One of the extra heart sounds is a heart murmur, which usually indicates turbulent and irregular blood flow within the cavities and through the valves of the heart. A heart murmur in children can have either physiological or pathological causes. Usually, a physiological heart murmur in children disappears once the underlying condition is treated or once the child reaches their teenage years or adulthood. A pathological heart murmur in children indicates an underlying heart trouble that is usually structural in nature. It needs to be assessed and managed by a cardiologist.also has risks. These are rare, but can include pelvic infection, the formation of scar tissue after surgery, and damage to the bowels or bladder. In very rare cases, damage to blood vessels or uncontrolled bleeding
Normally, the heart only produces two sounds called sound 1 (S1) and sound 2 (S2), heard as lub-dub on auscultation. In the presence of a murmur, these sounds are interrupted, preceded, or followed by a swishing or whistling sound, which is called a murmur. Common heart murmur types encountered in children are normal physiological, or innocent, murmurs.
Innocent murmurs are also called functional, benign, vibratory, or flow murmurs. Causes include a thin chest wall, a straight back, anemia, and fever. Children generally have thin chest walls and relatively straighter backs that make the heart closer to the surface of the chest. Blood flow is then easily heard and reported as a murmur.
When a child has a fever or anemia, the rate of his or her blood flow increases to facilitate the delivery of oxygen and nutrients to the organs. The increased blood flow leads to turbulent flow within the heart and manifests as a murmur that eventually disappears as the fever or the anemia resolves. Two innocent murmurs that are sometimes mistaken as abnormal ones include Stills murmur and venous hum. Stills murmur, also called musical murmur because of its musical quality, usually occurs in children between the ages 3 and 6 years. Venous hum is a soft humming murmur that can be heard over the jugular veins, also occurring in 3- to 6-year-old children.In general, with the exception of the venous hum, heart murmurs characterized as either diastolic, holosystolic, or late systolic are abnormal in nature. A murmur that has any of these qualities should prompt the physician to search for an abnormality in the heart or blood vessels. Pathological or abnormal causes of heart murmur in children include structural abnormalities of the heart valves, heart cavities, or arteries connected to the heart. Such structural abnormalities may be congenital or acquired.
Congenital anomalies like atrial septal defect (ASD), coarctation of the aorta, tetralogy of Fallot, patent ductus arteriosus (PDA), and ventral septal defect (VSD) all manifest with murmurs. ASD, VSD, and tetralogy of Fallot are conditions wherein there is an abnormal communication between the left and right sides of the heart. Acquired conditions such as rheumatic heart disease due to untreated streptococcal infection can lead to narrowing or insufficiency of the heart valves. Narrowing leads to valvular stenosis, while insufficiency leads to valvular regurgitation. Both of these also present with heart murmurs.
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1.Read and translate the text.
Obesity
Severe obesity, also known as morbid obesity, occurs when a person is severely overweight. Physicians generally measure obesity using a scale known as the body mass index (BMI), which helps doctors determine what percentage of a person's weight is body fat. Persons with a BMI of 30 or higher are generally considered obese, while persons with a BMI of 40 or higher may be considered to be suffering from severe obesity. Some experts define severe obesity as being 100 pounds (45.4 kg) or more overweight. Morbid obesity is considered a serious public health problem, because it raises a person's risk of developing multiple health conditions, including cardiovascular disease, diabetes, stroke, and depression.
Unhealthy diets and sedentary lifestyles are believed to be major contributors to obesity, especially in the developed world. Women who have had children may be more likely to experience obesity, due to the weight gain that can occur during pregnancy. Persons who are overweight as children or adolescents may be more likely to experience adult obesity.
Certain health problems, including chronic insomnia, and the use of certain prescription drugs, can contribute to weight gain and obesity. Researchers believe that environmental and genetic factors can play a large role in obesity. People who immigrate from less-developed to more-developed nations appear, for instance, more likely to develop obesity as they adopt the lifestyle and eating habits of the more prosperous culture.
Obesity and morbid obesity can put a patient's health at serious risk. Health complications related to severe obesity can include hypertension, cardiovascular disease, fatty liver disease, and type 2 diabetes. Persons suffering from severe obesity often have an elevated risk of arthritis, reproductive problems, stroke, and various cancers. Experts believe that even a small reduction in body weight can help drastically lower the risk of health complications related to obesity.
When obesity becomes severe, diet and lifestyle changes alone may no longer be sufficient to treat the condition. While diet and lifestyle changes are almost always considered essential to treating severe obesity, medication or surgery may also be advised. Some prescription weight-loss drugs approved by the United States Food and Drug Administration may assist weight loss by hampering the body's ability to absorb fats from food. Bariatric surgeries, including gastric bypass or the lap-band procedure, can assist weight loss by reducing the size of a patient's stomach or shortening the digestive tract so that it absorbs fewer nutrients. Weight loss surgeries and medications can have serious side effects, and are usually only considered for patients suffering severe obesity accompanied by dangerous medical complications.
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