Medicine for children to nourish the heart muscle

Currently, there are no exclusive myocardial nutritional drugs specially developed for children. All clinically used myocardial nutritional preparations have been verified for pediatric safety. These drugs are not household medicines. They must not be purchased by themselves for children to take. They must be prescribed by a pediatrician after assessing the myocardial damage.

I just met a mother in the outpatient clinic last week. She came in with the test sheet of her child after a cold, pointed to the CK-MB (creatine kinase isoenzyme) that was less than 2 times higher, and asked, "Doctor, please prescribe us the best medicine to nourish the heart muscle, so as not to leave any sequelae for the baby." This situation is really too common. Many parents panic when they see a floating arrow on the myocardial enzyme indicator. Don’t be anxious yet, let’s talk slowly.

The most commonly used drug in clinical practice is sodium fructose diphosphate, which is available in oral solutions and intravenous preparations. The principle is to replenish energy to damaged cardiomyocytes and help them repair quickly. However, there has always been controversy about this drug. Some colleagues around me think that it can be used as long as the cardiac enzymes are elevated, and speeding up recovery can also reassure parents; some colleagues feel that if the increase is mild and transient, and the child has no symptoms, the recovery speed will be almost the same with or without use, and there is no need to put additional burden on the gastrointestinal tract. My own habit is to check the child's condition. If he is active and active, and does not have minor symptoms such as sighing or fatigue, he will be sent home to rest and observe, and then he will be reexamined in two weeks. If there are really symptoms, it is not too late to start the treatment. Moreover, the taste of this medicine is sour, and many children will have diarrhea after drinking it. If I really need to prescribe it, I will usually get vaccinated with my parents in advance.

Another question that people often ask about is Coenzyme Q10. I would like to remind you, don’t give your children the large-dose fat-soluble tablets that adults use. Children use basically water-soluble drops or suspensions, and the dose can be controlled well if they are absorbed well. However, I read foreign pediatric studies in the past two years and said that for children with mild viral myocardial damage, there is no significant difference in the recovery rate between taking Coenzyme Q10 and taking a placebo, so it is not routinely recommended now. It is usually used together with myocarditis and obvious myocardial damage.

In more serious cases, such as severe myocarditis or children with underlying metabolic diseases, L-carnitine may be used. This is not something ordinary parents need to know about. It all depends on the doctor's judgment. Don't take the initiative to prescribe it based on random recommendations on the Internet. There is also a category of Chinese patent medicines such as Astragalus Granules and Shengmai Yin. Traditional Chinese medicine colleagues believe that if children are prone to sweating and lack of energy, they belong to the type of lack of heart energy. If used symptomatically, they will be very effective. As there is not much evidence-based evidence in large samples, we in Western medicine generally do not take the initiative to prescribe them. If parents have relevant needs, they will also recommend that they be evaluated by a Chinese medicine pediatrician before use.

Last year, there was a 7-year-old boy who sighed involuntarily after getting the flu. His troponin was also slightly elevated. His parents were already planning to hospitalize him for treatment. I evaluated his electrocardiogram and it was completely normal. After running for two days, Bu didn't complain about chest tightness and was exhausted, so he only prescribed oral fructose for 10 days. Qian Dingzhuwan told him not to take physical education classes this week, and don't be forced to practice Taekwondo. Eat more deep-sea fish and kiwi fruit every day, and sleep as much as you want. Later, all the indicators were normal during the reexamination. His mother said that she had been sold thousands of yuan of imported cardiac nutritional supplements before, but luckily she didn't buy them blindly.

I really want to remind everyone that the normal value of myocardial enzymes in children is a little higher than that of adults. Sometimes, running 800 meters or having a high fever may cause a transient increase. This is not considered myocardial damage at all, and there is no need to take medicine. Medicines that nourish the heart muscle are not "tonic". If you take too much, they will cause gastrointestinal burden. If you really need to take it, the doctor will calculate the dose based on the child's weight. Most of the treatment courses are 2-4 weeks, but the longer the better.

Having worked in pediatrics for almost 10 years, I have always felt that for the vast majority of children with mild myocardial injury, the best "myocardial nutrition medicine" is not medicine at all, but a steady rest. Don't rush to take math olympiads or dance classes as soon as your fever subsides. Give your heart muscle cells enough time to repair themselves, which is more effective than any expensive medicine.