Causes of systolic heart murmur in a newborn. Heart murmurs in a newborn: causes and treatment

The heart contracts continuously and rhythmically, due to which, when listening to it with a stethoscope, a characteristic sound"knock Knock". In this case, the doctor will not hear anything between beats, when listening to the heart. But sometimes, as the heart pumps, an additional sound or sounds called a heart murmur occurs.

Where do such noises come from? Do they indicate health problems? It is important for parents to understand what a heart murmur is in infants, what causes it, and when they should be concerned about a heart murmur.

Table of contents:

Heart murmurs are abnormal sound phenomena that occur between the “knock” and “knock” sounds of the beating heart.

The heart has four chambers: the upper ones are two atria (left and right) and the lower ones are the ventricles (also left and right). Blood from the vessels enters the heart through the atria and is pumped out of the heart through the ventricles.

What do heart murmurs sound like?

As the atria pump blood through the valves into the ventricles, the first sound "knock" is produced, also called S1. As the heart drains blood from the ventricles (and ultimately from the heart itself), a second sound, "knock" or S2, is created. The pause between S1 and S2 (“knock”-“knock”) is called systole, and the pause between S2 and S1 is called diastole. Usually these pauses are completely silent, silent. But sometimes the doctor can hear noise ranging from weak, barely perceptible to rough and pronounced.

Heart murmur can be of three types:

• systolic heart murmur (occurs when the heart contracts)
• diastolic heart murmur (formed when the heart is at rest).
• Continuous (systole-diastolic) murmur. A specific murmur that occurs during both heartbeats.

According to their origin, heart murmurs are divided into:

• Organic caused by defects of the heart or its blood vessels, dangerous to health.
• Functional, caused by growth processes, characteristics of age or the structure of the heart, are not dangerous for children.

Heart murmurs are heard by the doctor's ear as whistling, blowing, or rough, grinding sounds between heartbeats. Unlike the normal sound of contractions (knock-knock), a heart murmur is significantly different: it usually has a higher or lower frequency.

Heart murmurs can also be pronounced enough to make even the normal sounds of chamber contraction (“knock”-“knock”) unidentifiable in their stream, making it difficult to determine when the first “knock” ended, when the second “knock” began, and what phase the anomalous noise itself belongs to.

Are heart murmurs unusual in infants?

note

According to the American Academy of Pediatrics, heart murmurs are quite common and generally not considered abnormal. This means that heart murmurs heard by doctors do not necessarily indicate health problems in children.

Infants and young children mostly have “innocent” or functional heart murmurs that are common throughout childhood. They are associated with structural and growth characteristics children's heart and vessels. These heart murmurs are not dangerous because they occur due to completely normal, regular contractions of the heart muscle, heart valves, or due to the active flow of blood inside the heart.

Heart murmurs in a child under one year old: what does it mean?

Newborns or toddlers with a functional heart murmur are considered healthy children and do not require medical attention.

About 85% of infants have a functional heart murmur, which resolves as children grow and their hearts and blood vessels develop into adult-like structures.

Other causes of functional murmurs include:

• Infectious diseases
• fever
• low red blood cell count ()
• activity suppression thyroid gland ().

Sometimes heart murmurs are not entirely harmless and may indicate developmental abnormalities or acquired heart problems. We will give the most common reasons organic heart murmur in newborns and children of the first three years of life:

• Stenosis : this is a narrowing blood vessel or a valve that interferes with the normal flow of blood in the heart. The type and name of stenosis that affects the child’s health and blood circulation depends on the location of its occurrence. For example, pulmonary stenosis occurs when a certain gap in the pulmonary artery narrows. Other types of stenosis are (vessel, blood bearer V big circle and nourishing the entire body of the child) and subaortic stenosis (narrowing in the area of ​​the aortic valve, before exiting into the aorta itself).
• : Experts say about 1 in 100 babies today are born with a structural heart defect or multiple structural abnormalities. A common heart defect in children is interventricular septum. This is an abnormal opening in the ventricular septum, which is a layer connective tissue, separating the right ventricle from the left. Another defect is the defect of the interatrial septum, which separates the two atria.
• Valve insufficiency : at similar condition The heart valves do not close and do not close together completely. This creates a hole between them and causes a small amount of blood to leak back, which can cause complications, including a heart murmur. Examples of valve insufficiency problems include damage to the tricuspid valve (a hole remains between the right atrium and the ventricle) and the mitral valve (a hole in the valve between the left atrium and the ventricle).

Heart is very complex organ, and several factors combined can lead to a heart murmur. Ultimately, the type of heart murmur will help your doctor determine the underlying problem. Although parents naturally cannot diagnose murmurs themselves, as doctors do, they can monitor the dynamics of the child’s heart murmur symptoms by asking the doctor questions about the changes he hears.

Symptoms of dangerous heart murmurs in babies

Symptoms of a dangerous heart murmur in infants include:

Symptoms of a heart murmur usually overlap with other conditions. For this reason, it is important to immediately consult a doctor for examination and clarification for an accurate diagnosis.

How are heart murmurs diagnosed in infants?

Used to make a diagnosis in children diagnostic methods and tools that help in identifying the underlying problem causing the heart murmur:

Treatment for abnormal heart murmurs depends on what causes them.

Treatment methods for heart murmurs

Treatment for a heart murmur may vary depending on the cause, severity of the condition, and the age of the child. Some conditions that cause a heart murmur may go away on their own as the child gets older. Other conditions may be chronic but do not pose a risk to the baby.

In any case, the doctor must monitor the dynamics of the heart murmur to ensure the safety of the child.

If cardiac murmur is the result of defects of the heart or its vessels, in addition to murmurs there are severe symptoms mentioned earlier, then surgery becomes necessary. Usually only congenital heart defects require invasive procedures treatment, as well as taking medications.

Is there a way to prevent heart murmurs?

It is impossible to prevent heart murmurs caused by congenital heart defects, which are one of the common causes of their provocation. The best way to minimize the risk of a heart murmur is to have your baby examined by a trusted doctor as soon as parents see signs of possible heart defects and abnormalities.

Often, a heart murmur will be detected during a routine examination of the child. Early detection and treatment of heart defects will help normalize the child’s condition.

From the materials in this article, readers will be able to learn about the dangers of heart murmurs in a newborn, and what heart murmurs mean in a baby. The information will be useful to anyone who has small children.

Heart murmurs are very often detected in young children. Most of them are harmless, however, against the background of other existing symptoms, it is necessary to carefully examine the child to exclude structural cardiac abnormalities.

Normally, each heartbeat is accompanied by two sounds. Functional murmurs and heart murmurs in a newborn - extraneous sounds, which can be heard in any phase of the heart cycle, most often in the period between the first and second sound. Typically, such a noise is caused by an excessively fast or vortex nature of the blood flow inside the heart muscle.

Impaired blood flow inside the heart can occur due to existing abnormal communication between the heart chambers or turbulent blood flow through a damaged heart valve, which is the same reason why a functional murmur appears in the heart muscle in infants. A common cause of this disorder is a defect in the septum between the ventricles of the heart. This pathology appears as a hole in the wall that separates the chambers of the heart.

If there is a difference in such noise and pressure between the heart ventricles (it is higher in the left than in the right), blood flow is transferred more from the left to the right. Turbulent blood flow and murmurs can be heard with a stethoscope. There is an opinion that thirty percent of infants have ever had a heart murmur.

In this case, there are no anomalies. Auscultation of the heart small child immediately after birth - this is a mandatory part that is included in the examination carried out in the first days of the baby’s life. According to statistics collected around the world, for every thousand live births, eight have congenital heart defects.

Signs of heart disease in newborns: the appearance of shortness of breath; baby skin coloring Blue colour; Very rapid heartbeat; absence of pulse in the femoral artery. In newborns, some signs may not be immediately visible. It is necessary to pay attention if the baby experiences shortness of breath while sucking, he becomes very tired, and the skin and lips of the newborn turn blue while eating and at rest.

If your child has a murmur, you need to make sure there are no other signs of heart disease, such as rapid breathing, intermittent pulse, or decreased oxygen levels in the blood. If at least one symptom exists, the baby is sent for echocardiography to exclude or confirm heart disease.

Most heart murmurs are transient and do not indicate the presence of disease. U healthy child with a normal cardiac cycle, two heart sounds are heard using a stethoscope, which are clearly audible. They appear when the heart valves close. The first tone appears when the tricuspid slams shut and mitral valves, which are located between the atria and ventricles, at the beginning of systole.

And another tone is heard when the pulmonary artery valves slam shut, during the period of relaxation of the empty heart ventricles. Normally, it is slightly split, since the closure of the aortic valve occurs a little earlier than the closure of the valve in the pulmonary artery.

Noises in a newborn can be divided according to several criteria:

Presence of typical functional noises in completely healthy baby(if there are no symptoms indicating the presence of heart disease) should not be alarming or cause concern. And if there are signs, then echocardiography is performed. It allows you to visualize the cardiac structure and make the most accurate diagnosis.

This method has now supplanted others diagnostic studies such as electrocardiography and radiography chest. In addition to visualizing cardiac structure, blood flow patterns can be monitored using Doppler ultrasound scanning. This study allows us to obtain color picture blood movement inside the cardiac cavity and makes it possible to determine the direction of the abnormal flow, as well as the existing turbulence.

Causes and types of heart murmurs in children

Heart murmurs in newborns are divided into functional (they are harmless), congenital and acquired.

Functional murmurs are quite common in infants. They usually go away as the baby grows. Such noises do not affect blood circulation, which could later have Negative influence on the heart and other organs. All studies of such noises comply with the standards.

The next type - pathological noises - is a congenital pathology. It affects blood circulation. As a rule, such pathology is detected in early age because the child exhibits pronounced symptoms. But it happens that such an anomaly is accompanied only by heart murmurs, and doctors simply do not see the problem.

If the doctor hears a heart murmur in a baby that was not there before, it means that the body goes acute rheumatic process.

But other signs of infection will be visible here. This is an increase in body temperature, a change in the hemogram (blood tests), etc. Treatment in this case is medicinal. If there are no obvious symptoms, then the cause of the noise may be an old scar that remains after a past rheumatic attack.

And finally, the last type is congenital noise. They appear as a result of congenital heart diseases. As a rule, they are detected at an early age. These murmurs indicate that the heart is already formed with abnormalities. What is important here is not the noise, but how it affects the proper functioning of the heart. Congenital heart murmurs in infants are accompanied by a bluish tint to the skin, heavy breathing, or slow growth. These children need a thorough examination by a professional.

To assess the risk of cardiac disease in an infant, it is necessary to analyze the medical history ( bad habits parents, heredity, how the pregnancy went); conduct initial examination, where there should be electrocardiography (ECG). And if there is a suspicion of heart disease, conduct echocardiography (this is ultrasound with Doppler ultrasound); refer the baby to a pediatric cardiologist.

Common cardiac pathologies:

Atrial septal defect: low blood flow pressure, presence of a hole. The murmur occurs because the hole increases the speed of blood flow through the pulmonary valve.

Patent ductus arteriosus: This duct starts working while still inside the womb and closes after birth. If this does not happen, then the baby (often premature) begins to make loud noises.

Orifice valve stenosis: This occurs as a narrowing of the valve opening that leads outward from the ventricles into the pulmonary artery or aorta. This results in increased turbulent blood flow. The degree of obstruction to the blood duct is assessed by Doppler scanning during echocardiography.

Most of the acquired noise in infancy appears due to rheumatism. It causes inflammation of the heart valves and leaves scars. They either block the flow of blood or, conversely, allow it to pass through.

The heart is one of the most important organs person. It is responsible for blood flow, thereby providing all organs with oxygen and nutrients. But from time to time failures occur and heart murmurs appear.

“Your child has a heart murmur.” These words sound terrifying and create anxiety and panic among parents. In some cases it may be justified, but for most children everything is not as bad as expected. Most often, the noise is harmless: it is not accompanied by damage to the blood circulation and does not in any way impair the baby’s activity. But if the doctor does “listen” to the noise, then parents should listen to his advice and undergo additional examination with baby.

Causes and types of heart murmurs in newborns

A mandatory and regular examination of all newborns is listening (auscultation) of the heart. It allows you to early identify congenital heart pathology (if present), determine treatment tactics and prognosis.

So, children's heart murmurs are divided into functional (harmless), acquired and congenital.

Functional noise very common in newborns. They go away over time, usually when the child reaches adolescence. Functional noises are not accompanied by circulatory disorders, which could subsequently negatively affect the condition of the heart or other organs. The electrocardiogram and chest x-ray are normal. This type of murmur is very often heard in newborns and reflects the processes of circulatory restructuring that occur in the cardiovascular system due to adaptation to extrauterine life. It is believed that, on average, of all noises detected in newborns, 40-50% are innocent noises. Their presence is reported so that when noises are detected again by another doctor, parents explain that they were observed before.

Next view - pathological noises- associated with congenital heart pathology. It is she who, to one degree or another, disrupts blood circulation. Mostly cardiovascular pathology diagnosed early, in the first months of life, because the baby exhibits visible symptoms(shortness of breath, bluish skin, developmental delay of the child, etc.). But very often, pathology in the development and functioning of the heart is accompanied only by the presence of noise, and neither parents nor doctors suspect the seriousness of this problem. It is important to know that some newborns may not have noise at all, and it appears only a month later, after a certain restructuring of the blood circulation has taken place. This phenomenon, when noise increases over time, is considered unfavorable and dangerous to the health of the child.

The overwhelming number acquired murmurs V childhood occur as a result of an attack of rheumatism, which causes inflammation of the heart valves and leaves scars on them. This is the reason that they either “let” blood through or act as an obstacle to its normal flow. If the doctor "listens" for a heart murmur that has not been observed before, this may mean that there is a this moment at baby is coming intense rheumatic process. In this case, other symptoms of infection will be detected. These include: increased temperature, changes in hemogram (blood test) and others anomalous phenomena. In this case, drug treatment will be prescribed. If there are no signs of active infection, then the cause of the noise may be old scars that remain after a past attack of rheumatism.

And finally, the last view - congenital murmurs. They are caused by congenital heart diseases, usually detected at birth or in the first months of life (rarely after several years).

Some noises indicate that, first of all, the heart was formed with a deviation. What is important here is not the heart murmurs themselves, but how much the congenital defect interferes with proper operation hearts. Symptoms of the disease in a child may include a bluish tint to the skin, hard breath or slow growth. Children with congenital heart murmurs require careful examination by a specialist. Don't forget that with every dental treatment, they must take antibiotics to prevent germs from spreading from the wound in the mouth to the heart.

Features of examination of children in the presence of heart murmurs

• in order to assess the risk of cardiac disease in a child, it is necessary to analyze the medical history (heredity, bad habits of parents, the course of pregnancy);
• perform an initial examination, which must certainly include electrocardiography (ECG), if you suspect cardiac disease perform echocardiography (ultrasound of the heart with Doppler ultrasound);
• finally, refer the child for a consultation with a pediatric cardiologist.

Treatment of heart murmurs in newborns

Unfortunately, there is no way to eliminate heart murmurs. universal methods treatment. Therapy is prescribed individually for each sick child. It is necessary to take into account the examination results and the child’s well-being. Watch the baby. If he is active and cheerful, he has a good appetite, there is no cyanosis, then most likely you do not need to worry. In this case, you must strictly follow all the instructions of the attending physician.

If murmurs indicate a heart defect, there is also no need to be upset or panic. If the disease is mild, then it is likely that the doctor will get by with prescribing drug therapy, because practice shows that such a problem is not always solved promptly. Otherwise, experts advise not to delay and carry out the operation as early as possible. After this, the baby will be prescribed a gentle regime and constant surveillance at pediatric cardiologist at intervals that correspond to the severity of the disease.

Remember that any heart murmur requires clarification of the cause of its occurrence and further treatment! Don't wait for it to "go away on its own" (this may never happen).

Especially formalutka.net Dmitry Popenko

malutka.net

Main causes of heart murmurs in newborns

Conventionally, heart murmurs in a newborn baby can be divided into two main groups:

Let's talk about each of these groups separately.

1. Functional heart murmurs

This group of noises is due to the peculiarities of the structure and functioning of the newborn’s heart. The fact is that in the womb the fetal cardiovascular system functions completely differently. Since the placenta performs the function of nutrition and breathing for the unborn child, all blood flows of the fetus are aimed at excluding “sleeping” or non-functioning lungs from the systemic circulation.

For these purposes there is whole line the most interesting intrauterine devices:

Immediately after birth, such long-term adaptations cannot disappear overnight. Therefore, they partially function after birth, creating those same functional heart murmurs. On average, closure of the Arantsiev and Botallov ducts occurs in the interval from two weeks to two months, open oval window can last much longer - up to two years.

In some cases, an open oval window may extend into adult life, compiling a list of another group anatomical features– minor anomalies of cardiac development, or MARS.

MARS

This is a group of minimal changes in the structure of the heart that occupy a certain borderline state between normality and pathology. These include minor deviations in the structure of the heart chambers compared to the average values ​​in the population, great vessels and valve apparatus of the organ:

Typically, MARS do not affect human blood circulation or health in any way. Most often these minimal changes are an incidental finding on cardiac ultrasound. In some cases, certain minor anomalies in the development of the heart can produce heart murmurs, upon hearing which the doctor sends the child for examination.

2. Pathological heart murmurs

This group of murmurs is caused by certain heart defects - congenital or acquired. As for pathological noises in a newborn baby, in the vast majority of cases we're talking about O congenital defects hearts, since acquired defects simply do not have time to form within 28 days of the newborn period.

Congenital heart defects occur in approximately 1% of newborns, some of them are diagnosed at the stage of intrauterine life - during screening ultrasounds of pregnant women. Congenital heart defects are the leading cause of childhood mortality among developmental defects.

Tetralogy of Fallot – congenital heart defect

The main causes of congenital heart defects are:

It is important to understand that heart defects, unlike MARS and functional transition states of the neonatal period, necessarily manifest themselves clinically - that is, a heart murmur is accompanied by certain clinical symptoms.

Symptoms of heart defects

• Cyanosis or blue discoloration skin. Most often, this symptom is observed during physical activity. The baby's main physical activity is sucking and crying. It is during eating and crying that a child’s lips and nasolabial triangle above may turn blue. upper lip, limbs, nail bed.


• Shortness of breath - a child may choke at the height of physical exertion or even at rest. Such children often have very dangerous conditions– night apnea, when in the phase deep sleep the child simply stops breathing.
• Poor appetite and frequent regurgitation are associated with the fact that the baby has a very difficult time sucking.
• Lag in physical development in view of how poor nutrition, and insufficient tissue nutrition. Such children gain weight poorly, begin to hold their heads up late, roll over, and have weakened arms and legs.
• Lag in mental development due to insufficient enrichment of the blood with oxygen and nutrients and inadequate nutrition of the tissues of the nervous system.

There are different types of heart defects; there are huge multi-stage classifications. No need to bring detailed description all congenital heart defects, suffice it to say that the management tactics for such a child are determined by cardiologists and cardiac surgeons after a thorough examination.

What examinations are necessary in the presence of a heart murmur?

The first doctor to diagnose a heart murmur in a newly born baby is a neonatologist. In the first minutes after birth, the neonatologist listens to the baby’s heart and lungs, assesses skin color, crying patterns, and muscle tone.

If the doctor hears a heart murmur, the child is left under observation in the neonatal ward and a primary examination is prescribed. It includes:

The gold standard for diagnosing congenital malformations is cardiac ultrasound or echocardiography with Doppler. This study combines obtaining an ultrasound image of the heart and blood vessels and measuring the speed of blood flow in the chambers of the heart and large vessels. This research method is safe, informative and relatively accessible. Any heart murmur should be evaluated using this method soon after the baby is born.

If an ultrasound did not reveal the presence of congenital heart defects, and additional techniques did not show any abnormalities in the functioning of this organ and blood vessels, then the noise is considered physiological or functional. The child can be discharged from the maternity hospital in standard terms under the usual supervision of a local pediatrician.

If there was data on cardiac malformations obtained on perinatal screening pregnant woman, or such defects were discovered after birth, then the child should be transferred to cardiologists for a thorough examination and decision on further observation and treatment. Women who were diagnosed with congenital heart defects during pregnancy should give birth in specialized maternity hospitals, where there are all conditions for care and examination little patient.

Treatment of heart murmurs

If the murmurs are recognized as physiological or combined with minor anomalies of heart development, then such children do not receive any treatment. A wait-and-see approach is used for them. At each scheduled visit to the child, the pediatrician listens to the heart, noting the dynamics of the murmur. In some cases, such noises go away on their own during the first year of life.

It is also important to evaluate complaints and clinical symptoms. If the child eats well, gains weight, and develops within normal limits, then a heart murmur is definitely not subject to treatment or additional diagnostics.

If there are congenital heart defects, the child is registered with a cardiologist, who dynamically monitors the child. Some defects are corrected medicinally by prescribing cardiac medications. Some are subject to surgical treatment. The timing of the operation directly depends on the following factors:

Prognosis for the disease

As we have already understood, the prognosis for the life and health of a small patient depends on many factors, including logistical ones. A series of vices after surgical treatment is corrected completely, the child is cured.

Some defects are subject to multi-stage correction, including several heart surgeries and constant medication. Such children receive a disability group and most often have a severely limited quality of life.

Heart defects associated with severe genetic syndromes and combined with other developmental defects: anomalies of the limbs, brain, genitourinary system- usually incurable. Most of these patients die in the first months of life or remain deeply disabled. Therefore, it plays a huge role in the prevention of such defects. genetic counseling pregnant woman and high-quality ultrasound screening of the fetus, starting from the very early dates pregnancy. In the CIS countries, genetic screening of pregnant women reveals about 76% of pathologies, which is a very good indicator.

okardio.com

Causes of noise

Every parent who has heard the diagnosis of “heart murmurs” is concerned with the question: “where did they come from?” The main causes of pathological sound vibrations when listening to the heart, these are anatomical deviations from the norm:

• narrowed large vessels, coming from the heart;
• the valves of the heart itself are narrowed;
• the valve flaps do not close tightly enough (allowing blood to return);
• there are holes in the heart septum;
• there is a gap between the pulmonary artery and the aorta;
• the surfaces of the heart chambers have roughness, protrusions or depressions.

How then does a heart murmur occur? Let me remind you general structure hearts, just in case (in order to make the process of the appearance of noise clearer): 4 chambers - 2 atria and 2 ventricles, a septum separating the right and left half hearts from each other, leaflet valves-separators between the ventricles and atria.

There are many reasons for the problem; professional diagnostics will help you find out.

While pumping blood, we hear tones (when the valves close/open and the heart itself contracts/relaxes) - this is the heartbeat. The tones can be smooth or heard in discord, and in the interval between them, noises may arise caused by a partial change in the direction of blood flow and fluctuations in the speed of blood flow, which occur due to the reasons I have described above.

No need to be afraid: harmless and alarming noises

Why are not all heart murmurs dangerous? There are 2 types of noise:

• Functional murmur (or systolic murmur) - appears with minor anatomical deviations of the valves or in the cavity of the heart. FS does not negatively affect the heart itself or other organs. These noises are one of the developmental features of a growing organism. FS can actively change in the period up to 2-3 years, after 5 years, and during puberty they usually subside and disappear completely. The nature of the noise also changes when the child's body position changes. Children who are often ill (typical for the ages of 2 and 3 years) with an increase in temperature (when it drops) are prone to the manifestation of FS - noises disappear) and babies with a narrow chest.

Functional murmurs are a fairly common occurrence in children aged 2 to 3 years.

• Organic noise ( diastolic murmurs) - formed when there are significant deviations in anatomical development heart of the child, disrupting blood circulation, and often entails the development of serious aggravated pathologies.

Organic noise can lead to serious pathologies.

FS, unlike OS, are not displayed on x-rays and on an ECG. They can be detected on cardiac ultrasound.

A cardiogram does not always help to create a clear picture of the disease.

Olga's review (son is 2 years and 7 months old):

“A couple of times we heard heart murmurs when we were admitted to the hospital with a fever. Then everything went away on its own. Now local doctor found murmurs and sent us for an ECG, where we were reassured that everything was fine and our murmurs were due to age . The pediatrician decided to play it safe and sent us for an ultrasound - I thank her very much for this, because I was still terribly worried. An ultrasound showed a slight functional murmur, and the sonologist said that it would disappear on its own after a while. Everything worked out! Hooray!"

How to detect noise

The first heart murmurs can be diagnosed in the maternity hospital. This is done by a neonatologist. Newborn with small functional noise in the heart - this is normal. The norm is due to the transformation of blood circulation and the elimination of direct blood flow between the pulmonary artery and the aorta. If the doctor does not find any noises in the baby, then carefully observe yourself to see if the child displays the following symptoms (characteristic of pathological noises):

• dyspnea;
• bluish skin;
• difficulty breathing;

When alarming symptoms, go to the doctor immediately.

• no pulse is felt in the femoral artery;
• general underdevelopment.

A baby may also be diagnosed with congenital noises, which do not always appear immediately (usually within the first two months). These noises “indicate” that the baby’s heart has not developed enough or acquired defects during the mother’s pregnancy. Doctors monitor such babies with increased attention, and if there is an urgent need, the child undergoes surgery.

Diagnosis and possible treatment

How is a heart murmur detected in a child? The very first and most common method is listening to noises using a phonendoscope. If the doctor, while listening, finds extraneous sounds other than tones, he may prescribe the child an echocardiography, ECG, computed tomography, MRI or ultrasound of the heart. Dr. Komarovsky strongly advises to undergo full examination so as not to miss possible illness. Referrals for these procedures are issued by the local pediatrician. On ECHO, FS will not be shown, but OS and the causes of their occurrence will appear. If during a detailed examination of the child no serious structural changes in the heart, then the baby is registered and prescribed an annual examination in combination with a consultation with a cardiologist to monitor the dynamics of changes in heart sounds and structures.

If the noise does not pose a threat to the child’s life, he will simply be registered.

Don’t panic in advance and don’t look for scary information everywhere., if you heard that your baby was diagnosed with a heart murmur. The danger for the baby is the progressive heart defect and increasing heart failure, accompanied by murmurs. Only when the cardiologist, based on the results of all studies, makes final conclusions and makes a diagnosis, will it be possible to think about further actions.

Review from Maryana (my son is almost 3 years old):

“I still breastfeed my son. We are a little overweight, and recently doctors discovered a heart murmur. I was very worried when I learned about this - I blamed the child’s obesity as the cause of the noise. I reviewed a bunch of literature, literally interrogated doctors about what and how. Nobody confirmed my guesses about the dependence of noise on weight. We were sent for an ultrasound of the heart, which revealed pathology. To my universal happiness, our disease can be cured without surgery!”

Kids with overweight are more likely to suffer from heart disease.

What might these actions be? If a child has minor FS, he is allowed, even indicated, physical exercise, for example, dancing or swimming. Children with FS continue to be observed until the latter disappear. Noises can sometimes be observed until adolescence when the restructuring in the body ends.

Drug treatment is prescribed exclusively in rare cases.

Maintenance therapy - long-term use medications if surgery is undesirable.

• Surgery- if noise and birth defect identified, they try to eliminate it as quickly and early as possible in order to avoid possible severe complications. Children are sent to a surgical cardiac center for surgery and after the operation they are prescribed restorative procedures, acceptable physical activity and medications.

So, what should you do if your little one has a heart murmur:

1. Do not panic.
2. Watch your baby carefully.
3. Undergo a thorough examination.
4. Strictly act according to the instructions and prescriptions of the doctor.

Diana Bal

www.o-my-baby.ru

As you know, almost all organs of the fetus begin their work even before birth. Thus, the heart promotes the movement of blood through the vessels, the kidneys produce urine, and the glands synthesize hormones.

Only the lungs of the fetus are the organ that is inside female body does not function. With the first breath they straighten out and begin their work.

It is with the birth of a child that the heart begins to function more actively. Therefore, a mother can often notice how a neonatologist, using a stethoscope, listens to the heart sounds of the newborn in order to exclude possible noise.

Classification

All murmurs that occur in the heart of newborn children can be divided into innocent and pathological. The former usually occur due to a formation in the heart additional chords. In this case, hemodynamics are not disturbed.

Pathological noises occur in diseases such as:

• septal defect;
• pulmonary stenosis;
• open ductus arteriosus.

The diseases listed above are always accompanied by rather severe symptoms, so their diagnosis does not cause any particular difficulties.

Causes of heart murmurs

Many young parents are horrified by the mere thought that their newborn child may have a heart murmur. This fear is unfounded, since the diagnosis cannot be made only as a result of auscultation.

The causes of murmurs diagnosed in the heart of a newborn can be varied. In most cases, their occurrence is the result of the transition of intrauterine circulation to extrauterine circulation. So in the fetus, exclusively mixed blood flows through the vessels, which is associated with anatomical features. Mixing arterial blood and venous in the baby’s body occurs due to the presence of 3 anatomical formations in the heart:

• oval window;
• ductus arteriosus;
• venous duct.

After birth, they continue to function for a short time and close as the baby grows. That is why, in the first days of life, noises can be auscultated, since the above formations are still functioning.

Ductus arteriosus

The batal (arterial) duct is a formation that connects pulmonary trunk and aorta. It closes 2 weeks after the baby is born. In rare cases, it becomes overgrown by 2 months. If after this age during ECHO-CG in the heart premature baby murmurs are diagnosed, this indicates the development of a congenital defect.

Oval window

It is an anatomical formation that is located in the septum dividing the atrium cavity. Its closure, as a rule, occurs during the first month and is associated with a gradual, increasing increase in pressure in the left atrium. Many mothers, whose newborn children are diagnosed with heart murmurs due to the presence of an oval window, are worried about whether this is dangerous and, if so, how much? There is nothing wrong with this - the oval window can completely close by 2 years, and its presence has practically no effect on hemodynamics.

Ductus venosus

The main function of the ductus venosus is to connect the inferior vena cava and the portal vein. It disappears very quickly after birth and turns into a cord consisting of connective tissue.

Regardless of the cause, any heart murmur must be thoroughly diagnosed. Those children whose murmurs are a symptom of congenital heart disease require constant dispensary observation. If possible, it is carried out surgical intervention, the purpose of which is to eliminate vice.

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Dishormonal cardiopathy

The organs of the fetus begin to function long before it is born. Heart moves blood through the vessels, the kidneys produce urine, thyroid synthesizes hormones, the intestinal mucosa absorbs nutrients and water, and his muscles learn peristalsis. The only body, which does not work in utero, is the lungs. But this is not surprising. After the baby is born, they will open during the first breath, so they do not need preliminary training. From this moment on, the newborn’s heart will begin to work more actively. Therefore, the pediatric neonatologist listens with a stethoscope heart sounds and possible murmurs to have an idea of ​​the condition of the baby’s heart.

Many parents are horrified by the thought that their newborn baby heart murmur. This is a completely justified fear, since before the examinations It is impossible to say even a preliminary forecast.

Causes of heart murmurs in children up to a year are different. Most often they are associated with the presence of a transition period from intrauterine blood circulation to normal, extrauterine blood flow. IN arterial vessels Fetal blood always flows mixed, which is associated with the characteristics of the cardiovascular system. Mixed blood occurs due to the presence of three anatomical formations that contribute to this:

1. Duct arteriosus (Ductus of Batalus).
2. Oval window.
3. Ductus venosus (Ductus of Arantius).

By the time the baby is born, they continue to function, but over time they overgrow or close. When auscultating in the first days of life, the doctor always hears noises, which are caused by the presence of these anatomical features. But over time, the noise disappears.

• Batalov ductconnects the aorta and pulmonary trunk. It should stop functioning within two weeks, but sometimes it lasts up to two months. If according to the resultsEcho-KG if it is present later, this indicates the presence of a congenital heart defect.
• Oval windowis in interatrial septum. It usually closes within the first month of life due to increased pressure in the left atrium. If this does not happen, then there is no need to worry. It can close two years after birth. Most importantly, a patent foramen ovale rarely leads to hemodynamic disturbances, so its presence does not interfere with the development of the child.
• Ductus venosusconnects portal vein and the inferior vena cava, and disappears soon after birth. It is transformed into a connective tissue cord as a result of the collapse of its walls. It rarely persists during extrauterine circulation, so it is not a cause of congenital heart disease.

Typically, when a child turns one month old, he is sent to his first ECG . This method allows you to differentiate heart murmurs. If there is a suspicion of a more serious pathology, then prescribe Echo-KG . Now they allocate " innocent" And " pathological» noises. In the absence of hemodynamic disturbances, they speak of “ innocent» noises. They are much more common. In the presence of symptoms(cyanosis of the skin, frequent breathing, cyanosis of fingers and nails) they talk about “pathological” noises and look for a serious cause.

TO " innocent"murmurs include murmurs that arise due to the presence of additional, abnormally located chords in the heart. This phenomenon is very common and does not require any treatment, because the disease does not occur. Also to " innocent» noise is attributed newborn heart murmur due to unclosed oval window.

In other cases, noises “pathologist” And logical" and arise due to more serious problems. These include:

1. Pulmonary artery stenosis;
2. Ventricular septal defect;
3. Open battle channel;
4. Coarctation of the aorta and other heart defects.

The listed diseases are always accompanied by severe symptoms, therefore, are diagnosed within the first month after the birth of the child. If degree of defect expressed, then the only method treatment is surgical.

Sometimes heart murmur of a functional nature do not arise due to cardiac pathology. In situations where a large load is placed on the heart, this may be accompanied by the appearance of a heart murmur. Such situations happen when high temperature, heavy infectious process, pneumonia, anemia. But in these cases, with the elimination of the main process, the heart murmur disappears.

Regardless causes, any heart murmur should be carefully examined examination. If there is no serious cause for concern, then it is not necessary to register with a cardiologist. If we are talking about congenital heart defects, then the baby should be under the constant supervision of a cardiologist. If necessary, it is necessary to carry out surgery, during which the vice will be eliminated.

Heart murmurs in a newborn baby in most cases, although they are an undoubted cause for concern for parents, are actually not so scary. To dispel vain and unnecessary worries, you need to undergo: examination, establish exact reason diseases.

If treatment and supportive therapy are required, act only competently and scrupulously.

Description of the syndrome, how to detect it?

What does a heart murmur mean?

• The heart consists of four chambers: 2 atria and 2 ventricles. Between them there are valves, they continuously open and close.
  They take turns filling with blood in the diastole phase. And they empty (contract) in the systole phase.
• We call these tones knock but he has medical term- tone. In between there are pauses - called calms.
  It is in them that excess noise can be heard. There may also be harmless ones, completely safe for health and life.
• But there are often congenital anatomical abnormalities in the building, which lead to disability, and if adults are inactive, to irreversible consequences and even the death of a child.
  The need for surgical intervention leaves no time to think; you need to act.
• The noise can be detected in the maternity hospital, in the first days of life. If the baby has minor functional noises, this is considered normal.

1. difficulty breathing, shortness of breath;
2. blue discoloration of the skin;
3. loss of appetite, lethargy;
4. weak palpation or absence of pulse.

In infants, congenital noises may not appear immediately, but over the course of two or more months. This may indicate insufficient development, or a defect (during pregnancy).

Such children should be kept under constant control; if there is a threat to life, an operation is performed.

Types of heart murmurs

Heart murmurs in a newborn baby can be either dangerous (organic) or non-dangerous (functional).

Non-hazardous - not a consequence of heart disease:

• do not interfere with blood circulation;
• have minor structural changes;
• upon examination, an electrocardiogram and ultrasound examination show normal;
• do not affect the functioning of the heart.

Noises are often provoked by the cardiovascular system, blood circulation, being rebuilt, beginning to adapt to a new non-intrauterine life, hence the noises. Over time, they usually disappear completely.

Dangerous - this is a congenital heart defect, it is associated with a violation of blood flow.

It is diagnosed more often in the first days of life, based on the following symptoms:

The presence of vibrations is usually not a cause for concern. In many infants, noise may appear even a month later, after the restructuring of blood circulation. The subsequent increase in pathology is a dangerous phenomenon.

All murmurs can be roughly divided: diastolic, systolic. It is believed that systolic murmur in the heart of a newborn may have a functional nature.

And diastolic in most cases have an organic origin, i.e. the reason for this may be:

• aortic pulmonary septal defect;
• stenosis of the right or left atrioventricular orifice;
• the aortic duct is not closed;
• valve insufficiency pulmonary artery and aorta, etc.

Dangerous

At serious pathologies heart, the situation can develop in several directions:

1. Some people are immediately operated on.
2. If surgery is impossible for some reason, then treatment with medications is prescribed.
3. Some will simply be registered for the rest of their lives.

Non-hazardous

They make up about 40%, do not disrupt the functioning of the heart muscle, and do not lead to changes in blood circulation. They indicate the reorganization and adaptation of blood circulation, and the whole of cardio-vascular system to later life.

If a baby is diagnosed with this in the maternity hospital, it means that he will simply be registered with a pediatric cardiologist and will be monitored. Without any drug treatment. All you need is care and proper care. After some time, the situation may return to normal, the noises will completely disappear or, on the contrary, will intensify.

Reasons for appearance

The reason sometimes lies in the age of the baby, it can be dangerous or harmless. Sometimes anatomical formations, lead to mixing of venous and arterial blood, during intrauterine development. Over time they may disappear, then it will not be dangerous.

But when, after a certain period of time, they remain, this will indicate heart defect:

1. - connects the aorta and pulmonary artery. At proper development should close after birth in 1.5–2 weeks. Even at 2–3 months this is considered acceptable; if more, then this is definitely a heart defect.
2. - the duct between the atrial septa should close in the first month of life. But sometimes it remains open for up to 1 year, but this has almost no effect on the nature of the blood flow.
3. Ductus venosus- a vessel connecting the vein (cava) of the fetus with the umbilical cord. It should disappear 1–2 hours after birth, but sometimes the ductus venosus persists.

Organic noises indicate the presence of congenital defects.

Classification and main reasons:

1. Noises - appear when blood flow changes:
   • systolic type - caused by insufficiency of the tricuspid or mitral valves;
   • diastolic type - appears mainly with valve defects (pulmonary artery).
2. Ejection sounds are heard when the openings used for blood outflow become smaller:
   • mitral narrowing - diastolic in nature;
   • stenosis of the mouth of the aorta, pulmonary artery - has a systolic character.
3. Noises of pathological anastomosis - occur with developmental defects, this can be:
   • patent ductus arteriosus,
   • defect of the interventricular septum, but more often between the atrial septa.

Caesarean sometimes takes its toll negative consequences on the health and life of the newborn, medical care is often required after it.

Caesars are performed only for life's sake important indicators to save the life of mother and child. They are: emergency and planned.

In any case, the mechanism of childbirth is distorted. The baby experiences pressure from the head to the butt. Often the doctor’s hands also join in this. Therefore, it is not difficult to cause injury in this situation.

With natural childbirth, serious injuries are excluded and vital triggers are immediately launched:

1. The child is being pushed through birth canal mothers in turn: head, tummy, legs. This helps him push mucus out of his lungs, straighten his lungs, take his first breath, so he can scream.
2. Therefore, the discharge of cerebrospinal fluid (the fluid that washes the spinal cord, as well as the brain) occurs naturally.
3. During childbirth, the baby's hormones are released into the blood, which help him: breathe, suck, etc.
4. During childbirth, the baby does: multiple turns, flexions, extensions of the body, the mechanisms of fluid circulation are launched.

At caesarean section the child is taken out in a state of compression, which means that the triggering mechanisms will not be fully implemented. That is why such children may be predisposed to many ailments. A heart murmur in a newborn after a cesarean section will also be no exception.

Diagnostics

• All newborns still in the maternity hospital The first examination of the heart is carried out using an ordinary stethoscope - auscultation. If identified congenital pathology, immediately decide on treatment tactics and make a prognosis. The absence of noise does not always indicate the absence of a defect.
• Qualification of a pediatric cardiologist should be such that it should determine, based only on the nature of the noise, how dangerous the pathology is and whether surgical intervention will be required or not.
• Babies often make noise it is simply not heard or it is misinterpreted: due to inexperience, frequency of research, the condition of the child, etc.
• The neonatologist must identify heart murmurs in time and refer the newborn for further examination to medical institutions.

The following diagnostic methods are used there:

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It would be ideal if mother and baby could be constantly monitored by one doctor. This way, it will be easier to track and record: timbre, dynamics, nature of the disease. And it will be easier to decide on further treatment tactics.

If the noise is not dangerous, periodic monitoring will be required once a year: consultation and echocardiography. Children can eventually lead a normal lifestyle: dancing, sports, swimming, etc.

In particularly serious cases, therapeutic techniques are selected individually for each baby. Choose one of two treatment methods:

Conservative is:

• the autoimmune reaction is suppressed by non-steroidal anti-inflammatory drugs;
• heart failure is eliminated - neurotrophic drugs;
• pathogenic bacteria are killed by antibiotics;
• strengthen blood vessels - angio protectors.

Surgical- if the disease progresses rapidly, surgical intervention is indicated.

Is a heart murmur dangerous? ? Let's try to figure it out.

Not all noises are dangerous, but only those that cause serious violations in the work of the heart. If the examination does not reveal any serious health problems, then there is no cause for concern.

It is only necessary to make annual payments just to be on the safe side. preventive examinations, Ultrasound of the heart in dynamics.

But when the noises are accompanied associated symptoms: bluish skin, lack of body weight, poor appetite etc. Will clearly indicate a disease. Without timely treatment everything can end sadly.

Important:

• visit a cardiologist on time;
• undergo examinations to monitor the baby’s condition;
• strictly follow all doctor's instructions.

If surgery is required, do it immediately. Because it is prescribed in exceptional cases, life depends on it.

1. You cannot self-medicate.
2. Panic.
3. You can’t drag out time, wait for everything to go away on its own, untimely treatment can lead to irreversible consequences and even death.
4. You should not skip visits to the doctor or not follow his recommendations.
5. You should not expose your baby to ARVI and catch a cold.
6. The mother must monitor her health so as not to inadvertently infect the child: sanitize the oral cavity in a timely manner, wear a mask if sick, keep other family members away from the child to prevent any infection, etc.
7. You can’t feed artificial formula, try to establish breastfeeding, it is important.

If your newborn baby is diagnosed with a heart murmur, do not panic. Because most often they are functional (non-hazardous) in nature.