In this section, based on many years of observation of the children from the various acquired heart diseases and analysis of modern literary material describes the clinical, hemodynamic features, diagnosis of various acquired heart defects: isolated deficiency and stenoses mitral and aortic valves and combined mitral and aortic defects, failure tricuspid valves and narrowing of the right atrioventricular mouth, and describes the combined vices, of which understands the failure of bivalve and aortic valve stenosis of the left atrioventricular holes and aortic valve insufficiency, mitrale-tricuspid and Microline-aortic insufficiency. Particular attention is drawn to the value of the x-ray examination, interpretation of data of electric and phonocardiography. When considering the issue about the etiology of valvular lesions look at the value of rheumatic endocarditis and septic origin, describes their clinic. A special Chapter is devoted to the treatment of heart diseases. It versed dietary guidelines, the value of mode, data on the use of various medicines (antibiotics, salicylates, steroid hormones, cocarboxylase), physical therapy, Spa treatment in active and inactive phase rheumatism, and describes the purpose regimes, diet, the use of cardiac glycosides, cocarboxylase, diuretics, spirolactone (aldosterone antagonists), oxygen cocktails and other medical preparations with circulatory failure.
Section designed for pediatricians and rheumatologists.
Contains 8 tables, illustrated 30 drawings, a bibliographic index - 169 items.
Table of contents
Chapter I. Etiology of acquired heart diseases
Endocarditis different etiology
Chapter II. Vices butterfly valve
Failure butterfly valve
The narrowing of the left venous mouth (mitral stenosis)
Combined mitral heart disease
Chapter III. Aortic heart defects
The aortic valve insufficiency
Combined aortic Vice
Chapter IV. The vices of the tricuspid valve
The tricuspid valve insufficiency
The narrowing of the right atrioventricular holes (tricuspid stenosis)
Chapter V. Concomitant disease of the heart
Failure bivalve and aortic valves
Stenosis of the left atrioventricular holes and aortic valve insufficiency
Stenosis of the left atrioventricular holes and lack butterfly valve in conjunction with aortic valve insufficiency
Metrolina-tricuspid and Microline-aortic-tricuspid vices
Chapter VI. Circulatory insufficiency with acquired heart diseases
Chapter VII. Treatment of children with acquired heart diseases
Treatment of heart failure
During the years of Soviet power in connection with a permanent concern of the Communist party of the Soviet Union and the Soviet government about people, about people's health has been great progress in the protection of the health of the younger generation.
Significantly decreased the incidence of many serious diseases has sharply decreased child mortality.
The directives of the XXV Congress of the Communist party of the Soviet Union on the five-year development plan of national economy of the USSR in 1976-1980, planned the further prospects of improvement of health of children - the future builders of communism. Decisions of the Congress was a powerful stimulus for carrying out complex of measures on improving protection of people's health, especially women and children.
In connection with the creation of a coherent system for the prevention and treatment of rheumatism in our country over the last 15-20 years, great progress has been made in reducing the prevalence and reduced primary incidence of this disease in childhood. More than in 2 times reduction in the number of children suffering from rheumatic heart disease. Despite this, the percentage of occurrence of acquired heart disease in children remains relatively low, although in recent years it has become rather stable and is, according to many authors, 12-18%. According to the Leningrad cardiological dispensary, over the last 10 years, the incidence of heart disease rheumatic heart disease after primary held almost at the same level (in 1965 - 16 %, in 1975 - 15,6 %).
Long experience cardiological Department of the hospital. K. A. St Petersburg and cardiological sanatorium "Labour reserves" indicates that the most common acquired heart disease in children is mitral valve insufficiency (61,8%). the second place is combined mitral heart disease (16,8%), the third place is isolated aortic insufficiency (10%). "Pure mitral stenosis among acquired heart disease in children has a very small proportion (of 3.1%).
For the correct treatment and the most rational recommendations of the mode of exercise is very important functional assessment of hemodynamic where you need to take into account the degree of compensation of Vice. Therefore we consider very useful in the formulation of diagnosis acquired blemish to specify the degree of compensation (for example, for mitral insufficiency assessment of the degree of compensation, F. lang) and, of course, the degree of heart failure. The decreased incidence of circulatory failure (according to our observations, it is in 1974-1976, in comparison with 1972-1973 decreased almost twice), apparently due to a decrease in the extent of the damage valvular heart in the well-set stage of treatment: the active phase of rheumatoid arthritis in hospital, later in local sanatoria and, finally, monitoring conducted by kardioreumatology district polyclinics. Not less important and year-round carrying out bicimlendirilmis.
The possibility of rendering aid to patients with acquired heart diseases currently significantly expanded: in addition to the large complex of therapeutic measures, has successfully been applied surgical treatment. In this regard, greater importance has acquired an accurate clinical diagnosis of acquired heart diseases, timely and correct decision of a question on the degree of manifestation of one or another blemish on the availability of hypertension in the pulmonary circulation, on the stage of circulatory failure, and so on, is of great importance, in what period of rheumatism - active or inactive - is the patient. Only wide-ranging assessment of the child with a heart defect allows you to properly approach the issue of treatment, in particular to prevent the possibility of application of surgical methods. To solve these tasks, the pediatrician should, in addition to knowledge of the clinics of this or that heart disease, its complications, to be able to analyze the data of additional research methods : x-ray, ECG, phonocardiographic.
Therefore, the authors sought at the level of modern knowledge to cover the clinic, diagnosis, prognosis, treatment and prevention of acquired heart diseases in children.
In section used not only literature, but also many years of personal experience of the authors. For compiling this into account these observations for 220 children aged from 7 to 15 years with acquired heart disease who were treated and observed in the cardiological Department of the hospital. K. A. in St Petersburg and in the cardiological sanatorium "Labour reserves" in 1972-1976,
In creating his work, the authors believe that it will be beneficial for doctors-pediatricians and kardioreumatology monitoring children suffering from heart diseases and their treatment.