The child is noticeably thin

Introduction Because of the influence of certain diseases, children are significantly smaller and smaller than normal children. Pediatric apparently small and small is one of the clinical symptoms of congenital heart disease. The development of infants with congenital heart disease is significantly behind that of children of the same age, manifested as thinness, malnutrition, and stunting. Congenital cardiovascular disease is the most common type of congenital malformation. With the progress of cardiac diagnosis methods and surgical treatment techniques, most of the congenital cardiovascular diseases can obtain clear diagnosis and surgical correction treatment, and the prognosis is significantly improved.

Cause

As the fetal heart is disturbed during development, some developmental pauses or defects, and some of the degenerates are not completely degraded.

First, the environmental factors surrounding the fetus. Intrauterine viral infection in early pregnancy, more common after rubella virus infection, often cause patent ductus arteriosus and pulmonary stenosis, followed by Coxsackie infection (Coxsakie) can cause endocardial fibroelastosis, in addition to amniotic membrane disease, Mechanical compression around the fetus, maternal dystrophies, vitamin deficiency and metabolic diseases, maternal cytotoxic drugs or longer-term radiation exposure may be related to the occurrence of this disease.

Second, genetic factors. 5% of patients with congenital heart disease occur in the same family, and the disease is the same or similar, possibly due to genetic abnormalities or chromosomal aberrations.

Third, other. The incidence of patent ductus arteriosus and atrial septal defect in high altitude areas is high, which may be related to hypoxia. Some congenital heart disease is gender-oriented.

Fetal period: Mother did not pay attention to nutrition and health during pregnancy during pregnancy, resulting in fetal dysplasia. The baby's height and weight at birth are lower than normal, which directly leads to childhood thinness.

Neonatal period: Insufficient feeding during the neonatal period is another cause of the child being too thin. During the neonatal period, especially one week after birth, if the calorie is insufficient, insufficient nutrition will lead to growth and development throughout the childhood. Therefore, the child must be fed during the newborn period. If it is artificial feeding, the concentration of the milk powder must be in accordance with the scientific ratio.

Infancy: If parents do not add the necessary supplementary food to the baby in a timely manner, the total calorie intake of the infant is insufficient to meet the needs of rapid growth and development, which is also the cause of the child's thinness.

Early childhood: Children at this stage are mainly due to poor eating habits, such as excessive eating of snacks affecting the appetite of the dinner, and picky eating.

Other reasons: lack of trace elements. The most important thing that affects the growth of children is zinc. Zinc deficiency can reduce your appetite. So if your child is small, you should go to the hospital to check if there is a lack of zinc.

Pathological factors. Congenital diseases such as hypertrophic pyloric stenosis; iron deficiency anemia, tuberculosis, repeated respiratory infections, glomerulonephritis, rheumatic fever, protein-energy malnutrition and other chronic diseases, etc., will make children become thin and small.

an examination

Related inspection

Body function and nutrition

Diagnosis can be based on the clinical symptoms of congenital heart disease.

Light asymptomatic, when examined, found that severe cases may have difficulty breathing after breathing, purpura, syncope, etc., older children may have growth retardation. The presence or absence of symptoms is also related to the type of disease and the presence or absence of complications.

According to hemodynamics combined with pathophysiological changes, it can be classified into three categories:

First, there is no diversion class. There were no shunts on the left and right sides, no purpura, such as pulmonary stenosis, aortic stenosis, aortic coarctation, primary pulmonary artery dilation, primary pulmonary hypertension or right heart.

Second, left to right shunt class. There is an abnormal channel between the left and right heart chambers or between the main and pulmonary arteries. The left side pressure is higher than the right side. The left side arterial blood enters the right venous blood through the abnormal channel---left to right shunt, such as atrial septal defect, ventricle Septal defect, patent ductus arteriosus, main pulmonary artery septal defect, partial pulmonary vein malformation drainage, Valsalva sinus aneurysm broke into the right heart. Generally, there is no purpura. If there is pulmonary hypertension in the late stage, there is a bidirectional or right to left shunt, then purpura, also known as late purpura.

Third, right to left shunt class. The pressure in the right heart chamber or pulmonary artery is abnormally increased, and blood flow flows into the left heart chamber or the aorta through the abnormal channel. Shortly after birth, there are purpura, such as tetralogy of Fallot, trilogy of Fallot, tricuspid atresia, permanent arterial trunk, large blood vessel borrowing, Eisenmenger's syndrome.

Differential diagnosis

Differential diagnosis of small and small children:

1. Progressive wasting: Progressive wasting was performed in a short period of time. There was a comparison of body weights measured before and after weight loss, and there was obvious clothing widening, the belt became loose, the shoes became larger and the subcutaneous fat decreased, and the muscles were thin. Relaxed skin, protruding bones and other circumstantial evidence.

2, systemic weight loss: systemic weight loss refers to the body caused by disease or certain factors, weight loss, below 10% of the standard weight is weight loss (the author believes that the weight is 10% lower than the standard weight is lean Less than 20% is called weight loss).

3, severe skinny is "skinny": the patient is caused by protein-energy malnutrition disease, the clinical manifestation is weight loss, which is characterized by weight loss, subcutaneous fat disappears, dry and loose skin and loss of elasticity and luster, severe weight loss It is a "skin and bones". It is one of the clinical symptoms of protein-energy malnutrition.

Protein energy malnutrition (PEM) is a nutritional deficiency caused by insufficient food supply or disease factors, clinically manifested as marasmus and mastic dystrophy syndrome (kwashiorkor). Weight loss is the result of chronic lack of calories, protein and other nutrients in the diet, or problems caused by the patient's digestion, absorption and utilization of food. This type is mainly characterized by lack of energy and lack of protein. It is characterized by progressive weight loss, reduction of subcutaneous fat, edema and dysfunction of various organs. Malignant malnutrition is characterized by a lack of protein in the diet, and the supply of heat is still sufficient, mainly manifested as dystrophic edema. However, most patients are somewhere in between. Light chronic protein-energy malnutrition is often neglected. It affects children's growth and development, immune function, and is easy to get sick and difficult to recover.

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