Description
Description
2 Causes and Risk Factors 3 Classification 4 Dangers and Complications 5 Symptoms of 6 When to Call a Doctor 7 Diagnosis 8 Treatment 9 Forecasts and Prevention Description
Defect of the interventricular septum is a congenital( sometimes acquired) heart disease( CHD) thatcharacterized by the presence of a pathogenic opening between the cavities of the left and right ventricles .For this reason, blood from one ventricle( usually from the left) enters the other, thereby violating the function of the heart and the entire circulatory system.
Its prevalence is of approximately 3-6 cases per 1000 full-term newborn , not counting children who are born with small defects of the septum, which self-stop within the first years of life.
Among congenital malformations, VSD is the second most prevalent among children older than 3 years.
Causes and Risk Factors Typically, the defect of the interventricular septum in the fetus develops in the early stages of pregnancy, from about the 3rd to the 10th week of the .The main reason for this is the combination of external and internal negative factors, including:
genetic predisposition; viral infections transferred during the period of gestation( rubella, measles, influenza); alcohol abuse and smoking; administration of antibiotics that have a teratogenic effect( psychotropic drugs, antibiotics, etc.); exposure to toxins, heavy metals and radiation; strong stress. Classification of The defect of the interventricular septum in newborns and older children can be diagnosed as an independent problem( isolated vice), and as an integral part of other cardiovascular diseases, for example, Cantrella pentada( click here to read about it).
The size of the defect is estimated from the of its value with respect to the diameter of the aortic aperture :
defect up to 1 cm is classified as minor( Tolochinov-Roger disease); large defects are considered to be from 1 cm or those that are larger than half the aortic aperture in size.
Finally, the for the localization of the in the septum of the VSD is divided into three types:
Muscular defect of the interventricular septum in the newborn. The hole is located in the muscular part, away from the conduction system of the heart and valves, and with small dimensions can be closed independently. Diaphragm .The defect is localized in the upper segment of the septum below the aortic valve. Usually it has a small diameter and is self-sufficient as the child grows. Screwdriver .It is considered to be the most complicated type of blemish, since the hole in this case is on the border of the outflowing vessels of the left and right ventricles, and spontaneously closes very rarely. Danger and Complications With a small opening size and a normal child's condition, the VSD does not pose a particular danger to the health of the child, and requires only regular monitoring by a specialist.
Large defects - quite another matter. They are the cause of heart failure , which can develop immediately after the baby's birth.
Such children are susceptible to colds with a tendency to pneumonia, may lag behind in development, have difficulty with sucking reflexes, suffer from shortness of breath even after a little physical exertion. Over time, difficulties with breathing arise in a state of rest, because of which the work of the lungs, liver and other organs is disrupted.
In addition, VSD can cause the following serious complications:
Eisenmenger syndrome as a consequence of pulmonary hypertension; formation of acute heart failure; endocarditis, or infectious inflammation of the intracardiac membrane; strokes and thrombus formation; disruption of the valve device, which leads to the formation of valvular heart disease. Symptoms of Large defects of the interventricular septum appear already in the first days of life of , and are characterized by the following symptoms:
blueing of the skin( predominantly limbs and face), intensifying during crying; disorders of appetite and feeding problems; slowed development rate, impaired weight gain and growth; persistent drowsiness and fatigue; edema, localized in the limb and abdomen; heart rhythm disturbances and shortness of breath. Small defects often do not have pronounced manifestations and are determined by listening to ( severe systolic noise is heard in the patient's chest) or other studies. In some cases, children have a so-called heart hump, that is, a bulging chest in the heart.
If the disease has not been diagnosed in infancy, with the development of heart failure in a child in 3-4 years, there are complaints of on strong palpitations and chest pains, a tendency to nasal bleeding and loss of consciousness develops.
Patients often suffer from stagnant phenomena in the lungs, dyspnea and cough, and become very tired even after a small physical exertion.
When referring to a doctor VSD, like any other heart disease( even if it is compensated and does not cause inconvenience to the patient) necessarily requires constant monitoring of the cardiologist, since the situation at any time may worsen.
In order not to miss the alarming symptoms and the time when the situation can be corrected with the least loss, the parents of the very are important to observe the behavior of the child from the very first days of .
If he is too much and sleeps for a long time, often fusses for no reason and bad gaining weight, this is a serious reason for consulting with pediatrician and pediatric cardiologist .
Diagnostics of The main methods of diagnosing VSD are:
Electrocardiogram .The study determines the degree of overload of the ventricles, as well as the presence and severity of pulmonary hypertension. In addition, in older patients, signs of arrhythmia and impaired conduction of the heart can be determined. Phonocardiography of .With the help of FCG, high-frequency systolic noise can be fixed in the 3rd to 4th intercostal space to the left of the sternum. Echocardiography .Echocardiography allows to reveal an opening in an interventricular septum or to suspect its presence, proceeding from disturbances of a circulation in vessels. Ultrasound examination of .Ultrasound evaluates the work of the myocardium, its structure, condition and patency, as well as two very important indicators - the pressure in the pulmonary artery and the amount of blood discharge. Radiography .On the x-ray of chest organs, one can see an increase in pulmonary pattern and pulsation of the roots of the lungs, a significant increase in the size of the heart. Probing of the right cavities of the heart .The study makes it possible to identify increased pressure in the pulmonary artery and ventricle, as well as increased venous blood oxygenation. Pulse Oximetry .The method determines the degree of oxygen saturation of the blood - low indices are a sign of serious problems with the cardiovascular system. Cardiac catheterization .With her help, the doctor evaluates the state of the heart structures and determines the pressure in his cells. Differential diagnosis is performed with a defect of the aorto-pulmonary septum, stenosis of the pulmonary artery and aorta, mitral valve insufficiency, thromboembolism and other vices and diseases of the cardiovascular system.
Treatment of Small defects of the septum, which do not produce pronounced symptoms, usually do not require any special treatment, since is self-tightened to 1-4 years of life or later .
raises the question of surgical intervention of .
When preparing for surgery, conservative treatment is used to help regulate the heart rate, normalize blood pressure and maintain myocardial function.
Surgical correction of VSD can be of palliative or radical : palliative surgery is performed in infants with severe hypotrophy and multiple complications in preparation for radical intervention. In this case, the doctor creates an artificial stenosis of the pulmonary artery, which greatly facilitates the patient's condition.
The radical operations that are used to treat VSD include:
suturing pathogenic holes with U-shaped sutures; plastic defects with patches made of synthetic or biological tissue, performed under the supervision of ultrasound; open-heart surgeries are effective for combined defects( eg, tetralogy of Fallot) or large holes that can not be closed with a single patch. The best results are given by surgery performed at the age of 2-2.5 years, when patients usually have the first signs of heart failure.
This video tells about one of the most effective operations against VSD:
Forecasts and prophylaxis of
Small defects of interventricular septum( 1-2 mm) usually have a favorable prognosis of - children with such a disease do not suffer from unpleasant symptoms and do not lag behind in developmentfrom their peers. With more significant defects accompanied by heart failure, the prognosis deteriorates significantly, because without proper treatment they can lead to serious complications and even death.
in the conduct of a healthy lifestyle, timely visits to women's counseling, the abandonment of bad habits and self-medication .
Despite serious complications and not always favorable predictions, the diagnosis of an "interventricular septal defect" can not be considered a sentence for a small patient. Modern methods of treatment and the achievement of cardiac surgery can significantly improve the quality of life of the child and extend it as much as possible.
