Alteration in the cardiovascular function mostly among children links to Congenital Heart Disease (CHD). Among children who participate in sports activities, CHD is one of the most common triggers of Sudden Cardiac Arrest. There is a need for a proper examination of children taking part in different sports as they are vulnerable to sudden cardiac arrest. In most cases, physicians cannot report the cardiac arrest and its death-related cases because of inadequate screening of children taking part in sports activities. Like in the case given, the 16 years old boy is cleared to play despite the fact the nurse specialist reporting abnormal signs such as hearing an II/VI systolic murmur, loudest at the apex of the heart. The boy later collapses and dies because of many factors that people less considered before being cleared to play.
Diagnosis
Physicians can diagnose the kid with valvular hypertrophic cardiomyopathy (HCM) and Mitral valve incompetence (MVI). The heart’s Auscultating a grade II systolic murmur at the apex may indicate mitral valve involvement. According to Huether & McCance (2017), valvular dysfunction can occur from structural remodeling changes in congenital or acquired conditions such as rheumatic heart disease. As a result of the structural alteration, a condition such as a stenosis or regurgitation is possible. It is a condition where the valves fail to shut the backward flow of blood or prevent it from leaking back to the proximal chamber. As a result, the backward flow of the blood to the proximal chamber. Such a situation leads to an increasing volume of blood at the chamber increasing myocytes to adopt by changing to hypertrophied at the site due to Laplace law which ends up resulting in cardiac dysfunction or death. Valvular dysfunction, which links to the hypertrophied heart muscle, is called the valvular hypertrophic cardiomyopathy (HCM). In the case of the kid, the auscultatory finding could be pathologic, and findings could be severe because the position the kid is made to lie. In this case, more screening was necessary to ascertain the condition before the boy if cleared to play. Notably, both HCM and Mitral valve incompetence (MVI) can be asymptomatic until there is fatal heart failure. They manifest through heart failure, angina, syncope, dyspnea on exertion, and palpitations. Physicians can use the diagnostic tests, in this case, include an electrocardiogram (ECG), chest x-ray, and cardiac catheterization.
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Treatment
The MVI and HCM treatment focus on uprooting the cause of the diseases and also reducing the symptoms of heart failure. The first technique is the pharmacological approach, which includes prescribing medications such as ace inhibitors, beta-blockers; anticoagulants, vasodilators, and antiarrhythmic as underlined by the American Heart Association, (2016). According to the American Heart Association(2016), and surgical operation can also be effective. These include valve repairs or replacement procedures, like the Ross Procedure, or TAVAR.
Genetics
According to LaHaye, Lincoln, & Garg (2014), 2-3% of the population suffers from mitral valve prolapse (MVP). The authors further suggest that when physicians diagnose a patient with the MVP, such a person is at risk of being diagnosed with mitral valve regurgitation. The authors also claim that Genetic advances in MVP have occurred in association with connective tissue disorder, Marfan syndrome. Also, the loss of Filamin A (FLNA) at fetal development links to vulvar cardiovascular abnormalities. Therefore, it would be possible to link the boy’s condition to the family background. The Nurse should check the family medical history to ascertain such condition as such a procedure can help during diagnosis.
References
American Heart Association. (2016). Heart murmurs and valve disease. Retrieved from http://www.heart.org/HEARTORG/Conditions/More/HeartValveProblemsandDisease/Heart-Murmurs-and-Valve-Disease_UCM_450616_Article.jsp#.WVL1woqQzBI
Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby.
LaHaye, S., Lincoln, J., & Garg, V. (2014). Genetics of valvular heart disease . CurrCardiol Rep 16 ( 6 ):487 doi: 10.1007/s11886-014-0487-2
