Detection and treatment of hypertrophic cardiomyopathy in children

The article is professionally consulted by Resident Doctor, Doctor Nguyen Hung Tien - Resident Doctor of Pediatrics - Neonatology - Department of Pediatrics - Neonatology - Vinmec Hai Phong International General Hospital. Dr. Tien has more than 8 years of experience in the field of Internal Medicine - Neonatology, specializing in Emergency Resuscitation, Pediatric Cardiology, Neonatal Resuscitation and has been trained nationally and internationally. His strength is examination, emergency, consultation and treatment of common diseases in children, neonates, congenital heart defects, echocardiography and pediatric cardiovascular interventions.

Hypertrophic cardiomyopathy disrupts the heart's ability to contract and circulate blood, affecting the heartbeat, leading to arrhythmias. This is also a common cause of sudden death in young people, early detection and treatment help reduce the risk of death and increase the effectiveness of treatment.

Hypertrophic cardiomyopathy is relatively rare in children, the incidence is 1/500 is a disease of the heart muscle, caused by the abnormal growth of your heart muscle fibers causing the wall of the heart to thicken, especially is in the left ventricle, which leads to a narrowing of the left ventricular cavity, the ability to pump blood to the organ decreases, not providing enough oxygen for the body.
The disease often has no obvious symptoms, so it is often the cause of sudden death in athletes and young people.

2.1 Genetic factors Genetics is the main factor seen in hypertrophic cardiomyopathy in children, accounting for up to 50% of cases, the disease is inherited according to the dominant gene trait. This means that if a family member has the disease, other family members should also get tested for an early diagnosis.
2.2 Overload during the systolic period After a period of time, the ventricular contractions are overloaded, which also leads to hypertrophy, seen in diseases such as: aortic valve stenosis, coarctation of the aorta, hypertension, children mother with diabetes, neonatal corticosteroid treatment...
2.3 Other systemic diseases Noonan syndrome, glycogen metabolism disease...

To detect hypertrophic cardiomyopathy in children, you need to pay attention to follow up based on suggestive signs such as:
Shortness of breath, shortness of breath while walking or when the child exerts himself; Chest pain, dizziness, and lightheadedness on exertion accompanied by fainting; Fast or irregular heartbeat. However, most patients with this disease have no symptoms and the person can live a normal life like a normal person. Especially in cases of genetics, most of them are normal in the beginning, then symptoms such as palpitations, shortness of breath, chest pain and syncope appear on exertion. In addition to the above signs, hypertrophic cardiomyopathy in children can be detected by the following measures:
3.1 Clinical examination The doctor examines and listens to the heart with a murmur, the turbidity of the heart is wide..
3.2 Clinical examination Clinical In order to accurately diagnose the disease state, it is necessary to rely on subclinical signs
Electrocardiogram (ECG): Expression of left ventricular thickening, disorder of repolarization. Echocardiography: Helps to diagnose accurately, in addition, it can evaluate the extent of myocardial damage, the location of the enlarged myocardium, find the location of the blockage in the ventricles and the filling disorders of the heart.

4.1 Treating the cause First of all, find the cause, treat the cause first, such as intervene in cases such as aortic stenosis, coarctation of the aorta.
For idiopathic cases without a cause, the main treatment is lifestyle changes and symptomatic treatment.
4.2 Symptomatic treatment 4.2.1 Medical Treatment is the mainstay of medication, which includes:
Reducing heart rate and preserving myocardium with beta-blockers, eg propranolol. Prolong diastole and increase contractility with calcium channel blockers. Treat arrhythmias such as cordarone. Improvement of left ventricular dilatation with Avlocardyl 4.2.2 Surgery When treatment fails with drugs, unresponsive patients must use surgical methods or pure alcohol ablation for treatment.
Myocardiectomy: The enlarged portion of the interventricular septum will be removed to free the left ventricular outflow tract without obstruction. At the same time, surgery can repair the pathological heart valves for the patient. After surgery, up to 90% of patients with hypertrophic cardiomyopathy improve their condition and lead normal lives more than 30 years later. Myocardial ablation with pure alcohol: This method has just been applied recently, people put a catheter through the artery to the coronary artery supplying blood to the enlarged part of the heart muscle; After determining the appropriate branch of the artery, the surgeon will inject 3-4ml of pure alcohol, that branch of the artery will be blocked and stop the blood supply to the enlarged myocardium, resulting in the enlarged part of the heart. shrink after 8-12 weeks. However, this method is only suitable for certain patients. Heart transplant: Some patients need a heart transplant when they have severe heart failure and are unresponsive to treatment. 4.3 Lifestyle changes Avoid exertion and avoid participating in high-intensity sports such as football, basketball, athletics, etc. Follow up and follow up with your doctor on schedule to understand your condition. health. Adhere to medication and nutrition according to the advice of the treating doctor. Hypertrophic cardiomyopathy in children is mainly caused by genetic mutations, so the way to detect it early is when one family member has the disease, other family members should also be tested. In addition, when seeing a child with abnormal signs suggesting cardiovascular disease, they should go to the doctor and receive early treatment, to avoid being too severe, causing serious consequences.
You should take your child to medical facilities with pediatric cardiology for accurate diagnosis and early treatment. The Pediatrics Department at Vinmec is one of the few multi-specialty hospitals with a full range of doctors specializing in neurology, cardiology, gastroenterology, nutrition, psychology, endocrinology, hepatobiliary medicine, helping to quickly and promptly handle patients with medical conditions. detect diseases during the examination. As a key area of ​​Vinmec Health System, Pediatrics Department always brings satisfaction to customers and is highly appreciated by industry experts with:
Gathering a team of leading pediatricians: including leading experts, with high professional qualifications (professors, associate professors, doctorates, masters), experienced, worked at major hospitals such as Bach Mai, 108.. Doctors All of them are well-trained, professional, have a mind - range, and are knowledgeable about young psychology. In addition to domestic pediatric specialists, the Department of Pediatrics also has the participation of foreign experts (Japan, Singapore, Australia, USA) who are always pioneers in applying the latest and most effective treatment regimens. . Comprehensive services: In the field of Pediatrics, Vinmec provides a series of continuous medical examination and treatment services from Newborn to Pediatric and Vaccine, ... according to international standards to help parents take care of their baby's health from birth to childhood. from birth to adulthood Specialized techniques: Vinmec has successfully deployed many specialized techniques to make the treatment of difficult diseases in pediatrics more effective: neurosurgery - skull surgery, stem cell transplantation. blood in cancer treatment. Professional care: In addition to understanding children's psychology, Vinmec also pays special attention to the children's play space, helping them to have fun and get used to the hospital's environment, cooperate in treatment, improve the efficiency of medical treatment. To register for examination and treatment with Pediatricians at Vinmec International General Hospital, please book an appointment on the website for service.