Arrhythmia in children

Many concepts of failures in the work of the heart of children are combined into the common name "arrhythmia in a child." Pathological processes directly affect the frequency of heart contractions, their regularity and sequence.

The main muscular organ can work irrationally in children of any age. Sometimes the heart gives an arrhythmia in the norm, but more often this is a consequence of the pathology.

In childhood, the clinic of diseases is most often nonspecific, which creates difficulties for their diagnosis and early recognition.

The list of laboratory and instrumental studies is carried out in accordance with the characteristics of the growing organism.

Etiology and epidemiology

Pediatric practice is complicated by arrhythmias and similar pathologies much more often than therapeutic supervision of adults. Experts in this industry study in detail the reasons for statistical indicators for the most effective prevention. A separate discipline of pediatric cardiology has also been formed, which is also indirectly divided into subsections: it studies the pathologies of infancy, preschool age, arrhythmia in adolescents is considered separately.

Sometimes failures in the work of the heart occur even with the absolute health of the child. The main muscular organ may have a rarer or more frequent rhythm, contraction drivers may move in it, and blockades of the pathways may occur.

The first group combines etiological factors that have an origin directly related to the organ:

1. Congenital heart defects against the background of intrauterine infection, developmental delay, prematurity of the fetus.
2. Surgical interventions on the heart, pericardial sac.
3. Valvular and cardiac muscle defects of an acquired nature.

Arrhythmia in children as a consequence of an extracardiac cause of cardiac pathology occurs:

1. Due to the penetration of infectious agents into the myocardium, the inflammatory course of vasculitis, rheumatic disease. Myocarditis can become a complication of inflammation in the laryngopharynx, any intestinal infection, pneumonia. Sepsis is also unpredictable in terms of the formation of inflammatory foci that can also appear in the heart.
2. Due to dilated or dystrophic transformation of the heart against the background of intensive growth, disproportionate to the increase in the organ.
3. Sometimes the causes of rhythmogenic failures lie in malignant oncopathology in the heart.
4. There is a high risk of getting a heart injury in childhood, which will become a provocateur of unpredictable failures in its work.
5. Iatrogenic damage to the main muscular organ is carried out when probing its cavities, as well as during the angiography procedure.

Arrhythmia in adolescents often has psychogenic causes of functional disorders. Neurohumoral failures in the regulation of heart rate are observed with frequent emotional upheavals, experiences, and chronic stress.

Common pediatric classification

The myocardium is a special type of muscle tissue, which is endowed with unique properties of automatic excitation, excitation from an impulse and its conduction.

Against the background of these unique qualities, arrhythmia in children began to be divided into groups of similar pathologies:

1. When the automatism of the heart fails, the sinus node fires more or less frequently, resulting in tachycardia or bradycardia, respectively. The pacemaker is completely capable of migrating through the organ and creating separate elusive rhythms.
2. If the conduction of the heart suffers, the pathological process causes such emergency conditions as atrial flutter, paroxysm.
3. Conduction failure usually gives blockades of various parts of the heart. Separately, the atria, ventricle, and atrioventricular node can stop conducting the impulse.
4. Arrhythmia in children can be combined, which is unusual for adults.

This phenomenon is indicated by separate syndromes:

• weak sinus syndrome;
• long QT syndrome.

It is simple and convenient, as it divides cardiac failures into asymptomatic, not posing a threat to the life of the child, and clinically significant. Infrequent extrasystoles, sinus contractions or an increase in the number of contractions, and the movement of pacemakers during sleep may not interfere with the active life of the child at all. Clinically significant arrhythmias that attract attention, are stable and difficult to stop.

The main symptoms and their compensation

Arrhythmias are also detected in the emergency room infrequently, usually during a planned medical examination or during a complete examination for other diseases.

Close observation of the child, in particular, the baby, helps to identify arrhythmia.

Usually mothers notice for a short time:

• behavioral changes in children;
• change in color of the skin and visible mucous membranes;
• refusal of food and breast milk;
• inefficient suckling or meager weight gain.

The child may sleep restlessly; when crying, the cervical vessels may pulsate markedly.

Children close to school age with undiagnosed arrhythmia:

• have increased fatigue;
• physically unbearable;
• do not tolerate heat and climate change;
• complain of dizziness;
• noted pain in the chest;
• fall into a swoon.

Usually, arrhythmias do not develop outside of etiological causes so that they suddenly lead to death. However, arrhythmia with prolongation of the QT interval can provoke heart failure and acute hypoxia, which is fraught with multiple organ failure.

If you suspect a rhythm failure in a child, the doctor takes into account his age characteristics. The smaller the child, the higher his pulse and the greater the number of heartbeats, which should not lag behind each other.

Frequent non-functional arrhythmias do not require therapeutic compensation.

These children are provided with:

• normalization of sleep and wakefulness;
• limitation of emotional and physical stress in a protective regime in a hospital or at home.

Drug treatment of arrhythmia is indicated if an infection is recorded in its etiology, there is an electrolyte imbalance, severe somatic pathology. Modified surgical interventions on the heart in children in the absence of the effect of drugs are also common. Arrhythmogenic zones are eliminated by setting a pacemaker, by means of ablation of pathological foci.

Methods for diagnosing and eliminating arrhythmias are constantly being improved, especially in pediatrics.