Syndrom hypoplastického levého srdce u dětí

1.8.2013

syndrom-hypoplastickeho-leveho-srdce.jpg - kopie
syndrom-hypoplastickeho-leveho-srdce.jpg - kopie
Syndrom hypoplastického levého srdce u dětí je vrozená srdeční vada, při které je neadekvátně vyvinutá levá strana srdce. Během několika dnů po narození začne dítěti selhávat srdce. Dítě začne slábnout, trpí dušností, má potíže s jídlem a je velmi bledý a promodralý. Lékař stabilizuje stav dítěte nitrožilně podávanými léky, dítě bude muset podstoupit operace a pokud nebudou úspěšné, je jedinou možností transplantace srdce.

Syndrom hypoplastického levého srdce u dětí

Syndrom hypoplastického levého srdce je vrozená srdeční vada spočívající v neadekvátně vyvinuté levé straně srdce. Levá srdeční komora dítěte (pumpující komora), levá síň (komora, do které přichází krev z plic), aorta (hlavní krevní céva vedoucí ze srdce) a chlopně v levé části srdce nejsou správně vyvinuté. Následkem toho musí pravá strana srdce pracovat za dva, aby zajistila krevní oběh v těle dítěte. Během několika dnů po narození začne dítěti selhávat srdce. Bez okamžité léčby dítě do týdne umírá.

Příznaky syndromu hypoplastického levého srdce

Novorozenec se syndromem hypoplastického levého srdce vypadá zpočátku zdravě, ale začne slábnout, trpí dušností, má potíže s jídlem a je velmi bledý nebo promodralý. Má slabý pulz a vykazuje známky městnavého selhání srdce - nadměrné pocení, zduřelé břicho a potíže s dýcháním. Lékař často zjistí šelest na srdci. Srdce dítěte selhává a během několika dnů po narození se zastaví v důsledku špatného krevního oběhu.

Diagnóza a léčba 

Pokud se známky a příznaky projeví ještě v nemocnici, lékař obvykle určí diagnózu na základě rentgenu hrudníku, echokardiogramu nebo elektrokardiogramu. Objeví-li se příznaky této nemoci po příchodu domů, okamžitě dítě odvezte do nemocnice na vyšetření.

Lékař stabilizuje stav dítěte nitrožilně podávanými léky udržujícími srdeční činnost a krevní tlak. Během několika dnů bude muset dítě podstoupit operaci, při které mu bude provedena rekonstrukce levé části srdce. Po této operaci bude za 12 až 18 měsíců následovat druhá operace. Mezi operacemi bude dítě užívat antibiotika proti infekci a dále léky stabilizující srdeční činnost a krevní tlak. Lékař bude vývoj jeho stavu pečlivě sledovat. Nepodaří-li se touto dvoufázovou operací srdeční vadu odstranit nebo není operace vzhledem k závažnosti poruchy možná, doporučí lékař pravděpodobně jako jedinou možnost záchrany života dítěte transplantaci srdce, bude však třeba najít vhodného dárce.

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