Congenital heart defects (heart defects) – an abnormal structure of the chambers of the heart, large vessels or valves (often a combination) due to genetic predisposition, intrauterine growth disorders, infectious, autoimmune, metabolic and other diseases, injuries sustained by the mother during pregnancy.
Valve lesions can be congenital (due to intrauterine growth disorders) and acquired, that is, arising during life under the influence of diseases, infections or injuries. In most cases, complex birth defects require surgical correction in both children and adults.
What are the congenital heart defects?
pulmonary valve stenosis
stenosis of the aortic valve, orifice of the aorta, subvalvular stenosis;
mitral stenosis – narrowing of the bicuspid atrioventricular valve;
mitral valve insufficiency – incomplete closure of the bicuspid atrioventricular valve;
mitral valve prolapse – excess length of one or two valve leaflets;
insufficiency of the aortic valve;
atrial and ventricular septal defects;
anomalies in the development of cardiac cavities: Ebstein’s anomaly, a single atrium, a single ventricle;
transposition of large vessels – the aorta and pulmonary artery;
open arterial (Botallov) duct;
coarctation of the aorta;
The most common congenital heart disease is abnormal communication between the atria – an atrial septal defect.
Cause of heart disease
Usually, this message, which plays an important role in intrauterine development, is closed at the birth of the child. However, in some cases, this closure does not occur, and in the child, part of the blood from the left atrium enters the right, causing an overload of the volumes of the right ventricle.
What are the consequences
If the defect is large, then heart failure occurs over time .
Diagnosis and treatment of heart disease
Cardiac surgeons can timely recognize and eliminate the defect. In most cases, the defect is closed by X-ray surgeons using a catheter technique, without resorting to an incision.
A defect can appear between the ventricles of the heart – a defect of the interventricular septum.
Often, defects are combined with anomalies of the valvular apparatus of the heart or large vessels.
The valve apparatus of the heart consists of four valves: mitral (bicuspid), tricuspid (tricuspid), aortic and pulmonary valve. The work of the heart depends on the well-coordinated and correct work of these structures.
There are two main types of valve damage: insufficiency and stenosis .
In case of insufficiency, the valve flaps do not close completely, leaving a gap through which blood is thrown in the opposite normal direction. And with stenosis, the valves do not open completely, interfering with the normal blood flow. Isolated lesions of the heart valves are relatively rare, very often they are observed with other congenital heart defects. For example, a bicuspid aortic valve is often found in people with patent ductus arteriosus. With this defect, part of the blood (rich in oxygen) through the duct from the aorta that is not closed after the birth of the child enters the pulmonary artery, causing an overload of the right heart. In children and adolescents, this abnormal message is most often eliminated also without surgical intervention, by installing a “plug” through the catheter.
Another congenital malformation is stenosis of the descending aorta.
In the thoracic segment, the aorta attaches to the posterior wall, closer to the spine. In this place, the aorta is sometimes significantly narrowed, the internal organs do not receive a sufficient amount of arterial blood. Previously, this condition, called coarctation of the aorta, was only treated with surgery. But today, in most cases, the narrowing of the aorta is corrected by balloon dilatation and the installation of a stent frame. It should be emphasized that if the stenosis of the valve is an isolated lesion, then this is often eliminated by balloon expansion, in a minimally traumatic way.
How Valvular Heart Disease Manifests
Most often, patients’ complaints are nonspecific: shortness of breath, rapid pulse, arrhythmia, fatigue, cyanosis, dizziness.
The severity and nature of the symptoms depend on the location of the affected valve. With valvular defects of the left half of the heart (mitral and aortic), the lungs are the first to suffer, because blood stagnates in their vessels, which is manifested by shortness of breath. There are also signs of insufficient blood supply to all organs and systems, primarily the brain and the heart itself. Dizziness, fainting, angina pectoris occurs. If the valves of the right half of the heart (tricuspid and pulmonary valve) are malfunctioning, blood stagnation occurs in the vessels of the systemic circulation, i.e. all organs are affected except the lungs. Edema of the legs and feet, ascites (fluid in the abdominal cavity), enlargement of the liver, etc. develop (LIVER INCREASES, etc.).
Valvular defects of the heart are dangerous for their complications and effect on the body, therefore, the main prevention of pathological conditions is regular examinations and treatment of diseases leading to the formation of valvular defects.
The scope of the examination is determined by the doctor. The list of possible diagnostic procedures includes:
Holter ECG monitoring
3D Doppler color image