Research methods and sobennosti children's heart

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During the collection of anamnesis in children with heart disease should determine the nature of all transferred their diseases, presence of family heart disease, the facts appearance of cyanosis, feeding, crying, etc., During the inspection reveal the physical development of the child ( congenital heart defects, for example, possible infantilism), and the presence of dyspnea, cyanosis, heart hump, pulsation of peripheric vessels, fingers as drum sticks. At a palpation of the heart area define the nature and distribution of the apex beat. Percussion heart that children should be quiet, set the boundaries of the heart. It is necessary to take into account age peculiarities of children's heart (table. 1).
Data auscultation of the heart in children have some peculiarities. In the first two weeks of the child's life see embrionario, i.e. equality of pauses between the first and second, and the second and the first warm tones. In infants heart sounds moderately impaired, at the age of two second tone on the pulmonary trunk accentuation and often split. Children may listens functional and organic noise. Functional noise observed in children at school age and in the period of puberty. They arise when anatomically intact valves and valve openings and result from functional disorders of the heart muscle and valve system, as well as changes in current and composition of blood. Organic noise associated with anatomical changes of the valves or close their holes. The differential diagnosis between functional and organic noise is very complicated. For organic noise is characterized by consistency. They always wired, i.e. are heard almost all points. At change of body position they remain. For functional noise characterized by significant variability, which is revealed when listening to the child lying down and standing up.
In the study of the cardiovascular system in children using functional tests that help to determine reserve opportunities of an organism, the limits of the functional capacity of the circulatory system. In children, functional tests are used to identify the start or the latent insufficiency of blood circulation, and to assign the correct mode.

Table 1. The position of the cardiac impulse and the border of relative dullness of heart in children
Age (years) Push heart Borders of heart The diameter of the heart, see
top left right
0-2 1-2 cm outwards from the left srednesrochnoi line II edge 1-2 cm outwards from the left srednesrochnoi line Right parasternal line 6-9
3-7 1 cm outwards from the left srednesrochnoi line II intercostal space 1 cm outwards from the left srednesrochnoi line Medially from right parasternal line 8-12
7-12 On srednesrochnoi line or 0.5-1 cm inwards from it III edge Srednekolymsky line The right edge of a breast bone 9-14