IT IS CERTAINLY NOT EASY FOR THE PARENTS WHEN, AFTER THE PEDIATRIC EXAMINATION, THE DOCTOR ANNOUNCES THAT THE CHILD HAS A HEART MURRUM. Especially, there is great surprise and fear, if until then the child did not have any signs/simotome/, that something is happening in his heart.
WE ARE TALKING ABOUT TWO TYPES OF HEART MUMBLES:
1. HARMLESS OR PHYSIOLOGICAL i
2. ORGANIC OR PATHOLOGICAL FORESTS
Innocent murmurs are relatively common in children. According to various statistics, more than 50%, even up to 80% of cases occur in various stages of children’s growth. They are not the result of heart disease. These are noises of a physiological nature, and they are often heard due to increased or accelerated blood flow through the heart. This is, for example, occurs when the child is anemic or excited about the examination. The heart rate is also faster than in adults. For example.
at the age of up to 3 months in the awake state, the pulse can be measured up to 205/min, and in sleep up to 140/min, maximum, and this is not a pathology. From 3 months to 2 years. 190 at rest and 160/min in sleep, from 2 years to 10 years at rest 140/min, and in sleep 90/min, while over 10 years we tolerate about 100/min in the awake state, and 90/min in sleep. We, cardiologists, who deal with the ECHOCARDIOGRAPHY method, find structures, the so-called aberrant chords, which often vibrate with that accelerated, physiological flow, which often creates noise. Of course, location is also important here.
The characteristic of these noises is that they are soft in sonority, of a musical character, that they spread, and the findings of the ECG, echocardiography, X-ray of the heart and MRI of the heart are normal.
Organic heart murmurs can be the result of congenital heart defects, for example ventricular and/or atrial defects, open channel between large blood vessels, narrowing of blood vessels. All these changes can be maintained, so unfortunately, sometimes we diagnose several flaws in the heart.
Changes can also be of an acquired character as a result of attacks of viral or bacterial origin. These are inflammatory changes in the heart muscle/ myocarditis/, heart tissue/ pericarditis/ or heart valves/ endocarditis/. Here, we most often diagnose changes on the ECG, X-ray, echocardiography and magnetic resonance imaging/MR/. Children very often they also have clinical signs of the disease, which can be seen after a detailed history and how they are observed.
NOISES ON THE HEART are graded according to the LEVIN SCALE to the sixth degree. Up to the third degree, they have characteristics similar to physiological murmurs and are difficult to distinguish from them. THAT’S WHY EXAMINATION BY A CHILD’S CARDIOLOGIST IS NECESSARY.
A CHILD’S HEART IS IN THE EVOLUTION OF GROWTH AND DEVELOPMENT. There are some changes/often genetic/, which come to the fore with growth and development.
Forests need to be MONITORED in the growth and development of the child. Experts believe that a child with physiological hearing loss should come for a check-up at least once a year. The growth and development of the heart is monitored, but also any external factors/ viruses or bacteria/ that are not recognized.
Organic forests require control at least twice a year, and sometimes more often. After the diagnosis is made, a decision is made on the necessary correction of the congenital heart defect with interventional methods/stents, balloons or discs/, and in the case of complex defects, surgically. Children continue to be monitored after these procedures in the postoperative period, as well as in adulthood. I MUST STATE THAT SOMEONE WHO SUFFERED FROM A CONGENITAL HEART DEFECT
IT MUST BE ACCOUNTED THAT HE STILL HAS A GREATER CHANCE TO GET SOME FORM OF ACQUIRED DISEASE LIKE CORONARY INSUFFICIENCY IN OLDER AGE, AS ONE OF THE MOST COMMON DISEASES TODAY. AS THE OLD LATINS WOULD SAY – IT IS THE LOCUS MINORIS OF RESISTANCE/ A SENSITIVE PLACE IN THE ORGANISM/ AND THEREFORE BE CAREFUL.
The cardiologist also assesses the child’s physical activity. In physiological forest, all physical activities are allowed, in contrast to organic forest, where greater physical efforts are usually prohibited.
Also, in the case of congenital heart defects, antibiotic prevention of bacterial endocarditis is suggested in the case of bloody interventions/a procedure or dental treatment/.