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Ailmemts & Remedies Pediatric

Heart Murmurs in Babies

Definition
The heart has four separate chambers, and four one-way valves attaching them. The two lower chambers pump, and they’re called ventricles. The two upper chambers accept incoming blood, and they’re called atria.

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Blood that’s low in oxygen comes from the body into the right atrium, then goes through a valve into the right ventricle, and over to the lungs to get more oxygen. That oxygen-rich blood returns to the heart through the left atrium, then across a valve into the left ventricle. From there it’s pumped through the aorta, which is a large blood vessel, and on to smaller blood vessels throughout the body.

A heart murmur is the term used when an extra swishing sound is heard besides the normal heartbeat, which is the sound of the valves opening and closing. A doctor can hear these sounds with a stethoscope, but a child needs to sit very quietly for that to happen, because his heart is near his chest wall, and outside sounds can get picked up. You might be asked to hold your baby in your lap while the doctor listens, or calm him down; if he’s crying, it’s almost impossible to hear a murmur.

Parents often panic when they are told their baby has been diagnosed with a heart murmur, yet do not realize that heart murmurs are actually common in babies and that, in general, they resolve themselves without affecting the baby’s overall health.Murmurs are very common during childhood and the vast majority are not a sign of disease or anything to worry about. It is extremely important for parents to understand which type of murmur their child has been diagnosed with, if it requires further evaluation and treatment options available if the result is a serious heart defect.

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Symptoms:
There may be no other symptoms – a murmur is generally diagnosed by the sound heard through the stethoscope.

These murmurs usually get resolved by the time the child become adult. The defective heart murmur may need to be tested to find out the real cause of it. The child with innocent murmur can live as healthy life as any other child of healthy heart. Pathological heart murmurs is a defect in the heart with a hole which may be there in the two chambers of the heart. The chest pain, rapid heart beat, bluish color or fingertips, shortness of breath, fainting, fatigue with exertion and signs of congestive heart failure are some of serious symptoms of this disease.

However, if the murmur is due to disease – ie, it isn’t harmless or ‘innocent’ – the child may be cyanosed (blue, especially around the lips), short of breath (especially on feeding), off their feeds, failing to thrive (poor growth) or have frequent chest infections.

Causes:
The majority of heart murmurs are the result of the fast rate at which children’s hearts beat or normal variations in the structure of the heart. Some factors, such as fever or excitement, make these innocent murmurs more likely because they increase the speed at which the heart pumps.

The common cause of baby’s heart murmur is congenital heart disease which may occur when blood vessels or valves attached to the heart don’t get developed even before the child is born. Some children may get birth with heart defects. One in hundred children may be found with this type of birth disorder.

. Some serious heart defects may be due to some illnesses like rheumatic fever, heart disease, heart attacks. It is due to heart defects in structural disorder of a baby’s heart. The defects may be of valve abnormalities, cardiomyopathy and septal which produce murmur. Cardiomyopathy is usually a heart disorder of muscle which can result in defective functioning of the heart.

However, a heart murmur is also the most common sign of congenital heart defects caused by abnormal development of the heart tissues. This may be atrial or ventricular septal defects – a hole in the heart or an abnormal hole between two heart chambers. Sometimes the connections between vessels from the heart don’t close after birth as they should, resulting in patent ductus arteriosus.

Other abnormalities of the heart valves and still rarer problems can also cause a murmur.

Heart murmurs may also be caused by heart failure and infection involving the heart.

Diagnosis:
Although parents often fear the worse, not all heart murmurs are serious. They’re graded on scale from 1 to 6, where 1 is almost inaudible and 6 is quite loud. When your baby’s doctor hears it, he’ll note where in the heart it occurs, at what point in the heartbeat cycle, what type of sound it makes, and whether the noise changes when your child moves. If further evaluation is required, your child will be referred to a pediatric cardiologist.

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Sometimes a heart murmur will be heard at one appointment, when it wasn’t noticed at the last one. This could be because heart murmurs are better heard when children are in certain positions or have a different heart rate. It could also mean it’s due to a heart problem that’s recently developed, or one that’s been there since birth but hasn’t been severe enough to make a detectable murmur.

It can be difficult to tell an innocent murmur from a suspicious one. If a child has an unusual murmur but seems well, the doctor may suggest the child comes back for review in a few weeks or months.

Tests including a chest x-ray, electrocardiogram and echocardiogram may be recommended to examine the structure of the heart and check for abnormalities. If heart disease is suspected, more extensive tests may be needed.

Treatment :
The treatment of innocent murmur is not required at all. Congenital heart defects may be diagnosed after conducting laboratory tests. The parents should consult pediatric cardiologist after confirming the tests. The doctor will provide the suitable treatment to regulate the proper blood flow to the heart.

Some medications may solve the problem but in case of severity, the surgery can be conducted to treat the ailment. The mitral valve prolapsed may not require any treatment but only periodic checkups can be sufficient to be conducted. The doctor can prescribe some anti-biotic but medications should never be self prescribed which pose some serious problems.

The surgery may be conducted in serious types of cases. The anti-clotting medication, medications to put control on irregular heartbeat, palpitations and to open the blood vessels

Alternative treatment:
If a heart murmur requires surgical treatment, there are no alternative treatments, although there are alternative therapies that are helpful for pre- and post-surgical support of the patient. If the heart murmur is innocent, heart activity can be supported using the herb hawthorn (Crataegus laevigata or C. oxyacantha) or coenzyme Q10. These remedies improve heart contractility and the heart’s ability to use oxygen. If the murmur is valvular in origin, herbs that act like antibiotics as well as options that build resistance to infection in the valve areas may be considered.

Prognosis
Most children with innocent heart murmurs grow out of them by the time they reach adulthood. Severe causes of heart murmurs may progress to severe symptoms and death.

Prevention:
Heart murmurs in infants or babies can not be prevented but the blood pressure may be treated before the heart murmur gets developed. It is also advised to prevent rheumatic fever in the children to prevent heart murmurs. The regular check ups may be conducted to get to know the defects in advance to treat the ailment.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Sources:
http://www.ehow.com/about_5280475_heart-murmur-babies.html
http://health.stateuniversity.com/pages/696/Heart-Murmurs.html
http://www.livestrong.com/article/22104-heart-murmur-babies/
http://www.bbc.co.uk/health/physical_health/conditions/in_depth/heart/heartmurmurs2.shtml
http://www.mychildhealth.net/what-causes-baby-heart-murmur.html

http://fromyourdoctor.com/topic.do?title=Heart+How+it+Works&t=7986

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Coming soon, the Hips and Knees that will Never Wear Out

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Replacement body parts that never wear out could become a reality within a few years as the  scientists say.

Dodgy knees and hips will be repaired using tissue engineering, while donor heart valves from animals are being specially treated to last indefinitely.
Longer-lasting artificial joints are already being tested in a bid to ensure people will be able to enjoy another 50 active years.

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X-ray of female pelvix with total hips replacement

Scientists at the University of Leeds Institute of Medical and Biological Engineering have launched a £50million research initiative focused on areas of the body most affected by ageing, including joints, spine, teeth, heart and circulation.

Unlike studies involving stem cells and growing ‘spare parts’ in a lab, the programme uses the body’s own regenerative systems. The Leeds scientists have developed a chemical wash that strips cells away from donated cartilage, heart valves, blood vessels and other tissue before they are put into a human body.
Research shows they become repopulated with cells within about six months. Some 40 patients have already been treated with modified heart valves in a study in Brazil.

Professor John Fisher, director of the institute and one of the world’s leading researchers into artificial joints, said research so far had shown the valves did not deteriorate and were not rejected by the body, because ‘foreign’ donor cells had all been stripped away.
The unique method of removing living cells from human and animal tissue creates a biological ‘scaffold’ that can be regenerated within the body, at the site which needs repairing.

Worn-out ligaments and cartilage in knees can be replaced with a scaffold that will eventually attract cells to make the joint last longer.

Other areas targeted for treatment are the spine  –  where discs can be replaced  –  elbow and shoulder tissues and parts of the knee. Vascular patches are being devised that seal the holes made in arteries when surgeons clear a blockage.

The technique is not suitjointsable for whole organs, however. Professor Fisher has also designed a ceramic-on-metal hip joint that reduces ten-fold the wear and tear on artificial joints.

As a result people should be able to get spare parts at an earlier age, when they are less disabled, and they could last up to 50 years, he said.

The professor added: ‘Hip have been used for nearly 50 years but nowadays people want to cycle, play tennis, even go skiing, so they have to last longer.’
He said a scaffolding transplant would cost only around £1,000 a time. It was much more expensive to grow cells outside the body, and there was a higher infection risk.

Professor Eileen Ingham, deputy director of the Institute, said stem cells were not the answer to structural replacement of wornout bits of the body such as heart valves.

She said: ‘We are working with the NHS National Blood & Transplant Tissue Services to apply it to human donor valves. Once a patient has one, it should last a lifetime.’

Professor Christina Doyle, chief executive of Xeno Medical, predicted that in 20-30 years there would be techniques capable of regenerating human tissue off-the-shelf for use in operations.

She said: ‘It will be a case of the surgeon dialling up for spare parts to be delivered in a sterilised plastic bag.’

Source:Mail Online, 20th. Oct.’09

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