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Congenital heart defects. Heart disease - what it is, types, causes, signs, symptoms, treatment and prognosis The most common heart defects

Heart defects are a group of diseases characterized by a violation of the anatomical structure of the heart valves or septa. They usually manifest as hemodynamic disturbances.

These diseases occur in both adults and children and can be associated with a number of factors. To understand what a defect is, you need to know not only the causes of this disease, but also how it affects general functioning body.

Classification

Structure of the heart

To understand what types of heart defects there are, you need to know their classification. To begin with, it should be said that there are congenital and acquired defects.

Depending on the location of the lesion, there are the following types of defects:

Valve pathologies.
Pathologies of septums.

According to the number of affected structures, the following types of heart defects are distinguished:

Simple. Damage to one valve.
Complex. Damage to several valves.
Combined. A combination of insufficiency and stenosis in one valve.

The classification of heart defects also takes into account the level of general hypoxia of the body. Depending on this factor, the following types are distinguished:

White. Sufficient supply of tissues and organs with oxygen. Cyanosis does not form.
Blue. Early manifestation hypoxia, formation of central cyanosis.

Also, for the correct classification of congenital forms, the Marder table is used:


CHANGES IN HEMODYNAMICS	WHITE	BLUE
Not broken	Right-sided heart, malpositioned aorta, minor ventricular septal defect (VSD)	-
Overfilling the small circle	VSD, open ductus arteriosus, abnormal drainage of pulmonary veins	Transposition of the main vessels, ventricular underdevelopment, common truncus arteriosus
Impoverishment of the small circle	Pulmonary stenosis	Tetralogy of Fallot, false common truncus arteriosus, Ebstein's disease
Impaired blood flow in big circle	Aortic stenosis and coarctation	-

Causes

The etiology of congenital forms is represented by various chromosomal abnormalities. Also play a role environmental factors. If the mother had rubella during pregnancy, the child will have the following three syndromes:

Cataract.
Deafness.
Congenital heart abnormalities. Most often, this may be tetralogy of Fallot (a combined congenital defect that includes stenosis of the outflow tract of the right ventricle, displacement of the aorta, and right ventricular hypertrophy).
In addition to rubella, the impact on embryonic development of cardio-vascular system are caused by the following infectious agents:

Herpes simplex virus.
Adenovirus.
Cytomegalovirus.
Mycoplasma.
Toxoplasma.
Treponema pallidum.
Listeria.

The etiology of congenital defects is quite wide. This includes the consumption of alcohol by a pregnant woman and narcotic drugs. The teratogenic effect of amphetamines on the fetus has been proven.

Despite the fact that defects are not inherited, a family history of cardiovascular pathologies increases the risk of valvular heart defects in children. Also, some experts talk about possible development congenital defect in subsequent generations due to consanguineous marriage.

The most common cause is acute rheumatic fever. In addition, the etiology includes the following diseases:

Atherosclerosis.
Syphilis.
Autoimmune diseases.
Heart injuries.

Main manifestations

The pathophysiology of congenital heart defects lies largely in the disruption of normal blood circulation. Most often this contributes to:

Increased resistance to blood flow, leading to hypertrophy of the corresponding cardiac section.
Creation of a vicious message between both circles of blood circulation.

Very often, both of these pathogenetic mechanisms can be combined. In this regard, it is possible to highlight following signs heart defects:

Dyspnea.
Pathological noises.
Fainting conditions.
Cyanosis.
Heartbeat.
Rhythm disturbance.
Peripheral edema in the legs.
Ascites (accumulation of fluid in abdominal cavity).
Hydrothorax (fluid accumulation in the pleural cavity).

It is worth noting that compensated defects are most often asymptomatic and are detected during preventive examination. The main symptoms of heart defects appear when the body can no longer cope with hemodynamic disturbances on its own.

Diagnostics

Based on the symptoms identified during the examination alone, a diagnosis of heart disease is impossible. To do this, the doctor needs to carry out a number of physical and instrumental methods. Directly at the first visit to a specialist, propaedeutics of internal diseases plays an important role, in particular, auscultation and palpation examination.

To understand how to identify a heart defect, it is important to know the basic instrumental methods, used in the diagnosis of such diseases. The following studies are used:

Electrocardiography. An electrocardiogram will help identify changes in the functioning of the heart. ECG does not work for heart defects big role and most often helps to identify the consequences of the disease.
Echocardiography. This ultrasound diagnostics, designed for a thorough study of functional and morphological features hearts.
Phonocardiography is a technique that allows you to display heart sounds in graphical form.
X-ray. Allows you to identify the configuration of the heart, as well as detect transposition of blood vessels.

Modern pediatrics has a special place in the definition congenital anomalies allocates to prenatal detection. This diagnosis of heart defects is carried out in several stages. The initial stage lies with a regular gynecologist, and after suspicion of changes, the pregnant woman is referred to a specialist in fetal echocardiography.

Therapeutic measures

The main method of treatment for most heart defects is surgical. However, in order to reduce the intensity of disease progression, as well as normalize blood circulation, the following groups of drugs are used:

Anticoagulants. Their use is explained by the need to reduce the risk of blood clots.
Diuretics. Diuretics are needed to relieve edema syndrome, as well as compensate for heart failure.
β-blockers. Necessary to reduce the load on the heart and normalize blood pressure.
ACE inhibitors. Like previous drugs, they are needed to combat arterial hypertension.
Antiarrhythmic drugs. They are used for defects during which there is a disturbance in heart rhythm.
Vasodilators. Reduces the load on the heart.

Only a doctor can answer how to treat heart defects in each specific case, after first conducting a diagnosis. It is extremely important to follow all medical recommendations and use medications strictly in the indicated dosage.

Methods surgical treatment Heart defects in adults and children are quite diverse. Treatment is used for both acquired and congenital defects. Indications for surgical intervention directly depend on the degree of hemodynamic impairment. In congenital forms and in the presence of an obstruction to blood flow, the following interventions are performed to eliminate it:

Dissection of the valvular narrowing in the pulmonary trunk.
Excision of narrowed areas in the aorta.

In the event that the defect is accompanied by overflow of the small circle, it is necessary to eliminate the pathological discharge of blood. This is achieved through the following activities:

Ligation of the open aortic duct.
Suturing an existing atrial or ventricular septal defect.

In addition to the above, for congenital forms, the following operations of heart defects are used:

Valve plastic surgery.
Prosthetics.
Reconstruction.

Reconstruction is used for complex pathologies that are accompanied not only by disruption of the valve apparatus, but also by incorrect location of large vessels.

For a long time it was believed that surgical treatment for congenital heart defects should be performed at age five or even later. However, the level of medicine currently allows us to produce surgical correction in the first years of life.

In case of acquired pathologies of the valve apparatus, the main surgical intervention is prosthetics. The patient has an artificial valve installed in place of the damaged valve.

In case of acquired stenosis, valve plasty is performed to eliminate the existing obstruction.

Complications

To understand why heart disease is dangerous, you need to know what consequences can occur. The main complications are associated with the formation of circulatory failure. The following types are distinguished:

Left ventricular failure.
Right ventricular failure.

One of the main signs of severe left ventricular failure is shortness of breath, accompanied by the release of foamy, bloody sputum. Its color is due to the presence of special cells. Cells of cardiac defects are represented by alveolar macrophages containing hemosiderin. The presence of these cells is observed during pulmonary infarction or stagnation in the pulmonary circulation. And it is because of them that sputum in these pathologies has a “rusty” color.

Nursing process

Nursing process for heart defects plays a big role in improving the patient’s quality of life. This process has the following goals:

Improving the patient’s quality of life to an acceptable level.
Minimizing emerging problems.
Helping the patient and his family adapt to the disease.
Supporting the patient's basic needs or full recovery.

For heart defects, this process is carried out in several stages. In the first step, the nurse must determine the basic needs of the patient. The second stage is to set nursing diagnosis and identifying the patient’s main problems, among which the following should be highlighted:

Physiological. This group includes all complications of the main diagnosis.
Psychological. Anxiety regarding changes in quality of life, as well as fear of worsening the prognosis of the disease. This also includes a lack of knowledge and skills in general care for health.
Security issues. Attention should be paid increased risk infections, misuse appointed medicines, as well as the risk of falls if fainting occurs.

The third stage is to determine the goals that the nurse should set for herself in order to facilitate general state sick. The fourth stage includes the implementation of all nursing interventions, which must be carried out according to the protocol for the treatment and diagnosis of the defect. The last stage is an assessment of how effectively the nursing care, is carried out not only nurse, but also by her immediate superiors, as well as by the patient himself.

Preventive actions

Prevention of heart defects is an extremely important set of measures to reduce the risk of disturbances in the functioning of the heart valve apparatus. It is worth noting that in order to prevent birth defects to the expectant mother The following recommendations must be followed:

Timely registration.
Regular visits to the gynecologist at scheduled times for preventive examination.
Proper nutrition.
Elimination of bad habits.
Correction of concomitant diseases.
In the absence of vaccination against the rubella virus, vaccinate approximately 6 months before the planned conception.
Prophylactic intake of folic acid.

The main cause of acquired heart defects is rheumatism. That is why one of the main preventive measures is to prevent the development of acute rheumatic fever.

Maintaining healthy image life.
Proper nutrition.
Timely treatment of exacerbations of chronic pathologies.
Sanitation of infectious foci.

After treating adults and adolescents for rheumatism, bicillin prophylaxis is recommended.

Also in order to reduce the manifestations of the rheumatic process, as well as prevent possible consequences It is recommended to perform massage for heart defects. The following indications for massage are distinguished:

Inactive stage of the disease.
The period of reduction of the main manifestations.
Formed circulatory failure.

During the period of active inflammatory changes in the cardiac membranes, the use of massage is not allowed.

The unknown is always, at a minimum, alarming or people begin to fear it, and fear paralyzes a person. On a negative wave, wrong and hasty decisions are made, their consequences worsen the situation. Then again fear and again wrong decisions. In medicine, this “loop” situation is called circulus mortum, a vicious circle. How to get out of it? Let shallow but correct knowledge of the basics of the problem help solve it adequately and on time.

What is a heart defect?

Each organ of our body is designed to function rationally in the system for which it is designed. The heart belongs to circulatory system, helps the blood move and saturate it with oxygen (O2) and carbon dioxide (CO2). As it fills and contracts, 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 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 changes its filling with oxygen and carbon dioxide. Of course, as a result, problems arise for the whole organism, more or less pronounced and varying degrees danger.

A little about the physiology of blood circulation

The human heart, like that of all mammals, is divided into two parts by a dense septum. 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. Normally, the septum (called interventricular) has no holes, and the blood is 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, passes through the left atrium and ventricle, reaches the organs through the vascular system, gives them oxygen and takes in carbon dioxide, turning into a venous system. Further - again in right side hearts and so on.

The circulatory system is closed, which is why it is called “ circulation" There are two such circles, both 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 big, passing along its route, the blood from arterial again turns into venous.

Functionally left atrium And ventricle experience a high load, 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. The large vessels entering the heart are called veins. Outgoing – arteries. Normally, they do not communicate with each other at all, isolating the flow of venous and arterial blood.

Valves hearts are located between atria And ventricles, and at the border of the entrance and exit of large vessels. The most common problems are with mitral valve (bicuspid, between the left atrium and the ventricle), in second place - aortic(at the point where the aorta exits the left ventricle), then tricuspid(tricuspid, between the right atrium and ventricle), and in the “outsiders” - valve pulmonary artery , 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 with defects)

What are heart defects?

Let's consider the classification, adapted for patients.

Congenital and acquired - changes in normal structure And position hearts 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 anatomical structure the hearts of a child are still being formed in utero(during pregnancy), but appear only after birth. To get a more complete picture of the problem, see pictures of heart defects.

For convenience, they were classified based on 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 cyanosis and without it.

Ventricular septal defect (VSD)

Depending on the degree of defect and disruption of blood flow, the concepts were introduced compensated(due to thickening of the walls of the heart and increased contractions, blood flows in normal volumes) and decompensated(the heart enlarges too much, the muscle fibers do not receive the necessary nutrition, the strength of contractions decreases) acquired defects.

Mitral valve insufficiency

Function of healthy (top) and damaged (bottom) valves

Incomplete closure of the valves is the result of their inflammation and consequences in the form of sclerosis(replacing “working” elastic fabrics with rigid connective fibers). Blood during contraction left ventricle is thrown in the opposite direction, into left atrium. As a result, a greater force of contraction is needed to “return” the blood flow to the side aorta, And hypertrophies(thickens) all left side hearts. Gradually developing failure in a small circle, and then - a violation of the outflow venous blood from the systemic circulation, the so-called.

Signs: mitral flush(pinkish-blue color of lips and cheeks). Trembling chest, can be felt even by the hand - it is called cat purring, And acrocyanosis(bluish tint of hands and toes, nose, ears and lips). Such picturesque symptoms are possible only with decompensated vice, and with compensated they don't exist.

Treatment and prognosis: in advanced cases, for prevention , required . Patients live a long time, many do not even suspect the disease, if it is in compensation stages. It is important to treat all inflammatory diseases in a timely manner.

drawing: prosthetics mitral valve

Mitral stenosis (narrowing of the valve between the left atrium and ventricle)

Signs: if the vice decompensated, when measuring blood pressure bottom digit ( diastolic pressure) can drop to almost zero. Patients complain of dizziness if their body position changes quickly (lying down and standing up), and attacks of suffocation at night. The skin is pale, the pulsation of the arteries in the neck is visible ( carotid dance) and shaking the head. Pupils eyes and capillaries under the nails (visible when pressing on nail plate) also pulsate.

Treatment: preventive – for compensated defect, radical - artificial is sewn in 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 do not even suspect about the vice and live a full life.

The consequence of aortic disease is heart failure, stagnation of blood in the ventricle

Aortic stenosis, isolated defect

It is difficult for blood to escape from left ventricle V aorta: it requires more effort, and muscle walls hearts thicken. The less aortic orifice, the more pronounced hypertrophy left ventricle.

Signs: associated with a decrease in income arterial blood to the brain and other organs. Paleness, dizziness and fainting, heart hump(if the defect developed in childhood), attacks of pain in the heart ().

Treatment: we reduce physical activity, carry out restorative treatment - if there is no pronounced circulatory failure. In severe cases - only surgery, valve replacement or dissection of its valves ( commissurotomy).

Combined aortic disease

Two in one: failure valves+ narrowing aortic orifice. Such aortic disease heart is much more common than isolated. Signs are the same as for aortic stenosis, just less noticeable. In severe variants, stagnation begins in small circle, accompanied cardiac asthma And pulmonary edema.

Treatment: symptomatic and preventive - 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

Tricuspid (three leaflet) valve insufficiency

Due to loose closure valve,blood from right ventricle thrown back into right atrium. His ability compensate for the vice low, so it starts quickly venous blood stagnation V big circle.

Signs: cyanosis, veins necks are full and throbbing, arterial pressure slightly lowered. In severe cases - swelling and ascites(fluid accumulation in abdominal cavity). Treatment is conservative, mainly to eliminate venous stagnation. The prognosis depends on the severity of the condition.

Stenosis of the right atrioventricular (between the right atrium and ventricle) opening

Obstructed blood flow from right atrium V right ventricle. Venous stagnation quickly spreads to liver, it increases, then develops cardiac fibrosis liver– active tissue is replaced connecting(scar). Appears ascites, are common swelling.

Signs: pain and feeling of heaviness in hypochondrium on right, cyanosis with a yellow tint, always - pulsation neck veins Arterial pressure reduced; liver enlarged, pulsating.

Treatment: is aimed at reducing swelling, but it is better not to delay the operation.

Forecast: Normal well-being is possible with moderate physical activity. activity. If appeared and cyanosis- quickly see a heart surgeon.

Summary: purchased- mostly rheumatic heart defects. Their treatment is aimed both at the underlying disease and at reducing the consequences of the defect. In case of severe circulatory decompensation, only surgery is effective.

Important! Treatment for heart defects may have a better chance of success if people see their doctor on time. Moreover, malaise as a reason for going to the doctor is not at all necessary: you can simply ask for advice and, if necessary, undergo basic examinations. A smart doctor does not allow his patients to get sick. An important note: the age of the doctor does not really matter. What is really important is his professional level, ability to analyze and synthesize, and intuition.

Heart disease is an abnormality in the development or functioning of the heart muscle, blood vessels, valves or septa. Normal blood circulation is disrupted and heart failure develops.

Without timely treatment, such pathologies can lead to death. Therefore, it is important to notice the symptoms of heart disease early.

The signs of this pathology depend on the type of disease and its stage. There are congenital and acquired heart defects. Their symptoms are slightly different, although there are common signs.

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Clinical manifestations of congenital pathologies are less pronounced, and sometimes they are asymptomatic. Acquired heart disease has more specific symptoms.

Manifestation in children

This pathology occurs at the stage of intrauterine development due to improper formation of organs. Nowadays, more and more children are born with heart defects. In many cases, the pathology is diagnosed immediately after birth.

External signs of defects are heart murmurs, difficulty breathing and pale or bluish skin on the lips and limbs. This general symptoms, the rest clinical manifestations pathologies are associated with its location.

Common congenital heart defects include:

mitral stenosis or aortic valve;
pathology of the development of the interatrial or interventricular septum;
abnormalities in the development and functioning of heart vessels;
The most dangerous congenital defect is tetralogy of Fallot, which combines several serious pathologies.

All these developmental anomalies are dangerous to the life and health of the child, as they lead to circulatory problems. Heart failure and oxygen starvation develop.

Children with heart defects experience the following symptoms:

the heart rhythm is disturbed, the pulse in the hands is difficult to feel;
the chest may become deformed;
growth and development slows down;
the skin turns blue or pale;
severe shortness of breath and problems with breastfeeding appear.

Usually the defect is diagnosed in the first three years of a child’s life, and treatment is carried out on time. But the pathology has an impact on the patient’s entire future life.

The most common symptoms of heart disease in teenagers:

fatigue, lethargy and weakness;
frequent fainting;
the child’s skin is pale, the lips and limbs may turn blue;
blood pressure is unstable;
swelling often appears;
reduced immunity and frequent colds;
shortness of breath appears at the slightest physical exertion;
extremities are cold and often turn blue.

Most clinical manifestations are observed with combined heart disease.

In some cases, it can occur almost unnoticeably and be diagnosed only in adulthood

Symptoms of heart disease by type

Most often, such pathologies are formed due to abnormalities of the aorta or mitral valve, which connects the large vessels of the heart. Heart disease can develop due to hypertension and other diseases.

Depending on the location of the pathology and its characteristics, various clinical manifestations are possible:

	Most often it develops after rheumatoid endocarditis. The disease changes the shape of the valve and disrupts its normal functioning. Sometimes such an anomaly develops during intrauterine development. The valve becomes funnel-shaped and blood circulation is impaired. But when timely treatment the patient can lead a normal life. He is only concerned about the following symptoms: tachycardia or even interruptions in heart function; delayed pulse on the left hand compared to the right; chest pain; dry cough; labored breathing. In the first degree of valve damage, these symptoms are observed only during physical activity. In severe cases and improper treatment they are felt even at rest. Lung damage may also occur, which manifests itself as coughing, often with blood, swelling is possible.
	If the semilunar valves that close the aorta do not close tightly, aortic heart disease occurs. This anomaly is manifested by the fact that with each contraction of the heart, blood flows back into the left ventricle. As a result, less of it enters the body than needed. Therefore, a person feels symptoms of oxygen starvation: frequent headaches; weakness leading to loss of consciousness; may feel dizzy; there is noise in the ears; vision may deteriorate; blood pressure is often low; the skin turns pale. Due to improper functioning of the heart, a rapid pulse and shortness of breath are observed. There is a so-called Quincke's pulse at the base of the nail. But most characteristic feature aortic valve defect is the so-called Landolfi syndrome. It is characterized by the fact that the patient's pupils react to heartbeats. When blood is released, they narrow, and when the heart muscle relaxes, they expand. With this pathology, changes in the heart muscle quickly progress and develop.
	The most common abnormality of the functioning of the mitral valve. This defect can be congenital or acquired. This anomaly can be explained by pathology of the valve itself due to disturbances in intrauterine development or due to rheumatoid endocarditis. It happens that the hole that it covers turns out to be larger than the size of the valves. All this leads to blood flowing back into the left atrium. The main clinical manifestations of the pathology are similar to the symptoms of all cardiovascular diseases: heaviness and pain in the chest; shortness of breath and difficulty breathing; heart rhythm disturbance; weakness and fatigue. But there are also specific symptoms that are caused precisely by mitral valve insufficiency: blue lips and cheeks; swelling of the neck veins; a characteristic trembling sound when listening to the heartbeat - it is called “cat purring”; in some cases, due to circulatory problems, the liver becomes enlarged.
Aortic stenosis	Frequent congenital pathology is the fusion of the valves of the aortic mouth. This may also occur due to atherosclerosis or endocarditis. As a result, when the left ventricle contracts, blood cannot flow normally into the aorta. This leads to the following symptoms: the pulse weakens and becomes rare; is decreasing upper pressure, which results in a small difference between systolic and diastolic readings; the skin turns pale; dizziness and fainting appear; headaches often; When lying on the left side, shocks are felt in the heart. And, of course, as with all heart defects, the patient is bothered by pain in the chest. With stenosis of the aortic mouth they are paroxysmal, often very strong.
	This is a pathology of the development of the valve between the right atrium and the right ventricle. Most often it occurs together with other anomalies. This vice is expressed in venous stagnation blood, which causes the following symptoms: severe swelling; stagnation of fluid in the liver; a feeling of heaviness in the abdomen due to blood vessels in the abdominal cavity overflowing; increased heart rate and decreased blood pressure. Signs common to all heart defects include blue skin, shortness of breath and severe weakness.

How to determine the acquired form of pathology

After injuries, infectious and inflammatory diseases, rheumatoid endocarditis, as well as in severe cases of hypertension or coronary artery disease, heart disease often occurs in an adult. In this case, one or more valves may be affected, narrowing of the aorta and pathology of the intracardiac septa may develop.

At the slightest suspicion of a heart defect, you should visit a doctor. Since many symptoms of valve and vascular abnormalities are similar to angina, you need to undergo an examination.

The doctor orders an electrocardiogram, cardiac x-ray, MRI and echocardiogram. Blood tests are taken to determine blood sugar and cholesterol levels. The main sign of a defect during external examination will be heart murmurs.

In order to start treatment on time, you need to know the symptoms of acquired heart disease:

fatigue, fainting, headaches;
difficulty breathing, feeling of lack of air, cough, even pulmonary edema;
rapid heartbeat, disturbance of its rhythm and change in the location of pulsation;
pain in the heart area - sharp or pressing;
blue skin due to blood stagnation;
enlargement of the carotid and subclavian arteries, swelling of the veins in the neck;
development of hypertension;
swelling, enlarged liver and a feeling of heaviness in the abdomen.

It is very important to get checked regularly by your doctor, especially if you experience symptoms of heart failure.

Often the disease develops gradually, acquiring chronic form. With minor damage to one valve, the defect may for a long time don't show yourself in any way. In this case, the patient’s well-being constantly deteriorates, and heart failure develops, noticeable at first only during physical activity.

Of the acquired heart defects, aortic pathologies are the most common. This is due to poor lifestyle and nutrition. The aortic mouth is most often affected in older people, which results in progressive heart failure. The patient experiences paroxysmal pain in the heart, shortness of breath, and weakness.

Among young people, acquired heart disease such as mitral valve pathology is more common. In this case, symptoms such as shortness of breath and palpitations with any physical activity, pulmonary insufficiency, pale skin and blue lips.

It often happens that patients consult a doctor when the heart defect is already seriously manifesting itself. On initial stages Pathologists sometimes do not pay attention to clinical manifestations.

But for a positive treatment prognosis, the disease must be identified as early as possible.

Acquired heart defects

General information

Acquired heart defects– a group of diseases (stenosis, valve insufficiency, combined and concomitant defects) accompanied by disruption of the structure and functions of the valvular apparatus of the heart, and leading to changes in intracardiac circulation. Compensated heart defects can be secretive; decompensated ones are manifested by shortness of breath, palpitations, fatigue, pain in the heart, and a tendency to faint. If conservative treatment is ineffective, surgery is performed. They are dangerous for the development of heart failure, disability and death.

For heart defects morphological changes heart structures and blood vessels cause disturbances in cardiac function and hemodynamics. There are congenital and acquired heart defects.

In the stage of compensation with slight or moderate mitral valve insufficiency, patients do not complain and do not differ in appearance from healthy people; Blood pressure and pulse were not changed. Mitral heart disease can remain compensated for a long time, but when it weakens contractility in the myocardium of the left parts of the heart, stagnation increases, first in the pulmonary and then in the systemic circulation. In the decompensated stage, cyanosis, shortness of breath, palpitations appear, and later - swelling on the lower limbs, painful, enlarged liver, acrocyanosis, swollen neck veins.

Narrowing of the left atrioventricular orifice (mitral stenosis)

From laboratory research greatest diagnostic value for heart defects, rheumatoid tests, determination of sugar, cholesterol, general clinical blood and urine tests are carried out. Such diagnostics are carried out both during the initial examination of patients with suspected heart disease, and in dispensary groups of patients with an established diagnosis.

Treatment of acquired heart defects

Carried out for heart defects conservative treatment concerns the prevention of complications and relapses primary disease(rheumatism, infective endocarditis etc.), correction of rhythm disturbances and heart failure. All patients with identified heart defects require consultation with a cardiac surgeon to determine the timing of timely surgical treatment.

In case of mitral stenosis, a mitral commissurotomy is performed with the separation of the fused valve leaflets and the expansion of the atrioventricular orifice, as a result of which the stenosis is partially or completely eliminated and severe hemodynamic disorders are eliminated. In case of insufficiency, mitral valve replacement is performed.

At aortic stenosis An aortic commissurotomy operation is performed, and in case of insufficiency, aortic valve replacement is performed. In case of combined defects (stenosis of the orifice and valve insufficiency), the destroyed valve is usually replaced with an artificial one; sometimes prosthetics are combined with commissurotomy. In case of combined defects, operations are currently performed for their simultaneous prosthetics.

Forecast

Minor changes in the valvular apparatus of the heart, not accompanied by myocardial damage, can remain in the compensation phase for a long time and not interfere with the patient’s ability to work. Development of decompensation in heart defects and their further forecast determined by a number of factors: repeated rheumatic attacks, intoxication, infections, physical overload, nervous overstrain, in women - pregnancy and childbirth. Progressive damage to the valve apparatus and heart muscle leads to the development of heart failure, and acute decompensation leads to the death of the patient.

The prognosis for mitral stenosis is unfavorable, since the myocardium of the left atrium is unable to maintain the compensated stage for a long time. With mitral stenosis, early development is observed stagnation small circle and circulatory failure.

The prospects for working ability with heart defects are individual and determined by the amount of physical activity, the patient’s fitness and his condition. In the absence of signs of decompensation, work ability may not be impaired; if circulatory failure develops, light work or cessation of work is indicated. labor activity. For heart defects, moderate physical activity, quitting smoking and alcohol, and performing physical therapy are important. sanatorium treatment at cardiological resorts (Matsesta, Kislovodsk).

Prevention

Measures to prevent the development of acquired heart defects include the prevention of rheumatism, septic conditions, and syphilis. For this purpose, sanitation of infectious foci, hardening, and increasing the body's fitness are carried out.

In case of established heart disease, in order to prevent heart failure, patients are advised to follow a rational motor regimen ( hiking, physiotherapy), full-fledged protein nutrition, limiting the intake of table salt, avoiding sudden climate changes (especially high-altitude ones) and active sports training.

In order to monitor the activity of the rheumatic process and compensation of cardiac activity in case of heart defects, clinical observation by a cardiologist is necessary.

Heart disease is a disease of the heart valves in which the organ begins to malfunction. As a result of congenital or acquired changes in the structure of the valve apparatus, cardiac septa, walls, or large vessels extending from the heart, a disturbance in the blood flow of the heart occurs. Congenital heart defects are characterized by a variety of anomalies in the development of the heart and blood vessels and usually manifest themselves in childhood. Acquired defects develop into different age periods due to heart damage due to rheumatism and some other diseases.

What is the difference between a congenital heart defect and an acquired one?

Congenital defect hearts

Congenital heart disease is detected in approximately 1% of newborns. The cause of the disease is improper development of the organ inside the womb. Congenital heart disease affects the walls of the myocardium and large adjacent vessels. The disease may progress. If the operation is not performed, the child may develop changes in the structure of the heart, in some cases it is possible death. With timely surgical intervention, complete restoration of heart function is possible.

Prerequisites for the development of congenital heart disease:

developmental disorders of the fetus under the influence pathogenic factors in the first months of pregnancy (radiation, viral infections, vitamin deficiency, uncontrolled intake medicines, including some vitamins);
parental smoking;
alcohol consumption by parents.

Acquired heart defect

Acquired heart disease does not occur immediately after birth, but over time. It manifests itself in the form of malfunction of the heart valve apparatus (narrowing of the walls or insufficiency of the heart valves).

Surgical treatment consists of replacing the heart valve with a prosthesis.

If damage to two or more orifices of the heart or valves is detected simultaneously, they speak of a combined acquired defect. To prescribe surgery for an acquired defect, it is classified according to the degree of anatomical changes and disorders.

Causes of acquired heart disease:

Treatment of heart defects

People with heart defects require comprehensive treatment:

regime organization physical activity;
drug therapy heart failure and other complications;
diet;
physiotherapy.

Surgical treatment is the most effective. Surgical correction is applied to both acquired and congenital defects, and operations are increasingly being performed on newborns and children from the first year of life.

An acquired defect requires surgical treatment in cases where therapeutic treatment is ineffective and conventional exercise stress causes fatigue, shortness of breath, palpitations, and angina pectoris in patients. Surgeries for acquired defects are performed with the aim of preserving the patient’s own heart valves and restoring their function, including through valvuloplasty (suturing the valves, using animal heart valves, etc.). If valve-sparing surgery is not possible, valves are replaced with mechanical or biological prostheses.

How is heart surgery performed?

Most heart surgeries are performed under artificial circulation. After operations, patients need long-term rehabilitation with a gradual restoration of their physical activity. The deterioration of the operated patient’s condition may be associated with the development of complications caused by surgical intervention Therefore, patients should undergo periodic examinations in cardiac centers. With an uncomplicated course postoperative period many patients can return to work 6-12 months after surgery.

* Heart valve - a part of the heart formed by the folds of its inner membrane, ensures unidirectional blood flow.

** Myocardium - average muscle layer heart, making up the bulk of its mass.

*** Heart valve insufficiency is a type of heart defect in which, due to incomplete closure of the valve, due to its damage, part of the blood flows back to the parts of the heart from which it came.

**** Myocardial infarction — acute form coronary disease hearts.