They write that a schoolgirl who died in a physical education lesson had a heart murmur and an additional chord in the left ventricle. But she was still not released from physical education. Is this pathology not dangerous, and could it lead to death?
Indeed, there is information on the Web that the girl’s medical record mentions a heart murmur and an additional chord in the left ventricle. She was also reported to have had hypertrophic cardiomyopathy. After reading this, parents begin to worry about their children with the same problems. Knowledge in such a situation is the best adviser.
About how dangerous it is and whether these conditions are associated with sudden death, says aif.ru pediatric cardiologist, doctor of medical sciences, professor, chairman of the scientific council of the public organization “Crystal Heart” and a leading specialist in such problems in Russia Leonid Makarov:
“Heart murmur is not a diagnosis, but one of the symptoms determined by auscultation (listening) of the heart. Therefore, it is wrong to associate noise with the sudden death of a person. After all, it can be in healthy people. And not all diseases accompanied by noise can lead to such death. Moreover, a significant proportion of diseases that can cause sudden death occur without heart murmurs. But if they are, then echocardiography (ultrasound examination of the heart) is usually performed. It allows you to determine the cause of the noise. The method shows the structure of the heart, its size, changes in valves, walls of the ventricles and atria. It also allows you to assess hemodynamics – how the heart pumps blood, is it normal or not.
It is with echocardiography that additional chords are determined. But this is also not a disease, but, as a rule, a variant of the norm. They cannot be the cause of sudden death.
As for hypertrophic cardiomyopathy, which is written about, but which has not yet been officially confirmed, it can lead to such tragic outcomes in children and adults. This is a rare hereditary disease caused by genetic mutations. They are different, so the course of the disease and the prognosis also differ. But in principle, in this condition, a violation of the rhythm of the heart can occur, leading to its stop. To avoid this, the main thing is to identify the disease in a timely manner and prescribe adequate treatment. This includes drug therapy and, if necessary, insertion of an cardioverter defibrillator. This is a device that constantly monitors the rhythm of the heart, and if a dangerous arrhythmia starts, it inflicts an electrical discharge that extinguishes it. The level of physical activity with optimal treatment is determined by the doctor. But competitive sports are strictly prohibited.
There are several other diseases in which arrhythmias occur, causing cardiac arrest. Basically, they can be divided into two groups – cardiomyopathies and channelopathies. All of these are rare hereditary diseases. These include long or short QT syndromes (often seen simply on the ECG), catecholaminergic ventricular tachycardia, Brugada syndrome, arrhythmogenic right ventricular cardiomyopathy, hypertrophic cardiomyopathy. Unfortunately, in our country they are not detected as often as we would like. These diseases have been studied relatively recently and even not yet completely, so pediatricians, therapists, general practitioners and even cardiologists sometimes have a poor understanding of them. To combat these diseases, many countries organize specialized specialized medical centers. There they are successfully identified, and the whole family needs to be examined, since they are hereditary, very often proceed secretly and can be with several family members at once.
But even with such diagnoses, physical education is not prohibited and moderate exercise is allowed. To save patients in schools and other educational institutions, completely different measures are needed. Physical education teachers, school doctors, nurses, etc. should be trained in the methods of primary resuscitation. And the institutions themselves should be supplied with safe automatic external defibrillators. In many countries, all this is available, and half of these children are saved there. Nearly all of them die here. In order to stop this by introducing appropriate measures, it is vital to finally adopt amendments to federal law No. 323 “On the fundamentals of protecting the health of citizens in the Russian Federation.” They have been prepared, but several convocations of the State Duma have not been able to adopt them. Without this, everything will continue as it is now, we will regularly read about such tragedies in the media, and even more of them will pass silently and unnoticed. This is how 200 to 300 children die a year.”