Heart defects usually refer to abnormalities in the formation of the valves. The latter are responsible for properly directing blood flow in the heart.
Table of contents:
When there are abnormalities in the structure of the valves, there is a loading (greater than normal) of certain heart cavities, followed by hypertrophy and dilatation.
Division of heart defects
Heart defects can be differentiated into: congenital and acquired (also called valvular). The latter occur in humans much more frequently than the former. Acquired defe cts mostly affect the bicuspid valve (also known as the mitral valve). This separates the left atrium from the left ventricle. These defects can arise as a result of untreated or unrecognised rheumatic disease. The clinical division of heart defects is based on the distinction between defects with cyanosis (cyanotic defects) - especially congenital defects - and those without cyanosis (non cyanotic defects).
Congenital malformations
Congenitalheart defects affect approximately 1 per cent of all live births in the world's population. These defects mainly consist of anomalies in the anatomy of the heart created before birth. They are the result of abnormal embryonic development, which in turn arises as a result of complex genetic and environmental factors.
Types of congenital heart defects:
- atrial septal defect,
- ventricular septal defect,
- persistent Botall's ductus arteriosus (this ductus is essential in the child's fetal life, as the lungs are not yet developed; it is the vessel leading from the branch of the pulmonary trunk to the aorta; under normal conditions, the ductus is unobstructed in the fetus, but closes after birth),
- congenital stenosis of the aortic outlet.
Genetic diseases in the course of which congenital heart defects manifest themselves are:
- down syndrome,
- edwards syndrome,
- patau syndrome,
- turner syndrome,
- diGeorge syndrome.
ECG in the study of heart defects, photo: pantherstock
Diagnostic methods for the diagnosis of congenital heart defects: ECG, chest X-ray, echocardiography (so-called ECHO of the heart), cardiac catheterisation and angiography, magnetic resonance imaging, computed tomography, spiral tomography, isotope studies, flow assessment at the level of the heart, vessels and lungs, and assessment of myocardial function.
Extremely valuable during diagnosis is the medical history taken in advance with the patient and/or his/her family. This history usually includes questions about parental (especially maternal) illnesses, medications used during pregnancy (especially lithium salts, valproic acid, ACE inhibitors), drugs taken during pregnancy (especially ecstasy) and viral infections experienced during pregnancy. Cardiac malformations that are mild or undetected in childhood may become clinically manifest in early adulthood, when the cardiovascular system is already formed. At that time, anatomically defective valves may already be thickening and calcifying.
The basic clinical signs of a congenital heart defect include a grey shadow around the mouth, fatigue on feeding and mucosal cyanosis (so-called central cyanosis). Some congenital heart defects can pass spontaneously with age. This is most often the case with ventricular septal defect - during healing, the muscular tissue of the ventricles fuses together and eventually, closes - this is known as muscular VSD closure.
Treatment of congenital heart defects can be pharmacological and/or surgical. Among the medications used in the described conditions, diuretics (so-called diuretics) should be mentioned first and foremost: spironolactone, furosemide. Cardiac surgery for congenital heart defects involves anatomical correction of the heart at 2-4 months of age. It is important to remember a very important thing concerning the infant. If he/she is lethargic, coughing and, after X-ray examination of the baby, a bacterial infection is suspected, before the doctor prescribes an antibiotic, rule out a congenital heart defect beforehand through additional appropriate diagnostic tests.
Acquired defects
Acquired heart defects refer to anomalies in the structure of the valves. Thus, a distinction is made between defects:
- bicuspid (mitral) valve
- valve regurgitation,
- valve flap prolapse, tricuspid valve
- valve regurgitation
- valve stenosis.
Treatment of heart defects, photo: pantherstock
The most common symptoms of acquired heart defects of both valves include:
- exertional dyspnoea,
- cough,
- fatigue,
- palpitations,
- arrhythmia,
- haemoptysis,
- dizziness,
- fainting,
- risk of congestion,
- dilatation of the jugular veins,
- oedema.
Therapy of the heart defects described above consists of symptomatic pharmacological treatment of the most life-threatening symptoms - cardiac arrhythmias (e.g. beta-blockers), haemoptysis (e.g. diuretics), embolic incidents (anticoagulants).
