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Heart disease in newborns

Heart disease in newborns, or congenital heart disease, are various anatomical abnormalities that occur in the structures of the heart and large vessels during fetal development. Heart defects in newborns are difficult, and circulatory failure often joins them.

Doctors distinguish “blue” and “white” heart diseases, depending on whether the disease is accompanied by cyanosis – bluish skin and mucous membranes, which in turn is determined by the low oxygen content in the blood and high – carbon dioxide.

In the “blue” defects, that is, flowing with cyanosis, are those in which venous blood enters the arterial bed in large quantities. It:

tetralogy of Fallot, which includes four anomalies – stenosis of the pulmonary artery, a defect in the interventricular septum, a shift to the right of the aorta and an increase in the right ventricle;
atresia of the pulmonary artery – overgrowth of its lumen;
vessel transposition – interchanging arteries and veins.
The group of “white” malformations includes defects of the septa between the atria and between the ventricles.

Heart disease in newborns can also be represented by defects (narrowing or insufficiency) of the valves – the aorta, mitral and tricuspid valves.
Why does heart disease occur in newborns
In the fetus, the heart forms from the 2nd to the 8th week of pregnancy. It is during this period that heart disease can develop. The reasons for it may be:

heredity;
chromosomal abnormalities;
gene mutations;
adverse environmental conditions;
infectious diseases of mother at the beginning of pregnancy;
drugs, alcohol, smoking pregnant;
taking certain medications (amphetamines, antibiotics, anticonvulsants);
radiation radiation, etc.
The risk group includes women older than 35 years, those who have had spontaneous miscarriages, giving birth to a dead child.

How does heart disease manifest in newborns
Manifestations of heart disease can be very different depending on its type and effect on the general condition of the baby.

A disease may not occur at all if the child’s body is able to fully develop. In other cases, the following symptoms are possible:

cyanosis is the blueness of the nasolabial triangle, legs, arms or the whole body. The baby may turn blue when feeding or crying. But it should be remembered that cyanosis occurs not only with heart disease, it is a symptom of disorders in the central nervous system, respiratory organs;
shortness of breath – it can occur when the baby is active, and even when he is calm. You can find out if the child’s breathing is quicker by counting the number of breaths during sleep. Norm – no more than 60 per minute;
heart palpitations, but with some heart defects, bradycardia develops (slow heartbeat).
A baby with a heart defect also has common symptoms, such as drowsiness, lethargy, the baby does not suckle well, spits up, and sleeps restlessly. With severe defects, the baby may suffocate, lose consciousness.

Heart disease can also be suspected during examination of a child by heart murmurs that occur on the 3-4th day, sometimes later.
How to detect heart disease in newborns
Heart disease can be detected before birth. On ultrasound during pregnancy, many changes are already noticeable from the 14th week. In such cases, childbirth is carried out in a special way and, if possible, immediately operate on the baby.

If a heart defect in an already born child is suspected, an ultrasound of the heart and ECG is performed, phonocardiography is used to detect heart murmurs. To clarify the nature of the defect and develop an operation strategy, perform vascular catheterization and measure pressure in the cavities of the heart, take x-rays. If necessary, perform an MRI.

How is heart disease treated in newborns
With a mild degree of defect, the child is under the constant supervision of a cardiologist. In severe cases, an operation is performed, and the sooner this is done, the greater the chance of treatment success.

Operations are performed both on an open heart, using a cardiopulmonary bypass, and by the endoscopic method. Sometimes you have to operate in several stages: first, to alleviate the condition of the baby, and only then radically eliminate the defect. With a timely operation, the prognosis is favorable.

If time is lost, there may be a situation where it is no longer possible to help the child. Without surgery, in the first year of life, 70% of children die, 50% of them in the first month.

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