Children with congestive heart failure clinical manifestations

The symptoms and signs of congestive heart failure was mainly due to cardiac decompensation dysfunction, sympathetic excited, congestive venous system, increased blood volume and sodium and water retention caused by. Because of age, etiology and the different hemodynamic changes, Therefore, clinical characteristics in children of different age groups have some differences.
1. Period symptoms in infants Neonatal lethargy frequently manifests itself, weak, weak, and rejection of milk or vomiting. Infants of heart failure symptoms often not typical, a general acute onset, the disease progress rapidly, with fulminant after. Acute myocarditis and cardiac periosteum fibroelastosis in heart failure, often intense onset. Children can be a few minutes to a few hours or sudden breathing difficulties, inspiratory capacity at the sternum and rib along on both depression, breathing by quickly, and often more than a minute 60, or even 100 times. At the same time vomiting, irritability, sweating and looking pale or bruised and limbs of cool, the pulse fast and powerless, tachycardia, there are law, lung stem 1,10 audition for the performance of acute congestive heart failure. Congenital cardiovascular malformations such as atrial septal defect sustained chronic congestive heart failure, slow onset, symptoms mainly feeding difficulties, children with a small amount of milk Naturally, there is difficulty in breathing, fatigue and anti-feeding, weight should not increase. Fidgety hyperhidrosis, and grabbed willing to rely on the shoulders of the adults (which is the performance of infant respiratory sit), there are also quiet breathing difficulties, commonly found in cough, the sound of children with weak, and sometimes voice hoarse, as the expansion of the left pulmonary artery pressure due to the recurrent laryngeal nerve. Heart former District prominent, enhanced apical pulse, heart sector expansion. Hepatosplenomegaly, the blunt edge of a round, and tenderness. Lung wet 1,10 often no sound or only breathing sound. Jugular and no obvious swelling, weight gain only through the observation of the situation to judge the degree of swelling.
2. Symptoms of older children
Older children and adults in the performance of heart failure similar to the slow onset and more. Left and right heart failure performance are as follows:
(1) Left Heart Failure: can be found in patients with rheumatic mitral valve disease and hypertensive heart disease, the main symptoms due to acute or chronic lung congestion caused by. Clinical manifestations are:
① dyspnea: often the earliest symptoms began lighter, only after the emergence of children with limited activities, easy fatigue, while the rest at the end there, breathing fast and shallow. Have breathing difficulties due mainly to the lungs caused congestive respiratory center of the reflection stimulate enhanced. Regular breathing difficulties when lying on the increase in children with Hei take it sitting, showing respiratory sit phenomenon, as a result of sitting at the gravity of the blood accumulated in the lower extremities and more intra-abdominal, back to right ventricular blood volume reduction, it reduced lung congestion, dropped another seat at the diaphragmatic, pleural easy expansion. Paroxysmal nocturnal dyspnea rare in children.
② cough: because of lung congestion, bronchial mucosa congestive caused a chronic cough. ③ hemoptysis: 1,10 bleeding can result when blood oxygenation through the role of pulmonary vascular insufficiency.
④ bruised and generally heavier, as a result of blood through the lung congestive pulmonary vascular insufficiency when oxygenation.
⑤ lungs may have wheezing sound or moist 1,10 tone.
⑥ acute pulmonary edema: As caused acute left ventricular failure, congestive lung sharp deterioration, fluid accumulation in the alveolar capillary leakage within. Children with extreme difficulty breathing, sit breathing, cyanosis or pale skin, lips cyanosis due to sharp decline in stroke volume, it appeared extremities cool, fast and weak pulse of less than or inconsistent, occasionally alternating vein, that is a strong and the other weak pulse , blood pressure drop, tachycardia often law, a wheezing sound both lungs and moist 1,10 tone, the frequency of cough in children with a Xuemei sputum, a large number of serious Xiemei liquid from the nose and mouth emission.
(2) Right Heart Failure: The left ventricular failure can be caused by the left pulmonary congestive heart failure, pulmonary artery pressure increased, the increase in right ventricular systolic load; congenital cardiovascular malformations are often associated with pulmonary hypertension occurred right heart failure. Right heart failure symptoms of congestive mainly caused by the cycle of clinical manifestations are:
① edema: seen at the beginning of pituitary body parts, serious cases, mainly due to two: one for renal sodium and not on the back of increased absorption, increased extracellular fluid; for a systemic venous pressure increased, the capillaries into the interstitial returning to more moisture lymphatic capillaries and the more.
② hepatomegaly accompanied on a pain: acute heart failure, abdominal pain and tenderness over the liver, liver blunt edge of a round, liver may appear in edema before, and are thus right early symptoms of heart failure. Chronic heart failure, long-term liver bleeding may occur jaundice.
③ jugular: sitting at the jugular and still more obvious when oppression liver (liver neck reflux levy).
④ loss of appetite, nausea, vomiting, due to venous stasis caused by gastrointestinal tract.
⑤and mild proteinuria and a few red blood cells, caused by bleeding due to the kidney.