Parok heart mcb 10. Congenital heart defects. How is sinusitis treated?

Under congenital heart disease understand the isolation of diseases that are combined with anatomical defects of the heart or valvular apparatus. Their formation begins in the process of intrauterine development. The consequences of defects lead to violations of intracardiac or systemic hemodynamics.

Symptoms differ depending on the type of pathology. The most common signs are a pale or blue tint to the skin, a heart murmur, and physical and mental retardation.

It is important to diagnose the pathology in time, since such disorders provoke the development of respiratory and heart failure.

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birth defects hearts - ICD-10 code Q24 - include various pathologies of the cardiovascular system, accompanied by a change in blood flow. Subsequently, heart failure is often diagnosed, which leads to death.

According to statistics, 0.8-1.2% of the total number of newborns with the presented pathology is born annually in the World. Moreover, these defects account for about 30% of the total number of diagnosed birth defects in the development of the fetus.

Often the pathology under consideration is not the only disease. Children are born with other developmental disorders, where the third part is occupied by defects in the musculoskeletal system. In a complex, all violations lead to a rather sad picture.

Congenital heart defects include the following list of defects:

or ;
or ;
stenosis of the pulmonary artery;
open form of the arterial duct;

Causes

Among the causes of the presented pathology in newborns, I single out the following factors:

Chromosomal disorders	account for 5% of all detected cases; chromosomal aberrations often provoke the development of various intrauterine pathologies, as a result of which the child is born sick; in the case of trisomy of autosomes, a defect of the interatrial and interventricular septa is formed, and anomalies of the sex chromosomes lead to coarctation of the aorta.
Gene mutations	make up 2-3% of cases; the presented factor often provokes the occurrence of defects in the organs of the body; heart defects in such cases are only part of the possible dominant or recessive syndromes.
External factors	occupy up to 2% of all detected cases; here they distinguish diseases of a viral nature, taking illegal drugs and harmful addictions of the mother during pregnancy, radiation and radiation, and other harmful effects on human health in general; caution should be exercised in the first 3 months of pregnancy.
Rubella disease in a woman during pregnancy	This provokes glaucoma, cataracts, deafness, pathologies of the cardiovascular system, microcephaly - this disease leads to a change in the shape of the skull, as a result of which there is a developmental delay.
Viral diseases	In addition to rubella, diseases such as smallpox, herpes, hepatitis, HIV infection and tuberculosis, as well as adenovirus infections, are dangerous for a woman during pregnancy.
Use of alcohol and illicit drugs	against the background of a woman's alcohol addiction, a defect in the septa of the heart is formed in a child; adversely affect the use of amphetamines and anticonvulsants; any medicinal products must be subject to the approval of the attending physician.
Diabetes and rheumatism	The likelihood of developing fetal heart disease in women with the presented diseases is much higher.

The cause of pathology in newborns in the form of maternal diseases during pregnancy is 90% of cases. Risk factors also include toxicosis during pregnancy in the first trimester, threats of miscarriage, genetic predisposition, disorders endocrine system and "inappropriate" age for pregnancy.

Classification

Depending on the principle of changes in hemodynamics, there is a certain classification of the presented pathology. The classification includes several types of heart disease, where the key role is played by the effect on pulmonary blood flow.

Allocate:

Pathologies with unchanged blood flow in the small circle	The variety presented includes mitral defects, stenosis and coarctation of the aorta, and other disorders.
Pathologies with increased blood flow	Here, the defects are divided into two types, depending on the possible impact on the development of cyanosis. Provocative defects include an arterial duct of an open form, coarctation of the aorta of a child type, and others. Without consequences, atresia of the tricuspid valve and other defects are expressed.
Pathologies with poor blood flow	There is also a division into two groups: leading to the development of cyanosis and not leading to such complications.
Pathologies of the combined type	Determine violations of the anatomical relationship between the vessels and departments of a vital organ. Among the varieties presented include the discharge of the aorta, pulmonary trunk and other defects.

In practice, experts subdivide the considered pathologies of the heart into three groups.

Here are distinguished:

Violation of hemodynamics

Under the influence and manifestation of the listed factors-causes, the fetus in the process of development has characteristic disturbances in the form of incomplete or untimely closure of the membranes, underdevelopment of the ventricles and other anomalies.

The intrauterine development of the fetus is distinguished by the functioning of the arterial duct and the oval window, which is in the open state. The defect is diagnosed when they are still open.

The presented pathology is characterized by the absence of manifestation in fetal development. But after birth, characteristic disorders begin to appear.

Such phenomena are explained by the time of closing the message between the large and small blood circulation, individual characteristics and other defects. As a result, pathology can make itself felt some time after birth.

Often, hemodynamic disorders are accompanied by respiratory infections and other concomitant diseases. For example, the presence of pathology of the pale type, where an arteriovenous emission is noted, provokes the development of hypertension of the small circle, while the pathology of the blue type with a venoarterial shunt contributes to hypoxemia.

The danger of the disease in question lies in the high mortality rate. So, a large discharge of blood from a small circle, provoking heart failure, in half of the cases ends in the death of a baby even before the age of one, which is preceded by a lack of timely surgical care.

The condition of a child older than 1 year is noticeably improving due to a decrease in the amount of blood entering the pulmonary circulation. But at this stage, sclerotic changes in the vessels of the lungs often develop, which gradually provokes pulmonary hypertension.

Symptoms

Symptoms manifest themselves depending on the type of anomaly, the nature and time of development of circulatory disorders. During the formation of the cyanotic form of pathology in a sick child, a characteristic cyanosis of the skin and mucous membranes is noted, which increases its manifestation with each voltage. White vice is characterized by pallor, constantly cold hands and feet of the baby.

The baby himself with the presented disease differs from others in hyperexcitability. The baby refuses the breast, and if he starts to suck, he quickly gets tired. Often, in children with the presented pathology, tachycardia or arrhythmia is detected, sweating, shortness of breath and pulsation of the vessels of the neck are among the external manifestations.

In the case of a chronic disorder, the baby lags behind peers in weight, height, and there is a physical lag in development. As a rule, congenital heart disease at the initial stage of diagnosis is auscultated, where heart rhythms are determined. In the further development of the pathology, edema, hepatomegaly and other characteristic symptoms are noted.

Complications include, including, congestive pneumonia, angina pectoris syndrome and.

Diagnostic measures

The disease under consideration is determined by the use of several methods of examining a child:

visual inspection	A specialist can determine cyanosis and its nature. Here the skin tone is a sign.
Auscultation of the heart	Helps to identify changes in work in the form of disturbances in heart tones, the presence of noise. The physical method of examining the patient is carried out accompanied by electrocardiography, phonocardiography, radiography, echocardiography.
Electrocardiography	It is possible to reveal hypertrophy of departments and arrhythmia of the heart, characteristic conduction disorders. The presented identified defects with additional research methods make it possible to determine the severity of the pathology. A sick child is often carried out daily Holter ECG monitoring, which allows you to diagnose hidden disorders.
Phonocardiography	It is necessary to determine the duration and localization of noise in a vital organ.
X-ray of organs chest	It is carried out as a supplement to the methods already described, which together helps to assess the pulmonary circulation, the size and location of internal organs and other anomalies.
echocardiography	Allows you to visualize the anatomical defects of the septa and valves of the heart, allows you to determine the contractility of the myocardium.
Angiography and sounding of some parts of the heart	It is carried out for accurate diagnosis in anatomical and hemodynamic terms.

How to treat congenital heart disease

The presented disease is complicated by the operation of a sick child up to one year of age. Here, specialists are guided by the diagnosis of cyanotic pathologies. In other cases, operations are postponed because there is no danger of developing heart failure. Cardiology specialists work with the child.

Methods and methods of treatment depend on the types and severity of the pathology in question. If an anomaly of the intercardiac or interventricular septum is detected, the child undergoes plasty or suturing.

In the case of hypoxemia, at the initial stage of treatment, specialists perform palliative intervention, which involves the imposition of intersystemic anastomoses. Such actions can significantly improve blood oxygenation and reduce the risk of complications, as a result of which a further planned operation will take place with favorable indicators.

Aortic malformation is treated by resection or balloon dilatation of the coarctation of the aorta, or plastic stenosis. In the case of an open ductus arteriosus, a simple ligation is performed. Pulmonary artery stenosis undergoes open or endovascular valvuloplasty.

If a newborn is diagnosed with a heart disease in a complicated form, where it is impossible to talk about a radical operation, specialists resort to actions to separate the arterial and venous ducts.

The elimination of the anomaly itself does not occur. It talks about the possibility of carrying out the operation of Fontenne, Senning and other varieties. If the operation does not help in the treatment, they resort to a heart transplant.

As for the conservative method of treatment, here they resort to the use of drugs, the action of which is aimed at preventing attacks of shortness of breath, and other heart damage.

Prevention

The preventive actions for the development of the presented pathology in children should include careful planning of pregnancy, the complete exclusion of adverse factors, as well as a preliminary examination to identify a risk factor.

Women who fall into such an unfavorable list should undergo a comprehensive examination, where ultrasound and a timely biopsy of the chorion are isolated. If necessary, questions of indications for termination of pregnancy should be addressed.

If a pregnant woman is already informed about the development of pathology during the period of fetal development, she should undergo a more thorough examination and consult an obstetrician-gynecologist and a cardiologist much more often.

Forecasts

According to statistics, mortality due to the development of congenital heart disease occupies a leading position.

In the absence of timely assistance in the form of surgical intervention, 50-75% of children die before they reach their first birthday.

Then comes the compensation period, during which the mortality rate drops to 5% of cases. It is important to identify pathology in a timely manner - this will improve the prognosis and condition of the child.

Location of the heart in the left side of the chest with the apex pointing to the left, but with transposition of other internal organs (situs viscerum inversus) and heart defects, or corrected transposition of the great vessels.

Congenital coronary (arterial) aneurysm

Wrong position of the heart

Congenital:

cardiac anomaly NOS
heart disease NOS

In Russia, the International Classification of Diseases of the 10th revision (ICD-10) is adopted as a single regulatory document for accounting for morbidity, reasons for the population to contact medical institutions of all departments, and causes of death.

ICD-10 was introduced into healthcare practice throughout the Russian Federation in 1999 by order of the Russian Ministry of Health dated May 27, 1997. №170

The publication of a new revision (ICD-11) is planned by WHO in 2017 2018.

With amendments and additions by WHO.

Processing and translation of changes © mkb-10.com

Congenital heart disease code micb 10

The most common congenital heart defects in children and adults

Not all people without medical education are aware of congenital heart defects. This pathology is often detected in childhood and is difficult to treat. Medical therapy in this situation is ineffective. Many children with a similar pathology become disabled.

Heart defects from birth

The classification of congenital malformations is known to every experienced cardiologist. This is a large group of diseases in which various structures of the heart are affected and blood vessels. The prevalence of this congenital pathology among children is about 1%. Some vices are incompatible with life.

In cardiology, often different diseases are combined with each other. Congenital and acquired heart defects worsen the quality of human life. The following types of defects are distinguished:

accompanied by increased blood flow in the lungs;
with normal blood flow in the small circle;
with reduced blood supply to the lung tissue;
combined.

There is a classification based on the presence of cyanosis. It includes congenital heart defects of the "blue" type and "white". The following diseases are most often detected:

open Botallov duct;
coarctation of the aorta;
tetrad of Fallot;
valve atresia;
defect of interventricular and interatrial partitions;
narrowing of the lumen of the aorta;
stenosis of the pulmonary artery.

Main etiological factors

With congenital heart defects, the causes are different. The following etiological factors are of greatest importance:

chromosomal disorders;
gene mutations;
transferred viral infections mothers while carrying a baby;
defeat of the child by the rubella virus;
alcohol syndrome;
exposure to chemicals (heavy metals, pesticides, alcohol);
exposure;
inhalation of polluted air;
the use of low-quality water;
harmful professional factors;
taking toxic drugs during gestation.

The causes of heart defects often lie in external factors. For the future baby, diseases such as chicken pox, herpes, hepatitis, toxoplasmosis, rubella, syphilis, tuberculosis, HIV infection are dangerous. Narcotic drugs (amphetamines) have a teratogenic effect.

Maternal smoking adversely affects the formation of the fetus. Congenital malformations are more often diagnosed in those children who were born to mothers with diabetes. Risk factors are:

smoking;
alcohol addiction;
old age of father and mother;
taking antibiotics in the 1st and 3rd trimesters;
the presence of toxicosis in history;
reception hormonal drugs.

The most frequently detected pathology is open ductus arteriosus and VSD.

Opening of the arterial duct

In intrauterine development, the cardiovascular system of a child has its own characteristics. An example is an open ductus arteriosus. This fistula connects the pulmonary artery and the aorta. Normally, this duct overgrows within 2 months after childbirth. This is not the case when the child's development is impaired. The patent ductus arteriosus (PDA) is preserved.

Every doctor has a presentation on congenital heart disease. It should indicate that this pathology is quite common. In boys, PDA is diagnosed less frequently. Its share in the overall structure of congenital anomalies is about 10%. The disease is combined with another pathology - aortic coarctation, vasoconstriction or Fallot's tetrad.

This heart disease is more common in premature babies. After childbirth, it leads to a lag in physical development. In children weighing less than 1 kg, patent ductus arteriosus (PDA) is diagnosed in 80% of cases. Risk factors are:

asphyxia during childbirth;
burdened heredity;
parents living in the highlands;
performing oxygen therapy.

This disease belongs to the defects of the "pale" type. This pathology has its own code in the ICD-10. PDA is characterized by the shunting of oxygen-rich blood from the aorta into the pulmonary artery. This causes hypertension, which leads to an increase in the load on the heart. This is how hypertrophy and dilatation of the left sections develop.

Patent ductus arteriosus (PDA) occurs in 3 stages. The most dangerous 1 degree. With it, a fatal outcome is possible. Stage 2 occurs between the ages of 2 and 20 years. At this stage, an overload of the right ventricle of the heart and an increase in BCC in the pulmonary circulation system are detected. At stage 3, sclerotic changes develop in the lungs.

You need to know not only the causes of congenital heart defects, but also their symptoms. With an open duct, the following symptoms are possible:

pallor or cyanosis of the skin;
sucking disorder;
cry;
straining;
poor weight gain
developmental delay;
frequent respiratory diseases;
shortness of breath on exertion;
violation of the heart rhythm.

Complications include the development of vascular insufficiency and inflammation of the endocardium. Many patients have no symptoms.

Aortic valve insufficiency

With CHD, the bicuspid, aortic valves can also be affected. This is a dangerous pathology that requires surgery. The aortic valve is located between the left ventricle and the aorta. Its flap closes, blocking the way for the backflow of blood. With a defect, this process is disrupted. Part of the blood rushes back into the left ventricle.

Its overflow causes stagnation of blood in the small circle. good presentation on this topic states that the following changes underlie hemodynamic disorders:

congenital lack of one leaflet;
valve sagging;
different sash sizes;
underdevelopment;
the presence of a pathological hole.

This cardiac defect is both congenital and acquired. In the first case, most often the violations are minor, but if the person is not treated, then complications are possible. With this congenital heart disease, symptoms include chest pain, palpitations, swelling of the extremities, shortness of breath, tinnitus, periodic fainting, dizziness.

The function of the brain is impaired. Objective signs of aortic valve insufficiency are:

pale skin;
pulsation of the carotid arteries;
constriction of the pupils;
protrusion of the chest;
enlargement of the boundaries of the heart;
pathological heart murmurs;
acceleration of heart rate;
increase in pulse pressure.

All these symptoms appear if 20-30% of the blood returns back to the ventricle. Congenital malformations can appear from early childhood or through the years, when the heart cannot compensate for hemodynamic disturbances.

Stenosis and atresia of the aorta

In the group of congenital heart defects, the classification distinguishes coarctation of the aorta. This vessel is the largest. It distinguishes the ascending and descending parts, as well as the arc. Aortic coarctation is common in the CHD group. With this pathology, there is a narrowing of the lumen or atresia (overgrowth) of the vessel. The isthmus of the aorta is involved in the process.

This anomaly occurs in children. The proportion of this defect in the overall structure of pediatric cardiological pathology is about 7%. The narrowing is most often observed in the zone of the terminal part of the aortic arch. Stenosis is shaped like an hourglass. The length of the narrowed area often reaches 5-10 cm. This pathology often leads to atherosclerosis.

Coarctation causes left ventricular hypertrophy, increased stroke volume, and expansion of the ascending aorta. Collaterals are formed (a bypass network of vessels). Over time, they become thinner, which leads to the formation of aneurysms. Possible brain damage. You need to know not only what coarctation of the aorta is, but also how it manifests itself.

With this defect, the following clinical signs are revealed:

weight gain;
growth retardation;
dyspnea;
signs of pulmonary edema;
decreased vision;
headache;
dizziness;
hemoptysis;
nosebleeds;
convulsions;
abdominal pain.

The clinical picture is determined by the period of development of coarctation. In the stage of decompensation, severe heart failure develops. High percentage of deaths. Most often it is observed in age. In violation of brain function, neurological symptoms are pronounced. It includes chilliness of the extremities, headache, fainting, convulsions, lameness.

Tetrad and Triad of Fallot

Congenital heart defects in adults and children include the triad of Fallot. This is a combined vice, which includes:

septal defect between the atria;
narrowing of the pulmonary artery;
right ventricular hypertrophy.

The reason is a violation of embryogenesis in the 1st trimester of pregnancy. It is during this period that the heart is formed. Symptoms are mainly due to narrowing of the pulmonary artery. It is a large vessel originating from the right ventricle of the heart. He is a couple. They begin a large circle of blood circulation.

At the expressed stenosis there is an overload of a right ventricle. The pressure in the cavity of the right atrium increases. The following violations occur:

insufficiency of the tricuspid valve;
decrease in minute volume of blood in a small circle;
increase in minute volume in a large circle;
decrease in blood oxygen saturation.

Like other congenital malformations, Fallot's triad occurs latently at an early age. Fatigue is a common symptom. Along with the triad, Fallot's tetrad often develops. It includes pulmonary stenosis, repositioning of the aorta (dextroposition), right ventricular hypertrophy, and VSD.

Tetralogy of Fallot belongs to the group of cyanotic ("blue") defects. Its share is 7-10%. This pathology is named after a French doctor. This disease is formed at 1-2 months of intrauterine development. Tetralogy of Fallot is often combined with anomalies of the auricles, oligophrenia, malformations of internal organs, dwarfism.

On early stages symptoms are nonspecific. Later, tetralogy of Fallot leads to dysfunction of the brain and other vital organs. Perhaps the development of hypoxic coma and paresis. Young children often suffer from infectious diseases. The main manifestation of the defect is cyanotic attacks, accompanied by shortness of breath.

Patient Examination Plan

Treatment of congenital heart defects is carried out after the exclusion of other (acquired) diseases. Any qualitative presentation states that the following studies are required to identify the disease:

listening to the heart;
percussion;
electrocardiography;
x-ray examination;
registration of sound signals;
Holter monitoring;
coronary angiography;
cavity probing.

The diagnosis of congenital heart disease is made on the basis of the results of instrumental studies. With congenital anomalies, the changes are very different. With Fallot's tetrad, the following signs are revealed:

symptom of "drum sticks" and "watch glasses";
heart hump;
rough noise in the area of 2-3 intercostal spaces to the left of the sternum;
weakening of the 2nd tone in the area of the pulmonary artery;
deviation of the electrical axis of the heart to the right;
expansion of the boundaries of the body;
increased pressure in the right ventricle.

The main diagnostic criteria for patent ductus arteriosus are an increase in the boundaries of the myocardium, a change in its shape, simultaneous filling of the aorta and pulmonary artery with contrast, and manifestations of hypertension. If congenital malformations are suspected, the work of the brain is necessarily evaluated. Such studies as computed tomography and magnetic resonance imaging are of great informative value. Valves (bicuspid, tricuspid, aortic, and pulmonary) are assessed.

Therapeutic tactics for congenital malformations

If there are "blue" or "white" heart defects, then radical or conservative treatment is required. If an open ductus arteriosus is detected in a premature baby, it is necessary to use prostaglandin synthesis inhibitors. This allows you to accelerate the overgrowth of the anastomosis. If such therapy does not work, then after 3 weeks of age, surgery can be performed.

It is open and endovascular. The prognosis for congenital and acquired heart defects is determined by the severity of hemodynamic disorders. When a tetrad of Fallot is detected in a person, only surgical treatment is effective. All patients are hospitalized. With the development of cyanotic attacks are used:

In severe cases, an anastomosis is applied. Palliative operations are often organized. Shunting is in progress. the most radical and effective measure is the plasty of a ventricular septal defect. Be sure to restore the patency of the pulmonary artery.

If congenital coarctation of the aorta is detected, surgery should be performed in early dates. In the case of the development of a critical defect, surgical treatment is indicated at the age of a child under 1 year old. In case of irreversible pulmonary hypertension, surgery is not performed. The most commonly used types of surgery are:

plastic reconstruction of the aorta;
resection followed by prosthetics;
formation of bypass anastomoses.

Thus, congenital anomalies of the heart can manifest themselves both in childhood and later. Some diseases require radical treatment.

What is the danger of sick sinus syndrome and how to treat it?

Sick sinus syndrome (SSS) - failures in the conduction system of the heart. The sinus node does not cope with its duties and cannot produce electrical impulses in the required volume, so the heart begins to work incorrectly. As a result, heart rhythm disturbances appear. Pathology sometimes manifests itself in children and adolescents, but more often in people over sixty years of age, gender does not matter.

Code according to ICD.5 Sick sinus syndrome (SSS) in 2017.

Conduction system of the heart and sinus node

In the muscle of the heart there are special nerve fibers from which the conducting system of the heart is formed, it is controlled by the autonomic nervous system. Under the influence of physical exertion, when the heart contracts more often, the sympathetic part of the autonomic nervous system, during sleep, when the heart contracts less frequently, the conduction system of the heart is affected by the parasympathetic division of the nervous system.

The sinus atrial node is located in the right atrium near the mouth of the inferior and superior vena cava. It is formed from the combination of specific pacemaker rhythmogenic cells (1.5x0.4 cm), generating a nerve impulse, which sets the heart rhythm. During normal operation of the sinus node, impulses are formed at a frequency of 60 to 80 per minute. The sinus node sends an impulse to the atrioventricular node and further to the left and right bundles of His and Purkinje fibers, while all the chambers of the heart contract, providing sufficient nutrition to all the arteries of the body.

The blood supply to the myocardium occurs with the help of the right and left coronary arteries, which depart from the aorta. The right coronary artery supplies blood to most of the right ventricle of the heart, part of the cardiac septum, and the posterior wall of the left ventricle. The left coronary artery supplies the rest of the heart. The sinus node is supplied with the right coronary artery. With the defeat of this artery, the nutrition of the sinus node is disturbed. It is characterized by various violations.

Important! The sinus node is the main pacemaker of the heart. When it is violated, other foci are activated, trying to make the heart beat in a different rhythm, but this only destroys cardiac activity.

Node weakness formation

Currently, pathologies in which the function of the sinus node is impaired are divided into two groups:

Weakness of the sinus node, in which the site of the node or itself is damaged.
Sinus node dysfunction is caused by factors that are not related to the pathology of the sinus node.

Causes of sinus node weakness

The causes of the weakness of the sinus node are related to all anomalies that affect the node location area:

Deposition of calcium salts or replacement of normal cells by cells connective tissue around the sinus node. It is more common in people over 60 years of age.
Heart diseases. Congenital and acquired heart defects, inflammatory diseases heart (pericarditis, myocarditis), traumatic injuries, ischemia, hypertrophy in myocardiopathies and hypertension.
Systemic diseases (lupus erythematosus, scleroderma).
endocrine diseases ( diabetes, hyperthyroidism, hypothyroidism).
Stage of tertiary syphilis.
muscle dystrophy.
Malignant neoplasms in the heart.
Weakness of the sinus node without determining the cause (idiopathic).
Heart injury and surgery.
Violation of protein metabolism, when amyloid is deposited in the tissues of the heart.
Persistent increase in blood pressure.

Important! Bradycardia occurs in trained athletes due to the stronger influence of the vagus nerve.

Causes of sinus node dysfunction

The action of external factors affecting sinus node dysfunction:

Application medicines that reduce the automatism of the sinus node (Cordarone, Clonidine, cardiac glycosides).
Violation of the blood composition (hypercalcemia, hyperkalemia).
The manifestation of hyperactivity of the vagus nerve (with increased intracranial pressure, diseases of the digestive system, urinary organs, subarachnoid hemorrhage), hypothermia, sepsis.
Individual increased sensitivity of nerve receptors to external stimuli.
Dystrophy and general depletion of the body.
Sick sinus syndrome in children occurs due to age features(decrease in intensity of pacemaker cells).

Classification

SSS are classified according to the flow:

Latent. There are no clinical symptoms and ECG manifestations, rhythm disturbances are rare. It is possible to determine the dysfunction of the sinus node only with an electrophysiological study. Ability to work is not broken, treatment is not required.
Manifest and sharp. Symptoms are characterized by a sudden onset, more pronounced. It usually occurs with trauma or myocardial infarction. SSSU is recorded on the daily cardiogram.
Intermittent. The work of the pacemaker is influenced by the vegetative system, therefore, SSSU is characterized by manifestation at night.
Chronic and recurrent. The constant course of the disease with worsening and improvement of symptoms. The condition is stable or the disease progresses slowly.

The course of the disease is classified according to the nature of the rhythm disturbance:

Bradisystolic. The pulse is constantly slow (45-50 beats per minute). Restrictions in professional activity are possible.

Bradytahisistolic. Slow pulse alternates with rapid pulse or paroxysmal atrial fibrillation, atrial flutter. With the ineffectiveness of therapy, implantation of a pacemaker is possible.

Sinoatrial blockade. With this pathology, the sinus node works without disturbances, but some of the impulses are not conducted. The rhythm of heart contractions depends on the uniformity of the blockade of the impulse.
Interruptions in the work of the sinus node. The sinus node periodically does not produce an impulse.

The course of the disease is divided according to the degree of circulatory disorders:

Compensated. The symptoms are mild, the condition does not cause concern.
Decompensated. The symptomatology is strongly expressed, the general condition is severe, the patient is disabled. The patient needs an artificial pacemaker.

Important! Patients with a pulse less than beats per minute and manifestations of atrial fibrillation should be examined for sick sinus syndrome.

Symptoms

In the early periods, the disease is often asymptomatic, even if there is a pause of more than 4 seconds. And only in some patients, signs of bradycardia are characterized by a deterioration in well-being, which is caused by impaired cerebral or peripheral circulation. With the progression of the disease, the symptoms also increase:

Cerebral

With mild symptoms, there may be:

irritability;
feeling tired;
dizziness;
emotional instability;
impaired memory and intelligence;
pre-fainting states;
fainting.

As the disease progresses, cerebral symptoms become more pronounced:

pallor and coldness of the skin, cold sweat;
a sharp drop in blood pressure;
fainting can be caused by wearing a tight collar, a sudden change in body position, coughing;
manifestation of discirculatory encephalopathy.

The state before fainting is accompanied by tinnitus, there is a sharp weakness. Fainting is not accompanied by convulsions, ends on its own, but with a protracted course, they require resuscitation.

Cardiac

At the onset of the disease, patients experience the following symptoms:

dyspnea;
feeling short of breath;
chest pain;
patients notice a slow or irregular heartbeat;
feeling of a sinking heart (less than 50 per minute), palpitations or interruptions in the work of the heart.

With the progression of the disease, the following signs are added:

the appearance of chronic heart failure;
cardiac type asthma;
pulmonary edema;
increases the risk of ventricular tachycardia, turning into ventricular fibrillation, this condition can lead to sudden death.

Other symptoms

complaints from the gastrointestinal tract;
insomnia;
infrequent urination;
muscle weakness.

Important! Slowing the pulse less than 35 beats per minute is dangerous for the development of a heart attack, pulmonary edema and sudden cardiac arrest.

Diagnostics

Diagnosis of the disease is difficult. The diagnosis is made on the basis of the patient's complaints, anamnesis of his life, hereditary factors, the presence of bad habits.

An external examination of the patient is carried out, the condition of the skin, pulse rate, respiration, blood pressure.

In addition, a number of instrumental studies are being carried out:

General and biochemical analysis blood, urinalysis. Helps to identify a number of associated diseases.
A blood test for hormones to identify hormonal disorders that affect the course of the disease.
ECG (electrocardiogram). It may be completely normal, but may present with sick sinus syndrome on the ECG as arrhythmias.
Echocardiography. Allows you to see deviations from the norm in the structure of the heart (thickening of the walls, enlargement of the chambers of the heart).
Daily ECG (according to Holter). The cardiogram is recorded from 24 to 72 hours. Allows you to see the duration of periods of slowing the rhythm, the conditions for their onset and termination, the features of the work of the heart during the day and at night.

Load tests (treadmill test, bicycle ergometry). With a gradually increasing load on a special treadmill or bicycle ergometer, an ECG is monitored. The response of heart contractions to the load is checked, ischemia is detected.
Tilt test (orthostatic test). The patient on a special bed is at an angle of 60 degrees for 30 minutes. During the test, ECG readings are taken and blood pressure is measured. The method is carried out to exclude cases of loss of consciousness, not associated with SSS.
An electrophysiological study conducted through the esophagus. A thin probe is inserted into the esophagus to the level of the heart. At the same time, the parameters of heart activity are visible more clearly than on an ordinary ECG.
Tests using drugs (pharmacological tests). Special substances are introduced that remove the effect on the sinus node of the autonomic nervous system. The heart rate against this background is the natural frequency of the sinus node.
Carotid sinus massage. With this technique, sick sinus syndrome can be distinguished from carotid sinus syndrome.

Treatment

Treatment will be more effective if sick sinus syndrome is detected early. Treatment takes place in two directions:

Treat diseases that cause weakness of the sinus node ( medications, daily routine, diet).
Restoration of the sinus node, maintaining the normal functioning of the heart. The drugs used have a weak therapeutic effect and help only in the initial stages of the disease. To eliminate the pathology, a pacemaker is installed, which will ensure the correct heart rhythm.

pacing

Indications for pacing:

Bradycardia with a heart rate less than 40 beats per minute or pauses for more than three seconds.
The combination of weakness of the sinus node with any arrhythmias or with consistently high or low pressure.
Severe and frequent disorders of the coronary or cerebral circulation.
At least one attack on the background of bradycardia (Morgagni-Adams-Stokes syndrome).
If, during an electrophysiological study, the time to restore the function of the sinus node is more than 3500 ms.

In cardiology, modern pacemakers are used, which begin to produce regular impulses only after the pulse becomes less than necessary, and produce them until the function of the sinus node is restored.

Folk remedies

Treatment folk remedies SSSU must be agreed with the doctor. To combat stress, improve sleep, infusions of valerian, motherwort, mint, and yarrow are recommended.

Complications and prognosis

If the patient does not receive treatment, then the prognosis is extremely unfavorable. The disease progresses rapidly and can be fatal. Complications possible with SSSU:

development of heart failure.
Thromboembolism. Blockage of blood vessels with blood clots.
Stroke. Acute cerebrovascular accident.
Death.

Recovery or a significant improvement in the condition is possible with treatment only if only bradycardia is observed in the symptoms, there is no circulatory disorder or arrhythmia. In other cases, the installation of a pacemaker is indicated.

Prevention

Prevention of sick sinus syndrome is aimed at maintaining a healthy lifestyle:

Balanced diet. Eliminate strong coffee and tea from the diet.
Eliminate alcohol, stop smoking.
Perform vigorous physical activity.
Avoid stressful situations.
Watch your weight.
Control blood sugar levels.
Do not take any medications without a doctor's prescription.

Bicuspid aortic valve

Bicuspid aortic valve is the most common congenital heart disease found in adults: an abnormal aortic valve occurs in 2% of people.

Normally, the aortic valve has three cusps, which either open or close at certain phases of the cardiac cycle to ensure one-way blood flow: from the heart to the aorta, preventing back flow.

In the process of evolution or according to someone's plan, the aortic valve, which has three leaflets, has turned out to be the most effective and reliable valve, which is the case with the vast majority of people. But sometimes, even in the womb, something “goes wrong,” resulting in the formation of not a tricuspid, but a bicuspid aortic valve.

Despite such a seemingly gross anomaly, such a valve can perform the functions assigned to it for decades, while its owner does not experience even the slightest health problems. Nevertheless, due to various reasons, including due to the banal laws of mechanics, much more load falls on two valves than on three, which in half of the patients leads to a violation of its function.

The bicuspid aortic valve begins to pass blood back from the aorta into the left ventricle, in fact, aortic valve insufficiency develops. The reverse current through any of the valves of the heart is called regurgitation, and so, if this regurgitation reaches certain, critical values, the heart begins to experience overload.

Regurgitation significantly changes the normal blood flow in all parts of the heart, lungs and even in all other organs. When the bicuspid aortic valve begins to "give up", which manifests itself in the form of shortness of breath during physical exertion, dizziness, weakness, patients consult a doctor.

In some cases, not insufficiency is observed, but, on the contrary, stenosis (narrowing) of the aortic valve, which is accompanied by all the same manifestations as insufficiency.

A bicuspid aortic valve is diagnosed very easily, with the help of an ultrasound of the heart, the same study determines the degree of valve insufficiency - the degree of regurgitation.

If the doctor detects such an anomaly, then first of all it is necessary to decide whether an operation for valve prosthetics is required or it can be delayed and “organized” monitoring of the situation. It all depends on two things: complaints (they are assessed by a specialist) and the degree of regurgitation.

In a nutshell, it is difficult to describe complaints that clearly indicate the need for surgery, so it is easier to say that if the patient is not bothered by anything, he is able to perform physical activity without significant difficulties, and there are no signs of heart overload according to ultrasound, surgical treatment is not indicated. In all other cases, the issue is resolved individually. So, for example, a bicuspid aortic valve in a patient with moderate valve insufficiency may require more aggressive intervention. After all, with age, there is a possibility of developing concomitant, non-cardiac diseases, which can become a contraindication to intervention on the heart. In the same case, in a young patient, regurgitation of the II degree in some cases, especially in the absence of symptoms, makes it possible to observe the situation for years.

Of course, it is neither in the interests of the patient nor the doctor to hurry with valve prosthetics, because despite the fact that such an operation has long been not exotic, it is by no means simple. In addition, a patient with artificial valve it is required to take blood thinners for life, which is currently very troublesome in our country, and is associated with the risk of major, sometimes life-threatening bleeding.

Therefore, if there is a possibility that the problem can be solved without cardiac surgery, they are not in a hurry with the operation, but even if there is nowhere to go, then delay will only aggravate the state of health and can negate even the operation performed later. This refers to the development of heart failure against the background of overdistension of the heart cavities and an increase in pressure in the pulmonary artery, conditions to which it is highly undesirable to bring patients who have valvular pathology, including a bicuspid aortic valve.

Detailed guidance for parents whose children have been diagnosed with bicuspid aortic valve can be read here.

Please note that all information posted on the site is for reference only and

not intended for self-diagnosis and treatment of diseases!

Copying materials is allowed only with an active link to the source.

Since there are a lot of defects in the circulatory system, the GSP code according to ICD 10 cannot be one. In addition, the clinic of some of them is so similar that it is necessary to use modern informative diagnostic methods for differentiation.

There is a huge difference between acquired cardiac disorders and congenital malformations, as they are in different classes of the ICD. Despite the fact that arterial and venous blood flow disorders will be the same, the treatment and etiological factors will be completely different.

CHD may not require therapeutic measures, however, elective operations or even urgent ones are more often performed in case of serious, incompatible with life, non-compliance with the norm.

GSP encoding

Heart defects are in the class of congenital anomalies in the structure of the body in the block of anomalies of the circulatory system. The GSP in ICD 10 branches into 9 sections, each of which also has subparagraphs.

However, heart problems include:

Q20 - anatomical disorders in the structure of the heart chambers and their connections (for example, various non-closure of the oval window);
Q21 - pathologies of the cardiac septum (defects of the atrial and interventricular septum, and others);
Q22 - problems with the pulmonary and tricuspid valves (insufficiency and stenosis);
Q23 - pathologies of the aortic and mitral valves (insufficiency and stenosis);
Q24 - other congenital heart defects (change in the number of chambers, dextrocardia, and so on).

Each of these items requires further differentiation, which will determine the treatment plan and prognosis for the child. For example, with valve damage there may be symptoms of insufficiency or stenosis. In this case, the hemodynamic features of the disease will differ.

In the ICD, congenital heart disease implies any disturbance of blood flow.

That is why in all encodings a complete inversion of organs or their structures with full functioning is excluded.

ICD-10 was introduced into healthcare practice throughout the Russian Federation in 1999 by order of the Russian Ministry of Health dated May 27, 1997. №170

The publication of a new revision (ICD-11) is planned by WHO in 2017 2018.

With amendments and additions by WHO.

Processing and translation of changes © mkb-10.com

Specification Congenital heart disease ICD code 10

One of the most common developmental anomalies today is congenital heart disease.

Classification

According to this international classification, under the ICD 10 code, all existing heart defects are listed.

There are a lot of them. Conventionally, all vices can be divided into two groups, each of which has its own subgroups:

White. Heart disease in which there is no mixing of venous and arterial blood.
atrial and interventricular septal defect;
pathologies caused by depletion of the pulmonary circulation;
defects associated with the depletion of the systemic circulation;
pathologies not associated with hemodynamic disorders.
Blue. Venous and arterial blood mix.
defects caused by the enrichment of the small circle;
pathologies caused by the depletion of the small circle.

Each of the above groups and subgroups has its own specific code, which helps to determine the type of disease as accurately as possible.

Reasons for development

Factors that can provoke the birth of a child with a congenital pathology of the development and functioning of the heart can be divided into two large groups:

Genetic. In this case, we are talking about point gene changes or specific mutations of chromosomes.
Ecological. This group includes quite a few factors. Among the main ones are such as the effect of ion radiation on a pregnant woman, her contact with pesticides. Smoking and drinking alcoholic beverages are also included in this group. If during pregnancy a woman suffered any infectious or viral diseases, they can also provoke the development of congenital heart disease in a child.

Often, the factors that lead to heart disease can be combined.

Symptoms

When making a diagnosis of CHD, the pediatrician and cardiologist must first talk with the child's parents. In this conversation, it is necessary to establish how the child developed, when the first signs of vice began to appear, etc.

A congenital defect leaves an imprint not only on the functioning of the heart, but also on many other signs:

Body type. A change in physique can cause few vices. For example, in violation of the functioning of the aorta of the heart, the child has an accelerated development of the shoulder girdle. As a rule, such children do not gain weight well, and this is reflected in their physique.
Covers of the skin. If a patient is diagnosed with a white defect, his skin is too pale. With a blue defect, cyanosis of the integument is well manifested.
Respiratory system. Due to increased blood flow to the lungs, patients with congenital heart disease often suffer from shortness of breath and have difficulty breathing.
Digestive organs. The disease also affects the digestive system. For example, there is an increase in the size of the liver. Often, such patients experience vomiting with an increase in physical activity, which is accompanied by severe pain in the abdomen.

All these symptoms can appear from an early age, and may begin to remind of themselves as early as the age of 5-6 years.

Diagnostics

The more methods used to diagnose congenital heart disease code according to ICD 10, the more accurate and detailed the picture of the disease will be.

When diagnosing, the following methods are used:

Electrocardiogram. This method gives excellent results, even at the initial stages of pathology development. Based on the interpretation of the results of the cardiogram, the cardiologist can determine with great accuracy the intensity of the development of the disease and its danger to the life of the child.
X-ray. When conducting an X-ray examination in 3 projections, it is possible to establish the condition of the lungs and the entire respiratory system.
Echocardiography. Allows the cardiologist to get the most accurate picture of the patient's condition.
Angiography or catheterization. These techniques are more difficult to carry out, but they allow you to determine the amount of pressure in the lungs, as well as determine exactly in which direction the blood flow is directed (from the right atrium to the left or vice versa).

All of the above diagnostic methods are used in combination. Only in this case it is possible to establish an accurate diagnosis and choose an effective course of treatment.

Regardless of whether it is a congenital or acquired defect, you must be attentive to your health and the health of your loved ones, if one or more signs appear, immediately contact a pediatrician and a cardiologist. Be healthy!

Acquired heart disease code for mcb 10

What is the danger of sick sinus syndrome and how to treat it?

Code according to ICD.5 Sick sinus syndrome (SSS) in 2017.

Conduction system of the heart and sinus node

In the muscle of the heart there are special nerve fibers from which the conducting system of the heart is formed, it is controlled by the autonomic nervous system. Under the influence of physical exertion, when the heart contracts more often, the sympathetic part of the autonomic nervous system acts; during sleep, when the heart contracts less frequently, the parasympathetic nervous system affects the conduction system of the heart.

The blood supply to the myocardium occurs with the help of the right and left coronary arteries, which depart from the aorta. The right coronary artery supplies blood to most of the right ventricle of the heart, part of the cardiac septum, and the posterior wall of the left ventricle. The left coronary artery supplies the rest of the heart. The sinus node is supplied by the right coronary artery. With the defeat of this artery, the nutrition of the sinus node is disturbed. It is characterized by various violations.

Node weakness formation

Currently, pathologies in which the function of the sinus node is impaired are divided into two groups:

Causes of sinus node weakness

The causes of the weakness of the sinus node are related to all anomalies that affect the node location area:

The deposition of calcium salts or the replacement of normal cells with connective tissue cells in the region of the sinus node. It is more common in people over 60 years of age.
Heart diseases. Congenital and acquired heart defects, inflammatory heart diseases (pericarditis, myocarditis), traumatic injuries, ischemia, hypertrophy in myocardiopathies and hypertension.
Systemic diseases (lupus erythematosus, scleroderma).
Endocrine diseases (diabetes mellitus, hyperthyroidism, hypothyroidism).
Stage of tertiary syphilis.
muscle dystrophy.
Malignant neoplasms in the heart.
Weakness of the sinus node without determining the cause (idiopathic).
Heart injury and surgery.
Violation of protein metabolism, when amyloid is deposited in the tissues of the heart.
Persistent increase in blood pressure.

Important! Bradycardia occurs in trained athletes due to the stronger influence of the vagus nerve.

Causes of sinus node dysfunction

The action of external factors affecting sinus node dysfunction:

The use of drugs that reduce the automatism of the sinus node (Cordarone, Clonidine, cardiac glycosides).
Violation of the blood composition (hypercalcemia, hyperkalemia).
The manifestation of hyperactivity of the vagus nerve (with increased intracranial pressure, diseases of the digestive system, urinary organs, subarachnoid hemorrhage), hypothermia, sepsis.
Individual increased sensitivity of nerve receptors to external stimuli.
Dystrophy and general depletion of the body.
Sick sinus syndrome in children occurs due to age-related characteristics (decrease in the intensity of pacemaker cells).

Classification

SSS are classified according to the flow:

Latent. There are no clinical symptoms and ECG manifestations, rhythm disturbances are rare. It is possible to determine the dysfunction of the sinus node only with an electrophysiological study. Ability to work is not broken, treatment is not required.
Manifest and sharp. Symptoms are characterized by a sudden onset, more pronounced. It usually occurs with trauma or myocardial infarction. SSSU is recorded on the daily cardiogram.
Intermittent. The work of the pacemaker is influenced by the vegetative system, therefore, SSSU is characterized by manifestation at night.
Chronic and recurrent. The constant course of the disease with worsening and improvement of symptoms. The condition is stable or the disease progresses slowly.

The course of the disease is classified according to the nature of the rhythm disturbance:

Bradisystolic. The pulse is constantly slow (45-50 beats per minute). Restrictions in professional activity are possible.

Bradytahisistolic. Slow pulse alternates with rapid pulse or paroxysmal atrial fibrillation, atrial flutter. With the ineffectiveness of therapy, implantation of a pacemaker is possible.

Sinoatrial blockade. With this pathology, the sinus node works without disturbances, but some of the impulses are not conducted. The rhythm of heart contractions depends on the uniformity of the blockade of the impulse.
Interruptions in the work of the sinus node. The sinus node periodically does not produce an impulse.

The course of the disease is divided according to the degree of circulatory disorders:

Compensated. The symptoms are mild, the condition does not cause concern.
Decompensated. The symptomatology is strongly expressed, the general condition is severe, the patient is disabled. The patient needs an artificial pacemaker.

Important! Patients with a pulse less than beats per minute and manifestations of atrial fibrillation should be examined for sick sinus syndrome.

Symptoms

Cerebral

With mild symptoms, there may be:

irritability;
feeling tired;
dizziness;
emotional instability;
impaired memory and intelligence;
pre-fainting states;
fainting.

As the disease progresses, cerebral symptoms become more pronounced:

pallor and coldness of the skin, cold sweat;
a sharp drop in blood pressure;
fainting can be caused by wearing a tight collar, a sudden change in body position, coughing;
manifestation of discirculatory encephalopathy.

The state before fainting is accompanied by tinnitus, there is a sharp weakness. Fainting is not accompanied by convulsions, ends on its own, but with a protracted course, they require resuscitation.

Cardiac

At the onset of the disease, patients experience the following symptoms:

dyspnea;
feeling short of breath;
chest pain;
patients notice a slow or irregular heartbeat;
feeling of a sinking heart (less than 50 per minute), palpitations or interruptions in the work of the heart.

With the progression of the disease, the following signs are added:

the appearance of chronic heart failure;
cardiac type asthma;
pulmonary edema;
increases the risk of ventricular tachycardia, turning into ventricular fibrillation, this condition can lead to sudden death.

Other symptoms

complaints from the gastrointestinal tract;
insomnia;
infrequent urination;
muscle weakness.

Important! Slowing the pulse less than 35 beats per minute is dangerous for the development of a heart attack, pulmonary edema and sudden cardiac arrest.

Diagnostics

Diagnosis of the disease is difficult. The diagnosis is made on the basis of the patient's complaints, the anamnesis of his life, hereditary factors, the presence of bad habits.

An external examination of the patient is carried out, the condition of the skin, pulse rate, respiration, blood pressure.

In addition, a number of instrumental studies are being carried out:

General and biochemical analysis of blood, general analysis of urine. Helps to identify a number of associated diseases.
A blood test for hormones to identify hormonal disorders that affect the course of the disease.
ECG (electrocardiogram). It may be completely normal, but may present with sick sinus syndrome on the ECG as arrhythmias.
Echocardiography. Allows you to see deviations from the norm in the structure of the heart (thickening of the walls, enlargement of the chambers of the heart).
Daily ECG (according to Holter). The cardiogram is recorded from 24 to 72 hours. Allows you to see the duration of periods of slowing the rhythm, the conditions for their onset and termination, the features of the work of the heart during the day and at night.

Load tests (treadmill test, bicycle ergometry). With a gradually increasing load on a special treadmill or bicycle ergometer, an ECG is monitored. The response of heart contractions to the load is checked, ischemia is detected.
Tilt test (orthostatic test). The patient on a special bed is at an angle of 60 degrees for 30 minutes. During the test, ECG readings are taken and blood pressure is measured. The method is carried out to exclude cases of loss of consciousness, not associated with SSS.
An electrophysiological study conducted through the esophagus. A thin probe is inserted into the esophagus to the level of the heart. At the same time, the parameters of heart activity are visible more clearly than on an ordinary ECG.
Tests using drugs (pharmacological tests). Special substances are introduced that remove the effect on the sinus node of the autonomic nervous system. The heart rate against this background is the natural frequency of the sinus node.
Carotid sinus massage. With this technique, sick sinus syndrome can be distinguished from carotid sinus syndrome.

Treatment

Treatment will be more effective if sick sinus syndrome is detected early. Treatment takes place in two directions:

Treat diseases that caused weakness of the sinus node (drugs, daily routine, diet).
Restoration of the sinus node, maintaining the normal functioning of the heart. The drugs used have a weak therapeutic effect and help only in the initial stages of the disease. To eliminate the pathology, a pacemaker is installed, which will ensure the correct heart rhythm.

pacing

Indications for pacing:

In cardiology, modern pacemakers are used, which begin to produce regular impulses only after the pulse becomes less than necessary, and produce them until the function of the sinus node is restored.

Folk remedies

Treatment with folk remedies SSSU must be agreed with the doctor. To combat stress, improve sleep, infusions of valerian, motherwort, mint, and yarrow are recommended.

Complications and prognosis

If the patient does not receive treatment, then the prognosis is extremely unfavorable. The disease progresses rapidly and can be fatal. Complications possible with SSSU:

development of heart failure.
Thromboembolism. Blockage of blood vessels with blood clots.
Stroke. Acute cerebrovascular accident.
Death.

Prevention

Prevention of sick sinus syndrome is aimed at maintaining a healthy lifestyle:

Balanced diet. Eliminate strong coffee and tea from the diet.
Eliminate alcohol, stop smoking.
Perform vigorous physical activity.
Avoid stressful situations.
Watch your weight.
Control blood sugar levels.
Do not take any medications without a doctor's prescription.

congenital heart defects

Since there are a lot of defects in the circulatory system, the GSP code according to ICD 10 cannot be one. In addition, the clinic of some of them is so similar that it is necessary to use modern informative diagnostic methods for differentiation.

CHD may not require therapeutic measures, but elective surgeries are more often performed or even urgent ones in case of serious, incompatible with life inconsistencies with the norm.

GSP encoding

However, heart problems include:

Q20 - anatomical disorders in the structure of the heart chambers and their connections (for example, various non-closure of the oval window);
Q21 - pathologies of the cardiac septum (defects of the atrial and interventricular septum, and others);
Q22 - problems with the pulmonary and tricuspid valves (insufficiency and stenosis);
Q23 - pathologies of the aortic and mitral valves (insufficiency and stenosis);
Q24 - other congenital heart defects (change in the number of chambers, dextrocardia, and so on).

Each of these items requires further differentiation, which will determine the treatment plan and prognosis for the child. For example, with lesions of the valves, there may be phenomena of insufficiency or stenosis. In this case, the hemodynamic features of the disease will differ.

In the ICD, congenital heart disease implies any disturbance of blood flow.

That is why in all encodings a complete inversion of organs or their structures with full functioning is excluded.

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Description of acquired heart defects

Acquired forms of heart defects are manifested by dysfunction and structural changes in the myocardium, which leads to a deterioration in blood supply. As a result of such violations, many serious complications can develop.

A feature is that a significant part of the defects develop asymptomatically. Shortness of breath, palpitations, chest pain, and increased fatigue may indicate an increased risk of their development.

Such symptoms require attention and urgent referral to a specialist, since in case of untimely assistance, there is a high probability of developing heart failure, which leads to the death of the patient. The mortality rate during the operation ranges from 1 to 25%.

All information on the site is for informational purposes and is NOT a guide to action!
Only a DOCTOR can make an EXACT DIAGNOSIS!
We kindly ask you DO NOT self-medicate, but make an appointment with a specialist!
Health to you and your loved ones!

According to ICD 10, the code for congenital heart defects is Q20-Q26. Acquired defects are in the ICD under codes I34-I37, I0.5-I08, Q22-Q23.

Types of defects

The following types of violations are distinguished:

Cases of deformation of the bicuspid valve are more common, defects of the semilunar valve are somewhat less common. The deformation of the valves gradually increases and leads to their incomplete closure.

Stenosis is a consequence of a decrease in the diameter of the atrioventricular orifice, which occurs due to the formation of a scar at the site of fusion of the valve leaflets.

Stenosis and valvular insufficiency can affect one valve at a time. In such situations, one speaks of a combined defect. If the lesion simultaneously affects more than one valve, then we are talking about a combined form. Prolapse is the eversion of the valve walls.

Causes

Acquired heart defects can have the following etiology:

inflammatory process of the inner lining of the myocardium caused by rheumatism is the most common cause;
atherosclerotic lesions;
traumatic lesions;
rheumatism;
sepsis;
inflammatory processes in the myocardial membrane caused by infection;
connective tissue lesions.

Types of acquired heart defects

Classification of types of heart defects:

Mitral insufficiency is manifested by the reverse outflow of blood into the atrium due to the overlap of the left atrioventricular orifice by the bicuspid valve. The progression of failure is observed after myocarditis and myocardial dystrophy, which provoke a weakening of the muscle fibers surrounding the atrioventricular orifice.
The defect is not associated with changes in the valve, but with the expansion of the hole that it closes. With organic insufficiency, the valve leaflets decrease.
These changes are observed after rheumatic endocarditis. Functional insufficiency negatively affects the work of the muscular apparatus that ensures the closure of the MC.
In some cases, there may be no complaints about the well-being of patients. Then experts talk about “compensated mitral valve disease”, followed by the stage of decompensation. At this time, shortness of breath, pain increases, swelling in the limbs is observed, the liver increases in size, the veins in the neck fill up.

With mitral stenosis, a narrowing of the left atrioventricular orifice is fixed. This defect is a common consequence of infectious endocarditis.
The violation is manifested by an increase in the density and thickness of the valve walls, their fusion. The shape of the valve becomes similar to a funnel with a hole located in the center.
The defect develops due to cicatricial-inflammatory narrowing of the ring. The onset is asymptomatic, but the period of decompensation is accompanied by serious symptoms: expectoration of blood, heart rhythm disturbance, severe cough, shortness of breath and heart pain.
The mortality rate for mitral valve surgery is less than 0.5%. However, ¼ of patients may relapse.

With insufficient closing of the semilunar valves, we are talking about insufficiency of the aortic valve, leading to the outflow of blood into the ventricle.
Immediately signs of violations are not detected. However, with an increased load on the ventricle, coronary insufficiency develops, pain appears.
Characteristic signs are: pain in the head, blanching of the skin, discoloration of the nail plate.

If the stenosis progresses, then the process of fusion of the semilunar valve leaflets begins. There is scarring around the aortic opening.
There is a significant violation of blood circulation, regularly there are pains, fainting, dizziness. The severity of symptoms is directly dependent on the level of physical and emotional stress. The condition is accompanied by a slowing of the pulse and pallor of the skin.
Surgical intervention is fatal in 3% of cases.

Triskupidny insufficiency represents insufficiency of the right atriogastric valve. More often it is fixed in combination with other violations.
Stagnation of blood flow is characteristic, which causes pain in the chest. The veins in the neck swell, there are signs of cyanosis. There is a slowdown in blood flow, a change in the level of blood pressure.
These changes threaten a dangerous form of heart failure. The disease can affect the work of other organs: the work of the kidneys, liver, and gastrointestinal tract worsens.

Diagnostics

Diagnosis of diseases associated with impaired functioning of the heart is carried out by a cardiologist. The first examination includes palpation, auscultation and percussion. The specialist needs to determine the rhythms of the heart and the presence of noise. Visual inspection is allowed to detect signs of cyanosis and swelling.

Additional methods that can be used for the purpose of diagnosing:

Thanks to these methods, the heart rate is assessed, blockades are detected, the type of arrhythmia is determined, and signs of ischemia are detected. Stress tests are done to confirm aortic insufficiency. At the same time, control by a cardiologist-resuscitator is mandatory.

Detection of congestion in the lungs is carried out using an x-ray, which can also help in identifying signs of myocardial hypertrophy.

Accurate diagnostics can be carried out using methods such as MRI and MSCT. Mandatory is the delivery of laboratory tests: urine, blood for cholesterol, sugar and general, as well as a rheumatoid test.

Treatment

To a large extent, the effectiveness of treatment is influenced by the lifestyle of the patient. In addition to taking the drugs prescribed by the specialist, it is necessary to abandon high physical exertion and change the diet.

However, with the advanced form of the disease, conservative methods will not be effective, therefore, surgical treatment is required. In such cases, an operation is performed, and during the intervention, the heart defect is eliminated.

Surgical treatment of mitral stenosis involves mitral commissurotomy. During the operation, the fused valve leaflets are disconnected. Professional operation allows you to completely get rid of the defect. After surgery, a period of rehabilitation and drug therapy is necessary.

In aortic stenosis, an aortic commissurotomy is performed. If combined defects are detected, it is necessary to replace the valve with an artificial one.

Prevention

It is difficult to answer the question of how many people live with an acquired heart disease. Much depends on the timeliness of treatment and directly the type of pathology detected. In some cases, people can live to a ripe old age without even experiencing any symptoms.

Prevention of the development of acquired heart defects consists in the prevention and timely treatment of diseases that can provoke damage to the heart valve.

First of all, attention should be paid to the development of rheumatism, infective endocarditis, atherosclerotic deposits, syphilis. If signs of these diseases are detected, emergency measures should be taken to prevent the development of cardiac pathologies.

Special attention is paid to hardening as a method of preventing rheumatic and infective endocarditis. Prevention also includes the treatment of foci of chronic inflammation.

To prevent the development of already existing changes, medical methods are used to treat pathology, prevent the recurrence of rheumatism, as defined by national guidelines for the treatment of acquired heart defects.

Physiotherapy

Gymnastics will help improve the condition of a patient with heart defects, but certain limitations must not be forgotten. Excessive activity can only worsen the condition. Therefore, it is recommended to perform sets of exercises under the supervision of a doctor (at least at the first stage) and stop at the first malaise.

Physiotherapy exercises may include the following exercises (in sequence):

walking;
warming up the muscles of the body;
warm-up of the lower extremities;
breathing exercises;
exercises for the lower extremities;
warming up the muscles of the body;
breathing exercises;
exercises for the upper limbs and shoulder girdle;
walking;
breathing exercises.

Walking is a basic exercise that must be included in every class. It allows you to activate the work of the whole organism, preparing it for subsequent loads.

First, walking is performed at a slow pace, then it is necessary to make a gradual acceleration. At the end of the lesson, they also perform slow walking - this helps to normalize blood circulation.

When performing exercises on the muscles of the body, the main thing is not to be zealous and also do everything at a calm pace. These exercises are performed no more than 2 times.

Exercises on the upper limbs and shoulder girdle are designed to develop the skill correct breathing and strengthening the muscles of these areas.

The classification of rheumatic heart defects is described in this article.

Read here how to identify a heart defect in a child.

Exercises on the lower extremities are necessary to expand the vessels that are removed from the heart, thus it is possible to eliminate congestion.

Breathing exercises are of great importance, as they stimulate blood flow to the lungs and heart muscle, supplying it with oxygen, providing normal nutrition to the brain.

Purposes of disease classification
MKB 10 codes for various kinds arterial hypertension
Hypertensive crisis according to mcd
Prevention of hypertension

For people who are far from medicine, the phrase hypertension code for microbial 10 does not mean anything. Even if the person himself suffers from this formidable disease. Many understand that we are talking about high blood pressure, but where does the code with the strange abbreviation microbial and why it is with the number 10 remain a mystery to them.

Everything is quite simple - each disease has its own code in a special classifier of diseases. For various manifestations of hypertension in this list, several codes are assigned at once, and an incomprehensible microbial is a simple and understandable thing.

Despite differences in healthcare delivery different countries there is a single international classification of diseases. It contains an impressive list of various diseases, accepted at the international level.

The procedure for creating such classifiers has been carried out by the World Health Organization for many years. The full name of this document (icb) is more detailed - "International Statistical Classification of Diseases and Related Health Problems".

All diseases are divided into 21 classes depending on body systems, groups of diseases and human conditions. Each class has its own alphabetic and numerical values corresponding to a specific disease. One code contains 1 letter and 2 digits indicating the disease, and the third digit carries only a clarifying diagnosis.

WHO began to oversee the medical classification of diseases in 1948 after the 6th revision. The tenth revision of the ICD is now in force, which is why it is designated by the number 10. This version of the classification has emerged as a result of long-term international cooperation by searching for compromises that are convenient for all. The consent of the parties is necessary to achieve the objectives of the ICB.

Purposes of disease classification

At the moment, the unified classifier of diseases and health problems has only two goals - collecting statistics and facilitating work with data. The ICD provides uniform methodological approaches to disease statistics and makes it possible to compare international data.

Thanks to this normative document, conditions began to appear all over the world for a comparative analysis of statistical data on diseases and mortality occurring at different times in many countries. The appearance of codes has greatly facilitated this task, now there is no need to write the full name of the disease, but it is enough to indicate the code corresponding to it.

The international classifier allows you to determine the epidemiological situation, the prevalence of certain diseases, including the frequency of sharply “rejuvenated” hypertension. Arterial hypertension code for ICD 10 describes more than one common disease, the code may differ due to the concept of target organs damaged by this disease.

Arterial hypertension is very common cardiovascular disease and its frequency increases with age. In some countries and regions, the percentage of the elderly is as high as 65, and that of young people is about 20.

Despite the fact that the frequency increases with age, but hypertension does not change the ICD code for young people and the elderly. This applies to all types of disease - hypertension can disable various organs, and each of these types has its own code.

Hypertension often affects the following organs:

Eyes;
kidneys;
Heart;
Brain.

In each of the organs under the influence high blood pressure many processes can occur - all this is connected with the work of the vessels that are exposed to the negative effects of hypertension in the first place.

According to WHO, hypertension is in class IX, which includes diseases of the circulatory system. Hypertension code μb 10, depending on the type, is indicated by the code from I10 to I15, not including I14. With the exception of I10, each cipher has a clarifying third digit for a specific diagnosis.

Although it is not entirely correct to talk about specifics - there are also unspecified types of arterial hypertension. Most often it is hypertension with predominant simultaneous damage to the kidneys and heart. There is also a secondary unspecified hypertensive disease.

ICD 10 codes for different types of arterial hypertension

Hypertension cipher microbial 10, denoted by I11, including I11.0 and I11.9 denotes diseases with a primary lesion of the heart. This subgroup does not include combinations of heart and kidney damage, they belong to I13 codes and have 4 internal codes - I13.0, I13.1, I13.2 and I13.9

Codes I12 are for hypertension with kidney damage. The international classification distinguishes hypertension with the development of renal failure against the background of high blood pressure (I12.0). Under the code I12.9, hypertension is indicated with damage to the kidneys without the development of insufficiency of their functions.

Behind the alphanumeric designations I15.0, I15.1, I15.2, I15.8, I15.9, various variations of secondary hypertensive disease are hidden. The code for primary hypertension is I10. Hypertensive crises are usually noted in this way.

Read the full article about the symptoms and first aid for hypertensive crisis here.

Hypertensive crisis according to mcd

A hypertensive crisis, according to the microbial code 10, refers to essential hypertension, although a sharp jump in pressure that threatens life can also occur with secondary manifestations of the disease. The I10 code is sometimes changed to other codes for hypertensive diseases after the diagnosis has been clarified. Quite often this happens with hypertension, which affects the heart and kidneys at the same time.

In Russia, there is still no legislatively fixed classification of hypertensive crises. In the USA and a number of other countries, the crisis in hypertensive patients is divided into two types:

Complicated;
Uncomplicated.

The first of them requires urgent hospitalization, regardless of the code for ICD 10. The second is stopped at home with subsequent treatment in a hospital. And these data can also be subjected to statistical processing.

Many countries have their own statistical centers that process various data. Due to the presence of classifications of diseases, it is possible to determine the prevalence of a particular disease in a certain region or an entire country. This allows you to quickly collect all the data on any disease - hypertension in microbial 10 occupies several different codes, and not 20-25 definitions with the name of specified diseases.

The analyzed data allows the ministries of different countries to correctly respond to a surge in a particular disease. Additional surveys are being created to identify an epidemiological disease in the initial stages, work is being carried out with the population and medical workers. Also, on the basis of such an analysis, information brochures and various materials on preventive measures specific illness.

Prevention of hypertension

Hypertensive disease occupies several codes for microbial 10 at once. There are several types of hypertension, including those that can damage various organs. Codes for hypertension were determined by the World Health Organization and will later be processed by statistical centers. In order not to become another unit in statistics, it is advisable to take preventive measures in advance, especially if there is a hereditary predisposition.

Proper nutrition with enough minerals and vitamins, normal physical activity, optimal weight and moderate salt intake can seriously help to avoid hypertension. If you exclude excessive stress, alcohol abuse and smoking, then the likelihood of hypertension will become even less. And then you don’t need to worry about which microbial code 10 for hypertension will be completely unnecessary.

Diagnosis and treatment of heart defects

The heart is a powerful muscular pump that works tirelessly. Its size is not much larger than a human fist. This organ consists of four chambers: the upper pair is called the atrium, the lower ones are the ventricles. During circulation, blood passes a certain path: from the atria it enters the ventricles, then into the main arteries. Four heart valves take an active part in this process, which, opening and closing, allow blood to flow in one direction.

Heart defects are changes or disorders in the structure of an organ that change the movement of blood inside it or in the systemic and pulmonary circulation. Problems can arise with partitions, walls, valves, outgoing vessels.

There are two groups: congenital and acquired defects.

Vices acquired

According to the International Classification of Diseases (ICD) of the 10th revision, acquired defects belong to sections 105–108 of the classifier. The ICD is a regulatory document used to record morbidity, the reasons why the population turns to medical structures, as well as the causes of death.

Acquired heart defects (or valvular) are disorders in the functioning of the heart, caused by structural and functional changes in the functioning of the heart valves. Signs of such disorders are stenosis or insufficiency of the valve. The reason for their development is the defeat of autoimmune or infectious factors, overload and dilatation (increase in the lumen) of the heart chambers.

In 90 percent of cases, acquired heart defects occur as a result of rheumatism. Most often, the mitral valve is affected (up to 70% of cases), less often the aortic valve (up to 27%). The smallest percentage of tricuspid valve defects is revealed (no more than 1%).

Why do acquired defects occur?

The most common causes of the development of such defects:

rheumatism;
infective endocarditis;
atherosclerosis;
syphilis;
sepsis;
cardiac ischemia;
connective tissue diseases that are degenerative in nature.

Classification of valvular defects

Exist various systems classifications:

on an etiological basis: atherosclerotic, rheumatic, etc.;
based on the severity: which do not affect the hemodynamics in the cardiac chambers, the severity of moderate and severe;
by functional form: simple, combined, combined.

How to recognize the disease

Symptoms and their severity depend on the location of the defect.

mitral valve insufficiency

At the beginning of the development of this stage, the patient does not have any complaints. When the disease progresses, the following symptoms appear:

during physical exertion, shortness of breath is observed (later it may appear at rest);
pain in the heart (cardialgia);
cardiopalmus;
dry cough;
swelling of the lower extremities;
pain in the right hypochondrium.

mitral valve stenosis

This pathology has the following symptoms:

the appearance of shortness of breath during physical exertion (later appears at rest);
voice becomes hoarse;
a dry cough appears (may form a small amount of mucous sputum);
heart pain (cardialgia);
hemoptysis;
excessive fatigue.

Aortic valve insufficiency

During the compensation stage, palpitations and pulsations behind the sternum are occasionally noted. Later, the following symptoms appear:

dizziness (possible fainting);
cardialgia;
during physical exertion, shortness of breath appears (later occurs at rest);
swelling of the legs;
pain and feeling of heaviness in the right hypochondrium.

Aortic valve stenosis

This type of disease is extremely insidious, since such a heart disease may not make itself felt for a long time. Only after the narrowing of the lumen of the aortic duct to 0.75 sq. see appear:

pains that are compressive in nature;
dizziness;
fainting states.

These are the signs of this pathological condition.

Tricuspid valve insufficiency

Main manifestations:

cardiopalmus;
dyspnea;
feeling of heaviness in the right hypochondrium;
swelling and pulsation of the jugular veins;
arrhythmias may occur.

Stenosis of the tricuspid valve

Symptoms of the disease:

The occurrence of pulsation in the neck.
Discomfort and pain in the right hypochondrium.
Decreased cardiac output resulting in cold skin.

Diagnosis and treatment

In order to diagnose valvular heart disease, you should contact a cardiologist who will collect an anamnesis, examine the patient and prescribe a number of studies, including:

general urinalysis;
biochemical blood test;
echocardiography;
Plain chest x-ray;
contrast radiological technique;
CT or MRI.

Acquired heart defects are treated medically and surgically. The first option is used to correct the patient's condition during the defect compensation state or when the patient is being prepared for surgery. Drug therapy consists of a complex of drugs of various pharmacological groups (anticoagulants, cardioprotectors, antibiotics, ACE inhibitors, etc.). Heart defects are also treated in this way when, for some reason (one of them is medical indications), it is impossible to perform surgical intervention.

When it comes to the surgical treatment of subcompensated and decompensated defects, heart defects can be subjected to the following types of intervention:

plastic;
valve-preserving;
valve replacement with biological or mechanical prostheses;
valve replacement with coronary bypass surgery;
aortic root reconstruction;
valve prosthetics for defects that arose as a result of infective endocarditis.

Heart disease involves a course of rehabilitation after surgery, as well as registration with a cardiologist after discharge from the hospital. The following remedial measures may be prescribed:

physiotherapy;
breathing exercises;
drugs to support immunity and prevent relapses;
control analyses.

Preventive actions

In order to prevent valvular heart disease from developing, it is necessary to treat in a timely manner those pathologies that can provoke damage to the heart valves, as well as lead a healthy lifestyle, which involves:

timely treatment of infectious and inflammatory diseases;
immune support;
giving up cigarettes and caffeine;
getting rid of excess weight;
motor activity.

Congenital malformations of the heart muscle

According to the ICD 10th revision, congenital malformations are classified under section Q20-Q28. In the USA, the classification of diseases of the heart muscle with the codes "SNOP" is used, the International Society of Cardiology uses the code "ISC".

What are congenital malformations, when do they occur, how to recognize them, and what methods does modern medicine use to treat them? Let's try to figure this out.

An anomaly in the structure of large vessels and the heart muscle, which occurs in the period from the 2nd to the 8th week of pregnancy, is called a congenital defect. According to statistics, such a pathology is found in one baby out of a thousand. Achievements modern medicine allow to detect defects at the stage of perinatal development or immediately after birth. However, congenital heart defects in 25% of cases remain unrecognized, which is associated with the peculiarities of the physiology of the child or the difficulties of diagnosis. That is why it is so important to monitor the condition of the child, which will identify the disease in the early stages and begin treatment. This task falls on the shoulders of adults who are next to the child.

Congenital heart defects include anomalies that are associated with stenosis, as well as insufficiency of the aortic, mitral, or tricuspid valves.

Anomaly Development Mechanism

In newborns, heart disease has several phases of the course:

Adaptation: the child's body goes through an adaptation period to the hemodynamic disturbances that the defect causes. If there are severe circulatory disorders, there is a significant hyperfunction of the heart muscle.
Compensation: is temporary, there are improvements in motor functions and general condition child.
Terminal: develops when the compensatory reserves of the myocardium are exhausted and degenerative, sclerotic and dystrophic changes appear in the structure of the heart.

Heart disease in the compensation phase is accompanied by a syndrome of capillary-trophic insufficiency, which subsequently becomes the cause of metabolic disorders, as well as various changes in the internal organs.

How to recognize a defect in a child

A congenital defect is accompanied by the following symptoms:

the outer skin has a bluish or pale color (more often it is noticeable in the nasolabial region, on the fingers and feet). During breastfeeding, crying or straining the child, these symptoms are especially pronounced;
the child is lethargic or restless during attachment to the breast;
the baby is not gaining weight well;
often spit up when eating;
the cry of a child, despite the fact that there are no external signs or factors that can cause such behavior;
there are attacks of shortness of breath, rapid breathing;
sweating;
swelling of the upper and lower extremities;
swelling is seen in the region of the heart.

Such signs should be a signal for an immediate visit to a doctor for an examination. During the initial examination, the pediatrician, having identified heart murmurs, will recommend further management of the case by a cardiologist.

Diagnostic measures

A birth defect can be diagnosed through a series of tests, which include:

general blood test;
radiography;
EchoCG.

According to indications, additional diagnostic methods may be prescribed, for example, cardiac sounding. But there must be good reasons for this: for example, preliminary analyzes did not reveal the full clinical picture.

Treatment of birth defects

Children with a congenital defect must be observed by a district pediatrician and a cardiologist without fail. How many times should a child have a medical examination? In the first year of life, examination by specialists is carried out quarterly. After the child is one year old, you need to be examined every six months. Examination should take place monthly if the heart disease is severe.

There are a number of conditions that should be created for children with a similar problem:

Natural feeding with mother's milk or donor milk.
Increase the number of feedings by 3 meals, while the amount of food should be reduced by one meal.
Walking on fresh air.
Small physical activity, while there should not be signs of an uncomfortable state in the child's behavior.
Hard frost or direct Sun rays are a contraindication.
Prevention of infectious diseases.
Rational nutrition: control over the amount of liquid absorbed, salt, inclusion in the diet of foods that are rich in potassium (dried apricots, raisins, baked potatoes, etc.).

Congenital malformation is treated with surgical and therapeutic techniques. Most often, medications are used to prepare the child for surgery or treatment after it.

Surgery is recommended if severe heart disease is present. At the same time, depending on its type, the operation can be performed using a minimally invasive technique or by connecting the child to a heart-lung machine on an open heart. Certain symptoms indicate the need for surgical treatment in several stages: the first stage involves alleviating the general condition, the rest are aimed at the final elimination of the problem.

If the operation is carried out in a timely manner, the prognosis in most cases is favorable.

It is important to pay attention to the slightest signs of the disease and seek the advice of a specialist: it is better to be safe than to deal with irreversible consequences. This applies both to the monitoring of children by their parents and to the health of the adults themselves. You need to take a responsible approach to your health, in no case should you tempt fate and not hope for luck in matters that concern it.

No one can say for sure how long a person with heart disease can live. In each case, the answer to this question will be different. When people need surgery but stubbornly refuse it, the question is not how long a person will live, but how such people live. And the quality of life of a sick person is quite low.

Heart defects, both congenital and acquired, are a serious diagnosis, but with the right approach and an adequate choice of treatment, it can be corrected.

Signs of stomach cancer at an early stage

There are very serious questions about health, for example, how to identify stomach cancer, the first symptoms of which can be confused with other ailments. It is important to know what needs to be done in order to protect yourself from the development of a malignant tumor, and what are the methods of treatment and prognosis with an established diagnosis.

It is known that this oncological disease is more common in people over fifty years of age and is 10-20% more common in men than in women of the same age. Gastric cancer is one of the leading causes of death (about 10% in the world and 14% in Russia), so the information related to it is always relevant, especially for our country.

Gastric cancer is common along with lung, intestinal, skin oncological diseases and malignant tumors of the mammary glands. Every year, 750 thousand people die from it in the world, while the incidence depends on geography. In Western European countries and America, for example, the frequency is low, while in Russia, Brazil, and Japan it is high.

Russia shows the following ratios of survival to stages of the disease:

Stage 1 is detected in 10-20% of people, 60-80% of whom overcome the five-year period;
Stages 2 and 3 with local lesions of the lymphatic system are detected in 30% of patients, 15-45% of them manage to live for five years;
Stage 4 with metastases spreading to nearby organs is found in half of the patients, for whom a favorable outcome after five years is only a 5-7% probability.

A positive prognosis, even in the case when the disease can be cured, is not always possible, since there is a tendency to relapse, which is difficult to eliminate by repeated intervention. Unfortunately, in Russia the situation is such that 35% of patients are significantly late with the examination.

The appearance of a tumor node is difficult to detect for a long time.

Often, diagnostic misses are associated with the similarity of symptoms of gastrointestinal diseases and heart diseases that are not related to oncology:

If the tumor is located in the cardiac segment (end of the esophagus), this is associated with chest pain, especially with high blood pressure in patients over 50 years of age;
if the localization of degeneration is near the duodenum, it may look like gastritis, ulcer, cholecystitis, pancreatitis, which are characterized by vomiting, gastrointestinal bleeding and pain.

Incorrect diagnosis and the absence of obvious signs do not allow time to recognize the main cause of deviations in the elderly.

The doctor and the patient should be alerted by the following observed sensations characteristic of small cancer (two or three points minimum):

Permanent heaviness and discomfort in the abdomen, belching, heartburn;
retrosternal pain felt in the back, difficulty in swallowing;
prolonged pain in the abdominal region, which is not removed by medicines;
constant fatigue and weakness at the slightest physical exertion, dizziness;
loss of appetite up to an aversion to food and rapid weight loss, a change in mood for the worse (depression);
rejection of meat and fish, atypical intelligibility in food;
fast onset satiety with very little food, in which there is no satisfaction;
enlargement of the abdomen due to accumulation of fluid (ascites);
pale skin (anemia);
a slight increase in temperature over a long period;
flatulence and defecation disorders (gas formation and unhealthy stools).

The patterns inherent in the disease are revealed by clinical experience.

Two or three signs must be combined:

Painful sensations in the central epigastric region, as reported by two-thirds of the subjects;
strong weight loss, which is observed by half of the patients;
gag reflex and nausea accompanying food intake - within 40% of people;
nausea and bloody vomiting (signs of intoxication) - in the region of a quarter of patients;
blanching of the mucous membranes - about 40%.

It is worth noting that depending on where the cancerous tumor develops, the manifestation of various signals is observed. This does not rule out general symptoms.

1. A malignant formation closer to the esophagus is accompanied by heart pain and constraint of swallowing function up to the cessation of food intake, dehydration progresses.
2. The affected middle region of the digestive organ is characterized by developing anemia (lack of hemoglobin) and gastric bleeding, with its profusion changing the color and consistency of feces to pitch-black, liquid (at the same time fetid).
3. Damage closer to the duodenum has consequences such as stool disorders, vomiting and belching with a rotten egg smell.

Do not forget about suspicious health problems so as not to complicate a dangerous condition. It is necessary to notice the symptoms of stomach cancer in a timely manner and seek medical help long before the advanced stages of cancer cell development. After all, such a delay in most cases threatens death.

The development of malignant tumors is a long process, passing through many degrees. Highlighting the stages, the following systematization can be given.

1. Progression of mutations under the influence of carcinogens.
2. Diseases that precede cancer.
3. Activation of oncology against the background of the influence of carcinogens and precancerous diseases.

Stage I

Internal causes are immune, infectious, age and hereditary factors. For example, people with blood type II fall ill 20% more often, an A. pylori infection increases the chance of a cancerous tumor several times; after overcoming the fifty-year age threshold, there is a multiple increase in risks.

The external causes of the first stage include diet. Dangerously unlimited food spicy, salty, hot, fried, smoked, canned food, pickled vegetables. It should also be noted in this regard that there is no measure in the use of drugs (antibiotics, analgesics, hormonal drugs), an excess of starch, nitrates, nitrites, synthetic food additives(dyes, flavors, flavor enhancers). Finally, the unconditional harm in this regard of tobacco and strong alcohol has been proven.

The lack of some useful substances and vitamins. For example, vitamin C is responsible for the quality and quantity of hydrochloric acid, reducing bleeding, vitamin E regulates the resistance of mucous membranes, and vitamin B12 and folic acid involved in normal cell division.

II stage

III stage

The previous factors in interaction with the yet unknown causes trigger carcinogenesis. However, it can be reliably stated that serious complications usually appear after Helicobacter pylori infection, damage to the digestive organ and the activity of carcinogens.

The process of occurrence of a malignant tumor is not studied deeply enough. The absence of symptoms can last for years.

Gastric pathologies are varied.

There is the following classification of cancers according to the principle of growth:

1. Intestinal type. Metaplasia (a transitional state) occurs, that is, the gastric mucosa shows similarities with the intestinal mucosa. It is more often observed in people of solid age and originates from chronic diseases of the gastrointestinal tract. The prognosis is relatively favorable.
2. Diffuse type (penetrating). Genetically determined. Mutated cells spread along the gastric walls, the mucosa is normal.
3. Mixed type.

In addition to forms, the degree of prevalence is also classified, which is of the greatest importance.

So, the most common adenocarcinoma develops as follows:

1st stage - cancer cells do not go deep into muscle tissue, they may spread to neighboring lymph nodes;
2nd stage - the penetration of the tumor deep into the wall of the stomach begins, the lymph nodes are damaged;
3rd stage - complete damage to the gastric wall, increased damage to neighboring lymph nodes, there is a possibility of infection of nearby organs;
Stage 4 - peripheral metastases.

Mutation of cells can spread in different ways and take different forms. As a result, there are various definitions.

Signet cell carcinoma

This aggressive disease belongs to the diffuse type with altered squamous cell formation. It is characterized by a certain predominance among female patients, as well as peaks of occurrence in the intervals between 40-50 and 60-70 years. Almost half of the patients have blood group II. A relationship with bad habits and external adverse factors has not been found, however, the species is more often observed in cities.

Infiltrative cancer

A type of carcinoma with indistinct boundaries of the neoplasm, one of the most malignant. The lesion is localized mainly in the thickness of the gastric wall. The foci of oncological cells are 5-8 cm apart. Noticeable hereditary predisposition and the possibility of development in relatively young people. The clinical stage is accompanied by violations of peristalsis, vomiting. The tumor is stony, often spreading metastases.

Poorly differentiated cancer

In addition to these typologies, there is another generally accepted codification - the International Classification of Diseases (ICD 10), in which a disease is assigned a code with a subcode for clarification. ICD 10 has some shortcomings, so it is possible to improve it in accordance with the latest research.

Tumors of a malignant nature are classified by the World Health Organization into 11 types according to cellular forms. In 90% of cases or more, adenocarcinoma is found - a neoplasm of glandular cells.

Early detection of the disease is problematic, and reducing the mortality associated with it is an important task of medicine. Of great importance for detection is the vigilance of doctors general practice and their professional sensitivity. It is useful to know that many methods contribute to the correct diagnosis.

There is such a concept - screening - a regular examination, even in the absence of symptoms, which contributes to the timely detection of neoplasms. For this, FGS is used - fibrogastroscopy - a popular endoscopic method in which a thin and flexible tube equipped with a small video camera and a light bulb is inserted into the stomach through the mouth. area, the mucosa is taken and the sample is sent to the laboratory (biopsy), which allows for an accurate diagnosis. The effectiveness of gastroscopic studies is confirmed by the experience of Japan, where mortality rates, despite the incidence rate, are low.

Diagnosis is also made using other relevant methods, such as:

FGDS (fibrogastroduodenoscopy) is a more advanced form of gastroscopy, in which the duodenum is additionally examined; the method can be modified with optical attachments (until it is possible to observe the cellular level), but it is inconvenient for differentiating benign and malignant neoplasms;
radiography of the gastrointestinal tract - for this, patients take a contrast solution (barium) orally, covering the mucous membrane, after which clear radiographs are obtained, showing even minor changes(the X-ray method can also be applied to the chest, skull, limbs to detect metastases);
CT (computed tomography) and PET (positron emission tomography), which allow you to take X-rays from different angles and give a clear picture, find out the spread of oncological formations using radiopharmaceuticals (radioisotopes), used due to their selective concentration;
MRI (magnetic resonance imaging), which allows layer-by-layer examination using powerful magnets - like CT, one of the most informative methods;
diagnostic laparoscopy, in which a laparoscope (a tube with a mini-camera) is inserted into the patient's abdomen through an incision to determine the boundaries of the spread of oncological formation in abdominal cavity and the possibility of its removal, while tissue and fluid can be taken for research;
ultrasound ( ultrasonography), which helps to detect the tumor itself and damage to the lymph nodes, neighboring organs - can be carried out from the outside (including using a degassed liquid to fill the organ under study) and from the inside (with an endoscopic probe);
tumor markers used to assess the response of tumor tissues to therapy when the diagnosis is established;
analyzes - biochemical, immunological and general for blood, fecal occult blood analysis and urinalysis.

Science goes to great lengths to find the best means of fighting disease. So, in foreign oncological centers drugs with a "targeted" action (destroying mutated tissues) are used - immunoglobulins and enzyme inhibitors.

In Russia, the predominant method is surgical (radical). The complexity of the operation is determined by the degree of damage.

1. If the thickness of the gastric wall is not damaged, an endoscopic resection is performed (the instrument is inserted through the mouth or a minimal opening is performed). In simple cases, cauterization of neoplasms is used using electrothermal and laser exposure.

2. Subtotal gastrectomy involves the removal of the damaged part of the digestive organ, and with total gastrectomy, the stomach is cut out along with nearby tissues. It is also possible to eliminate neighboring lymph nodes and organs affected by metastases.

3. When recovery is impossible, a palliative operation is used - resection of oncological formation to alleviate the patient's condition. In hopeless cases, when the diseased areas are no longer operable, a gastrostomy is used - an opening in the anterior abdominal wall for food to enter.

Radiation therapy (X-ray radiation in small doses) is used before and after surgery, in the first case - neoadjuvant (to facilitate resection), in the second - adjuvant (to destroy cancer cells). Side effects of radiation are usually stool disorders and nausea, but in some cases the method will help to avoid surgery.

Often, chemotherapy is also used with radiation therapy (of the same two types - neoadjuvant and adjuvant), the complex of which, with little chance of a cure, prolongs the patient's life and alleviates symptoms, but generally has a negative effect on the body. The consequences of chemotherapy (removable recovery) are baldness, weight loss, liver damage with toxins, hematopoiesis disorder, immune suppression and more.

Drug treatment is also prescribed as a symptomatic therapy - for pain relief, elimination of flatulence, nausea and vomiting, normalization of digestion and strengthening of immunity.

There is also a relatively new method of therapy - photodynamic. It comes down to the use of light and photosensitizers (drugs used to identify affected areas). Cancer cells are exposed to laser beams (LED tubes), resulting in a toxic reaction and they die without destroying healthy tissue.

The tactics of treatment is chosen depending on the degree of carcinogenesis. Most often, surgery is used in combination with chemotherapy.

Lifestyle and diet for patients

Patients should adhere to certain lifestyle and dietary guidelines to minimize the risk of relapse:

Prolonged sleep and rest, normalization of the regime;
limitation of physical activity;
walks in the open air;
support for good mood;
spa treatment (excluding physiotherapy);
regular visits to the doctor for diagnosis and treatment;
the first 3-6 days (depending on the complexity of the operation) after surgery, it is allowed to drink only water, then liquid, pureed food is given, and only after that the diet gradually expands.

After the operation, you need to eat 4-8 times a day in small portions. Boiled, stewed and baked foods are allowed for consumption - cereals and soups, vegetables, fruits that do not contribute to clear fermentation, dairy products, bread, lean fish and meat. Whole milk and confectionery are limited.

Alcohol, tobacco, coffee and food that irritates the gastrointestinal mucosa are excluded. Due to the loss of a large amount of fluid by the body (due to vomiting, bleeding), up to 2 liters of water per day is recommended, and juices with pulp can help with this (especially if there are no edema).

Prevention

Don't forget the importance of a healthy diet.

To reduce the chances of cancer, you should strive to implement the following tips:

Reducing the harmful effects of a polluted environment and chemical compounds, attention to the quality of vegetables used for food (exclusion of carcinogens and nitrates);
the use of milk, fresh products containing vitamins and minerals;
reduction in the amount of fatty, fried, spicy, smoked foods, preservatives, salt;
natural diet (avoiding overeating and irregular meals);
avoidance of bad habits;
moderate medication;
a thorough examination and compliance with the instructions of the attending physician in the presence of precancerous ailments.

Parok heart mcb 10. Congenital heart defects. How is sinusitis treated?

Causes

Classification

Violation of hemodynamics

Symptoms

Diagnostic measures

How to treat congenital heart disease

Prevention

Forecasts

Congenital heart disease code micb 10

The most common congenital heart defects in children and adults

Heart defects from birth

Main etiological factors

Opening of the arterial duct

Aortic valve insufficiency

Stenosis and atresia of the aorta

Tetrad and Triad of Fallot

Patient Examination Plan

Therapeutic tactics for congenital malformations

What is the danger of sick sinus syndrome and how to treat it?

Conduction system of the heart and sinus node

Node weakness formation

Causes of sinus node weakness

Causes of sinus node dysfunction

Classification

Symptoms

Cerebral

Cardiac

Other symptoms

Diagnostics

Treatment

pacing

Folk remedies

Complications and prognosis

Prevention

Bicuspid aortic valve

GSP encoding

However, heart problems include:

Specification Congenital heart disease ICD code 10

Classification

Reasons for development

Symptoms

Diagnostics

Acquired heart disease code for mcb 10

What is the danger of sick sinus syndrome and how to treat it?

Conduction system of the heart and sinus node

Node weakness formation

Causes of sinus node weakness

Causes of sinus node dysfunction

Classification

Symptoms

Cerebral

Cardiac

Other symptoms

Diagnostics

Treatment

pacing

Folk remedies

Complications and prognosis

Prevention

congenital heart defects

GSP encoding

However, heart problems include:

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