Cardiovascular diseases represent the main cause of death in adults. Fighting these conditions would be more effective if the diagnosis and especially prevention of cardiovascular diseases began in childhood. The total number of children suffering from cardiovascular diseases increased by 1.5-fold in past decades. Rheumatic diseases occur less frequently in children, but, as a rule, they are represented by chronic pathology, leading to early disability and a significant life quality deterioration.
Rheumatic diseases are often associated with symptoms of cardiovascular disease and vice versa, so it seems reasonable to discuss cardiovascular diseases and rheumatic disorders in one chapter. For example, valvular heart disease with the subsequent development of circulatory failure in patients with a history of carditis during an initial acute rheumatic fever episode. Many rheumatic diseases are treated with systemic glucocorticoids, and arterial hypertension is an adverse effect associated with glucocorticoid therapy. So, for long time, in Russia, there was a single pediatric subspecialty called 'cardio-rheumatologist', thus emphasizing commonality of these diseases.
CARDIOVASCULAR DISEASES
Congenital heart defects
Congenital heart defects (CHD) occur at the critical period of fetal cardiovascular system formation at 5-8th weeks of primary heart tube development (fig. 6.1).
There are three stages in the development of the heart and main vessels: 2-4 weeks - formation of the primary cardiac tube; 5-8 weeks - development of the heart and large blood vessels; 10-12 weeks (placental period) - growing size of the heart, volume of muscle layers, and blood vessels differentiation.
Etiology and pathogenesis