and restless sleep can be distinguished. If the baby's body is subjected to rather heavy loads, then severe shortness of breath occurs, the pulse accelerates. After complex treatment, the state of he alth stabilizes, and all the symptoms of the disease disappear.
The second degree is further divided into two forms. In the first form, shortness of breath appears even with a slight load. The child complains of loss of appetite, restless sleep, pain in the right hypochondrium and palpitations. The symptoms are more pronounced.
In the second form of the disease, the child's he alth worsens. Even in a completely calm state, the pulse quickens, the liver enlarges, shortness of breath occurs, colic appears, insomnia, the skin turns blue and swelling occurs.
The third degree is the most severe, while the patient feels very bad. Shortness of breath does not stop, and swelling diverges throughout the body. This degree is characterized by the fact that it is irreversible. It is possible to normalize the patient's well-being, but the effect will be short-lived. Dangerous and severe pathologies occur in the heart and other organs that affect the nervous system.
The third degree manifests itself in the form of drowsiness, depression, however, at the same time, mental overexcitation and insomnia can be observed, and also occursblurred consciousness.
Causes at an early age
Heart failure is a condition of the cardiac muscle in which it cannot contract and eject the required volume of blood, resulting in congestion in the circulation. In infants and children under 3 years of age, the causes of heart failure are usually associated with the presence of congenital heart defects. Among the main risk factors, the following should be highlighted:
- genetic predisposition;
- chronic alcoholism women;
- taking certain drugs during pregnancy;
- an early viral infection.
Among the main causes of heart failure in children are cardiac defects. At the same time, immediately after the birth of the child, characteristic signs are observed, in particular, cyanosis, severe anxiety, shortness of breath, convulsions, loss of consciousness. Without urgent surgery, the child may die.
Causes of occurrence in older age
If older children show signs of heart failure, it could be:
- previous rheumatism;
- hypertension;
- cardiomyopathy;
- myocarditis;
- infective endocarditis.
All these disorders and pathologies can provoke a rapid deterioration in he alth and the development of heart failure. It is very important to determine the presence of signs of the disease in a timely manner and visit a doctor for diagnosis and treatment.
Basicsymptoms
Symptoms of heart failure in children can be very different, it all depends on which part of the heart is affected. Among the main signs of the course of pathology in infants, one can distinguish such as:
- frequent crying;
- anxiety;
- constant and heavy sweating;
- breathing disorder.
During breastfeeding, the baby loses strength very quickly and stops sucking milk, and also begins to cry.
Among the main symptoms of the disease in preschool children, the following should be highlighted:
- children try to sit or lie down;
- reducing the child's physical activity;
- children don't really want to participate in games;
- shortness of breath appears during an attack of fear, as well as during active games.
In adolescents during the period of rapid development of the body, shortness of breath appears, which many parents do not attach much importance to for a long time. At the very beginning of the development of the disease, no painful manifestations are observed. If during active movements or when coughing in the region of the heart pain occurs, this is a reason to see a doctor. Blue lips and excessive pallor of the skin may also be observed. In this case, it is imperative to provide timely assistance to the child.
First Aid
If you suspect acute heart failure, be sure to immediately call an ambulance. During an attack, oxygen starvation occurs. Be sure to give the victimchild first aid. Emergency care is as follows:
- you need to open the collar and provide fresh air;
- baby should be placed in a comfortable position;
- calm the victim, distract him from fear and pain;
- to reduce the flow of blood to the heart, make baths for hands and feet;
- you can also apply a venous tourniquet, and after 20 minutes relax it.
If the pressure has risen, then the child should be given half or a whole tablet of Nitroglycerin, which he should put under the tongue. To save his life, it is imperative to take all the necessary measures for rapid hospitalization. Transportation should be carried out with the utmost care.
Diagnostics
Treatment of heart failure in children requires prior competent and comprehensive diagnosis. It is carried out in non-invasive ways:
- radiography;
- electrocardiography;
- exercise test;
- ultrasound diagnostics.
In particularly difficult cases, cardiac catheterization may be indicated to make an accurate diagnosis. Timely diagnosis is important, because if the diagnosis is not made in a timely manner, this can lead to very dangerous consequences. Heart failure leads to a decrease in blood supply to internal organs, as well as to the brain. As a result of this, the child may be severely retarded in mental and mental development, and if treatment is not started in a timely manner, growth may stop. This does not applyonly height, but also the lack of growth of internal organs.
Features of therapy
In the treatment of acute heart failure in children, clinical guidelines are aimed at prolonging and improving the quality of life of the child. The applied therapy must necessarily be complex, and it includes the impact on the provoking factor, increasing the contractility of the heart muscle, and preventing complications.
Children's clinical guidelines for heart failure are dietary guidelines. Diet therapy is aimed at increasing the number of meals. You need to eat in small portions 5-6 times a day. The food consumed should be varied, enriched with vitamins and microelements. It is especially important to include foods high in calcium and potassium in your diet. It is imperative to exclude spicy and fatty foods, tea, chocolate, coffee from the usual diet.
Be sure to reduce physical activity. In severe cases, bed rest should be observed. After the normalization of well-being, you need to gradually return to physical activity, since a lack of exercise can lead to muscle atrophy. When conducting drug therapy, drugs such as:
- cardiac glycosides (Digitoxin, Digoxin, Lantoside);
- cardiotonics ("Dobutamine");
- diuretics ("Veroshpiron", "Furosemide").
For the prevention of thrombosis and thromboembolism, the use of suchdrugs such as Warfarin, Heparin. To normalize metabolism in cells and improve trophism, magnesium and potassium preparations are prescribed. Antidepressants and sedatives may be prescribed for restless children.
In case of respiratory failure, oxygen therapy is prescribed. With strict adherence to clinical recommendations for heart failure in children, the prognosis for life is quite favorable. The earlier the disease is detected and treated, the more favorable the prognosis for the life and development of the child. If therapy is carried out in a timely manner, then there is a greater chance that parents and the child will not remember the disease in a few years.
