Enlarged heart in a child

Heart disease is very common not only in adults, but also in children of different ages. They can be detected in a newborn, and in a nursing baby, and in a schoolchild, and in a child of adolescence. One of the manifestations of such diseases is an enlarged heart, which is also called cardiomegaly.

What is it

An enlarged heart in a child is diagnosed based on changes in its size and shape. At the same time, either one chamber of the heart or the whole heart can increase in a child. Moreover, its increase can occur due to the expansion of the chambers, in which the walls remain thin, and due to the thickening of the walls, which is called hypertrophy.

Causes

The following pathologies can lead to an increase and expansion of the heart in a child:

Congenital heart defect. An enlarged heart is provoked by defects such as patent ductus arteriosus, Ebstein's anomaly, aortic stenosis, tetralogy of Fallot, pulmonary artery stenosis, atrial septal defect, and others.
Acquired defect caused by bacterial endocarditis or rheumatism. As a result of inflammation of the inner lining of the heart, the valves are damaged, which leads to problems in the work of the heart. The disease manifests itself with fever, weakness, abnormal murmurs, and other symptoms.
Myocarditis. Such a fairly common disease is inflammation of the heart muscle caused by viruses, bacteria or other pathogens.
Cardiomyopathy. This is a genetically determined heart disease, in which there may be a thickening of its walls (such cardiomyopathy is called hypertrophic) or expansion of cavities with thinning of the walls (this is a manifestation of dilated cardiomyopathy).
Heart surgery. In 20-40% of children who underwent such an intervention, it is possible to develop cardiotomy syndrome 2-3 weeks after the operation. The pathology is manifested by severe weakness, fever, chest pains, breathing problems and heart murmurs.
Oncological process in the heart or the development of a benign tumor in the tissues of the heart.
Extra-heart reasons for example, sarcoidosis, amyloidosis, hyperthyroidism, lupus, toxoplasmosis, collagenosis, certain medications, fasting.

Symptoms

The clinical manifestations of cardiomegaly are associated with disturbances in the functioning of the heart and a disease that provoked an increase in this organ. The most common symptoms of heart failure are noted in children. In the early stages, the child does not tolerate physical activity, he has shortness of breath and weakness, complaints of pain in the heart, increased fatigue. In case of serious heart disease, in which it increases in size, the child will have the following symptoms:

Increased heart rate.
Insufficient weight gain.
Slowdown in development.
Pale skin or cyanosis.
Swelling of the veins in the neck.
Increased liver size.
Swelling.
Frequent lung diseases.
Shortness of breath and cough.
Lowering blood pressure.
Violation of the rhythm of the heartbeat.

Diagnostics

The pediatrician can suspect an increase in the child's heart after examining the crumbs, because with him the doctor must assess how the chest looks, whether it is symmetrical, whether there are convex or flattened areas on it, whether it is enlarged and whether it has changed its shape. Next, the specialist palpates the chest, looking for pulse points and assessing whether they are in characteristic places. In addition, percussion and auscultation are used in diagnostics.

Having identified alarming changes, the baby is sent to:

Radiography. In most cases, it is on the x-ray that the heart is enlarged, because its darkening area with such a pathology becomes larger.
Echocardiography. This examination will confirm the presence of heart defects that could cause an enlargement.
Electrocardiography. The examination will confirm the presence of hypertrophy in the heart.
Heart tissue biopsy. This analysis allows you to see changes within the myocardium.

The purpose of all examinations will be to determine the cause of the enlargement of the heart, as well as to exclude conditions that can "disguise" as cardiomegaly, for example, excess fluid in the pericardium or in the pleural cavity.

What to do

If the child has an increase in the size of the heart, you should go with the baby to the cardiologist and undergo the necessary laboratory and instrumental examinations. Only after identifying the cause of cardiomegaly will it be possible to make the correct diagnosis, after which a cardiologist should choose the treatment for babies with an enlarged heart.

Depending on the cause of the cardiomegaly, the child may be prescribed antiarrhythmic drugs, antiviral or antimicrobial drugs, anti-inflammatory drugs, diuretics, glycosides, and other drugs. In some cases, such as birth defects, surgical treatment is recommended. In a serious condition, you have to resort to organ transplantation.