Heart defect
Synonyms
Heart vitium, heart malformation
Definition of heart defect
A heart defect is a more innate or acquired Damage to the Heart or individual Heart structures as well as adjacent Vesselsthat become a Function restriction of the cardiovascular system or the cardiopulmonary system.
frequency
Approximately 6,000 children a year are born in Germany with a congenital heart defect, that is approx 0.7 to 0.8% of all newborns. Thus the heart vitia belong to the most common congenital malformations of the newborn.
causes
About 90% of all heart malformations are of multifactorial origin, genetic causes can only be found in 10% of cases. These include chromosomal aberrations and monogenic hereditary disorders such as
- Down syndrome (trisomy 21),
- Edward syndrome (trisomy 18),
- the Patau syndrome (trisomy 13),
- Turner Syndrome
- Di George syndrome (deletion 22q11),
- Williams-Beuren syndrome (deletion 7q11.23).
Toxins and alcohol can also cause heart defects, such as in fetal alcohol syndrome. Certain drugs and infections such as rubella can cause heart disease. Frequently, further malformations in other organ systems can occur in connection with heart malformations.
Classification of heart defects
Heart malformations can innate or acquired be. In addition, it can heart be affected alone, as well as the adjacent vessels be involved. These include:
- Transposition of the great arteries (TGA), so a transfer of large arteries at the Heart like the aorta;
- Double inlet ventricle (DIV) is English and means a double inflow to the ventricle;
- Total pulmonary vein confluence (TAPVR) and Truncus arteriosus communis, thereby becoming the major ones during fetal development Body artery (lat. aorta) and the Pulmonary artery (lat. Pulmonary trunk) not completely separated from each other.
Another distinction between heart defects is that of cyanotic and azyanotic Cardiac vitia. In the case of cyanotic heart defects, the patients appear blue (cyanosis), there deoxygenated blood bypasses the lungs and goes straight back into the Body circulation flows. This is for example
- Right-left shunts before as well
- at Fallot's tetralogy (a complex heart malformation),
- Pulmonary atresia (Closure of the pulmonary valve),
- Double outlet ventricle (Double outflow of one ventricle),
- Tricuspid atresia,
- complete transposition or a Truncus arteriosus communis.
To the azyanotic Heart defects all belong to Constrictions from heart valves and vessels as well as the Left-right shunts. It will oxygenated blood from the left ventricle deoxygenated blood of right ventricle mixed in. These include, for example
- Atrial septal defect,
- Partial pulmonary vein malocclusion,
- Ventricular septal defect or
- a Persistent ductus arteriosus botalli.
Furthermore, the heart malformation can be divided into one Left heart obstruction and a Right heart obstruction. The danger of right heart obstruction is one Decompensation of the right heart due to a previous enlargement of the right heart tissue. This includes
- Pulmonary valve stenosis,
- Tricuspid valve stenosis,
- Pulmonary valve regurgitation,
- Tricuspid regurgitation.
In the Left heart obstruction it comes to one Clasp of the Outflow tract the left ventricle. The resulting increased stress on the Heart muscles leads to an enlargement of the left heart tissue. Examples of left heart obstruction are
- Aortic stenosis,
- Aortic regurgitation,
- Coarctation of the aorta,
- Broken aortic arch,
- hypoplastic left heart syndrome,
- Mitral valve regurgitation and
- Mitral valve stenosis.
There are also diseases of the Excitation conduction system:
- QT syndrome,
- Sick sinus syndrome and
- Wolff-Parkinson-White Syndrome.
In addition to the innate there are, as already mentioned, acquired heart disease. This includes the Inflammation of the lining of the heart (Endocarditis), occurring after surgery Cardiac arrhythmias, Heart muscle disease and the Myocarditis.
therapy
The biggest pillar of therapy is probably the surgery one, but also interventional can be treated and at Ductus arteriosus botalli even medicinal.
In cardiac surgery, interventions on congenital heart malformations are divided into curative (healing) and palliative operations. In the case of curative measures, an operative production takes place normal functionwhat a normal life expectancy implies. Further measures are usually not necessary. At Partial corrections further medical measures are necessary to restore normalized function. For example, palliative surgery is one Heart transplant. It is not possible to restore normal function to the sick heart through surgical interventions.
forecast
Due to various medical-technical and drug advances, one is clear Increase in life expectancy (about 90% of the Children with congenital heart disease now achieve that Adulthood) can be seen in countries with appropriate intervention options. A problem that arises here is responsibility for the patient. The Pediatric cardiology is a branch of paediatrics, while the cardiology belongs to internal medicine. This treats diseases of the heart that occur especially in adulthood. Meanwhile, the jurisdiction problem that this creates for Adults with congenital heart defects (EMAH) results through interdisciplinary Cooperation well resolved.
