ACADEMIC RESEARCH IN MODERN SCIENCE
International scientific-online conference
63
HEART FAILURE IN YOUNG CHILDREN.
Satibaldiyeva Zebo Shuxratullayevna
Teacher, Kokand State Medical University Branch of Andijan
Abdiqulov Nozimjon
Student, Kokand State Medical University Branch of Andijan
https://doi.org/10.5281/zenodo.15369049
Аннотация:
Сердечная недостаточность у детей возникает при
врожденных кардиоваскулярных пороках, воспалительных (кардиты) и не
воспалительных (кардиомиопатии) болезнях, поражении миокарда
вследствие системных заболеваний, генетических синдромов. Ключевые
симптомы — одышка в покое и при нагрузке, отеки нижних конечностей,
повышенная утомляемость. Статья написано об этом.
Ключевые
слова:
Заболеваниие,
генетических
синдромов,
кардиомиопатии, этиологическая структура, гипертрофическая формы.
Abstract:
Heart failure in children occurs with congenital cardiovascular
defects, inflammatory (carditis) and non-inflammatory (cardiomyopathy)
diseases, myocardial damage due to systemic diseases, genetic syndromes. The
key symptoms are shortness of breath at rest and during exercise, swelling of
the lower extremities, and increased fatigue. The article is written about this.
Key words:
Disease, genetic syndromes, cardiomyopathy, etiological
structure, hypertrophic forms.
Definition:
Chronic heart failure (CHF) is a syndrome that develops as a
result of various diseases of the cardiovascular system (CVS), leading to the
inability of the heart to provide systemic blood flow adequate to the metabolic
needs of the div, which is accompanied by intracardiac and peripheral
hemodynamic shifts, structural restructuring of the heart, disorders of the
neurohumoral regulation of blood circulation, stagnation in large and/or a small
circle of blood circulation.
The main part:
The causes of signs of heart failure are noted when the
contractility of the myocardium is impaired with its direct or indirect damage.
The etiological structure depends on the age of the child. The main causes of the
disease in newborns are congenital heart defects, hypoxic myocardial damage in
the perinatal period. In older children, cardiac insufficiency occurs under the
influence of various factors, the main of which are
Organic heart diseases. Most often, the pathology becomes a consequence of
inflammatory processes — endocarditis, myocarditis, pericarditis. In children,
dilated and hypertrophic forms of cardiomyopathy are often the cause of heart
failure.
Rhythm and conduction disturbances. Children mostly have nonparoxysmal
and paroxysmal ventricular tachycardia, complete atrioventricular blockages,
atrial or ventricular extrasystoles. Rare causes include Wolf-Parkinson-White
syndrome.
ACADEMIC RESEARCH IN MODERN SCIENCE
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Acute rheumatic fever. Rheumatism causes cardiac dysfunction in
adolescents. The disease is caused by damage to the valve apparatus and
hemodynamic disorders. Clinical symptoms of myocardial failure develop after
one attack of rheumatic fever.
Extra-cardiac pathologies. Among the causes of heart failure, the proportion
of systemic connective tissue lesions and vasculitis increases. Rarely, signs of HF
occur in neuromuscular diseases, mitochondrial diseases, and genetic
syndromes.
Research results:
The etiology and pathogenesis of the causes of CHF in
children are diverse, age-dependent, and fundamentally different from those in
adults. Thus, in newborns and young children, the main causes of heart failure
are congenital heart defects. In 78% of children with CHD, heart failure
disappears after surgery. In preschool and school age, the causes of heart failure
are idiopathic and inflammatory heart diseases: infectious endocarditis,
myocarditis, cardiomyopathy, primary pulmonary hypertension, pericarditis.
Recently, the number of cases of myocardial lesions in systemic connective
tissue diseases, vasculitis, especially in Kawasaki disease, has been increasing.
Heart damage in various genetic syndromes, neuromuscular diseases, including
mitochondrial pathology, is also often accompanied by the development of heart
failure. In addition, diseases that cause chronic myocardial overload due to its
increased intensity (tachyarrhythmia) or increased peripheral vascular
resistance (hypertension) are important. The pathogenesis of heart failure in
children includes: hemodynamic, neurohumoral, immunological mechanisms of
CHF development, as well as endothelial dysfunction and disorders of cellular
energy exchange. The preservation of the etiological factor contributes to the
progression of CHF with morpho-functional manifestations of late
maladaptation or decompensation in the form of pulmonary congestion,
edematous syndrome, apoptosis and cell necrosis with a decrease in cardiac
output and the development of arrhythmias.
Treatment of heart failure in children.
Conservative therapy-First, the
doctor evaluates the clinical symptoms and echocardiographic signs of HF,
determines its variant and severity in order to select the optimal therapeutic
regimen. The child is not prescribed drugs that are potentially dangerous for the
progression of the disease (calcium antagonists, NSAIDs, corticosteroids).
Medications of the following groups are used to treat heart failure:
Cardiotonics. Medications improve the strength and efficiency of heart
contractions, increase the release of blood from the left ventricle. Cardiac
glycosides and non-glycoside cardiotonics are used.
Diuretics. By reducing the volume of circulating blood, they reduce the
load on the ventricles, improve central and peripheral blood circulation. Loop
and potassium-sparing diuretics are effective.
ACE inhibitors. The main group of drugs for pharmacotherapy and
prevention of heart failure, which quickly eliminate its symptoms. They act on
ACADEMIC RESEARCH IN MODERN SCIENCE
International scientific-online conference
65
the pathogenetic mechanisms of the disease development, have a hypotensive
effect.
Beta blockers. Medications improve the contractile activity of the
myocardium and the delivery of oxygen to the organ, have an antiarrhythmic
effect. They reduce the direct toxic effect of catecholamines on the heart and
remodel the diastolic function of the left ventricle.
Cardiometabolic drugs. Medications that improve blood supply and
myocardial trophism are recommended for all types of HF. They increase the
effectiveness of other drugs and accelerate recovery from inflammatory
cardiopathology.
Surgical treatment- Surgical intervention is mainly prescribed for
congenital malformations accompanied by heart failure. If symptoms of life-
threatening conditions are detected, the operation is performed on newborns
immediately after their birth. Compensated conditions are an indication for the
planned care of pediatric surgeons in the first or second year of a child's life. In
case of severe arrhythmias, a pacemaker is installed.
Conclusion
The five-year survival rate of patients is 50%. The prognosis after it is
variable and depends on the severity of heart failure, concomitant pathologies,
treatment effectiveness, lifestyle, etc. Treatment of heart failure in the initial
stages fully compensates for the condition of patients; the worst outcome is
observed with stage III heart failure.
Heart failure as a set of diseases associated with deterioration of the
contractile function of the heart muscle is a dangerous pathology for humans.
The consequence of this condition is an insufficient supply of nutrients and
oxygen to the myocardium, which affects the functioning of all internal organs
and systems and human well-being. Heart failure of varying degrees occurs in
both men and women.
In case of acute or severe chronic heart failure, bed rest and complete
mental and physical rest are prescribed. In all other cases, moderate exercise
should be followed, which will not worsen the condition. Fluid intake is limited
to 500-600 ml per day, salt — 1-2 g. Compliance with an easily digestible diet
rich in vitamins is prescribed.
Pharmacotherapy of heart failure can improve the condition and quality of
life of patients.
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