What are the dangers of an open oval window? What is an open foramen ovale in a child’s heart and how to treat it

Modern science has advanced so far that it can diagnose minor anomalies at the earliest stages. The birth of a child is a wonderful event in the life of every woman. But very often, “newly made” mothers, having heard the diagnosis of an open foramen ovale in a newborn, panic and have no idea what to do? Let's try to figure out what kind of anomaly this is, where it comes from and whether it is so dangerous.

What is a patent foramen ovale in a newborn?

Physiologically main body The human body has a septum that divides it into the atria. In the center of the septal tissue there is an oval-shaped depression. Below this depression is the smallest open passage with a valve that opens towards the left atrium. The diameter of this open hole is slightly larger than 2 mm.

Why does the oval window open in a newborn?

The cardiovascular system of a newborn is still very weak, and his life activity rests on it heavy loads. For example, when a newborn cries, coughs, or sulks, blood pressure in the right side of the heart (right atrium) increases. In order to reduce this pressure, the body resorts to opening the oval window in a newborn. When this happens, you may notice a blue discoloration around the baby's mouth.

It should immediately be noted that in many newborns the process of tightening the valve occurs for a year or even two.

Open foramen ovale in a newborn: normal or pathological?

After birth, the baby's lungs open and begin to work. With the first breath, they are cleared of amniotic fluid and filled with oxygen. At these moments, blood circulation begins to perform its functions in a small circle that passes through the lungs. Now the blood is saturated with oxygen thanks to the lungs and there is no need to pump blood inside the heart through an open window. When the small circle works in the left part of the heart (atrium), the pressure increases and becomes stronger, which contributes to the closure of the oval window valve in the newborn. Over time, the valve muscles grow to the heart septum, and the oval window becomes part of the heart.

When is a patent foramen ovale considered normal in a newborn?

Complete closure (overgrowth) can vary from three months to two years. Previously this minor pathology was not detected, so more than 10% of adults have a minor anomaly of cardiac development. Cardiologists do not consider such an anomaly a defect. Since the time when modern technology allowed us to “examine” the open foramen ovale in a newborn; almost 50% of 5-year-old children still have an open valve in the septum of the heart.

When is a patent foramen ovale considered a pathology in a newborn?

WITH medical point vision, the problem is not the presence of an open window in the heart, because it functions only when absolutely necessary. The oval window becomes pathological in a newborn when:

  • the valve remains the same size as at birth, and the heart grows over the years. In such cases, the valve is unable to completely close the open foramen ovale, which allows blood to constantly flow between the atria;
  • The diagnosis of open foramen ovale in a newborn is accompanied by heart disease, which helps to increase pressure in the right atrium and open the valve.

The reason for the development of a patent oval window

Doctors find it difficult to definitively answer the question of what causes the development of such an anomaly.

There are two main theories put forward:

  1. A physiological feature of the human body, if the valve does not overgrow throughout life, without concomitant diseases.
  2. If the valve is small (underdeveloped) and does not completely close the oval window, then the violations occurred in utero. They could be caused by internal and external factors.

Internal causes of anomaly:

  • heart disease;
  • genome heredity;
  • maternal diabetes;
  • premature birth (premature fetus), why this happens, read;
  • the mother suffered an infectious disease or severe poisoning during pregnancy; This article will tell you what to do if a pregnant woman is poisoned.

External factors, increasing the risk of valve underdevelopment:

  • drinking alcohol during pregnancy;
  • smoking;
  • taking medications containing insulin, lithium, phenobarbital.

To avoid the development of pathologies and check whether the fetus is developing normally, a pregnant woman should undergo special examination. Such an examination is written about in articles and.

How do you know if your child has a patent foramen ovale?

A special examination is not prescribed to identify a minor anomaly in the heart, except if the mother has such a pathology. In other cases, the problem becomes known completely by accident during a regular or extraordinary examination.

Symptoms that may indicate the presence of an abnormality may include:

  • In small children, when coughing, crying, or straining, blue discoloration appears around the mouth. IN calm state she passes;
  • there are noises (of an extraneous nature) in the child’s heart;
  • older children experience rapid fatigue with little physical activity, causeless fainting, and dizziness;
  • a tendency to colds is often recorded.

What therapy is necessary for such an anomaly?

If hemodynamic disturbances are not present, the doctor recommends general strengthening and health procedures, such as:

  • hardening;
  • daily walk;
  • balanced diet.

If there are minor deviations in functioning cardiovascular systems s, then the doctor may additionally prescribe vitamins and medications designed to support the heart muscles.

In cases where the anomaly occurs together with a heart defect, surgical intervention is necessary. Today, there are operations that allow one to enter the heart through the femoral artery and fix the valve for a while so that it can adhere to the heart muscles.

When an open valve does not perform its function of constantly holding back blood, the pathology is called an atrial septal defect. With this diagnosis, children after 3 years of age are assigned health group II.

The diagnosis of a patent foramen ovale in a newborn is not a death sentence. If the valve does not heal by the age of 5, the hole will remain open, most likely the person will live with a minor anomaly all his life. Until diseases associated with increased blood pressure in the right atrium (develop after 50–60 years) appear, such an anomaly will not have any impact on a person’s life.

Author of the publication: Alexey Kulagin

A diagnosis of a patent foramen ovale in a child is not a death sentence. There is no need to panic when you hear it. Sometimes, healing from it is a matter of time and growing up.

Most parental fears are associated with ignorance of the nature of this cardiac anomaly. Let us consider in detail what this anomaly is, how it is diagnosed and treated.

What is a patent foramen ovale in the heart?

While in a state of intrauterine development, the child does not breathe, his lungs do not take part in the blood circulation.

Oxygen and substances necessary for the fetal body are distributed to the organs in another way, called choreal:

  1. from the placenta arterial blood enters through a vein located in the umbilical cord in the so-called. Arantium duct,
  2. passes into the inferior vena cava, where it mixes with venous blood;
  3. then the blood through this vessel and the superior vena cava enters right atrium;
  4. then, through the open foramen ovale in the interatrial septum, with the help of a valve-shaped fold, blood enters the left atrium;
  5. further - into the left ventricle and aorta.

Thus, the open oval window plays one of the main roles in this period of development of the cardiovascular system: with its help, blood spreads into the brain and spinal cord, bypassing the lungs that are not yet functioning.

After the birth of the child, when starting work respiratory system, choreal blood circulation becomes unclaimed. Due to the increasing pressure in the left atrium, due to the onset of lung function, the oval window is blocked by a valve-shaped fold: it is mechanically pressed against the interatrial septum, blocking the oval window.

If this position is maintained after a period of time from 2 months to 5 years, the hole becomes overgrown with connective tissue and only a small hole remains, normally the diameter of a catheter.

In some cases, the process of tissue fusion is disrupted and the window does not close completely.

Reasons why the oval window does not close

Why doesn't the oval window close around its entire perimeter? This occurs if the valve size does not correspond to the metric parameters of a given hole.

This disruption of the development of the cardiovascular system occurs for a number of reasons, among which experts note the following:

  • smoking and use of chemicals by the mother during pregnancy,
  • underdevelopment of the valve due to premature birth of a child,
  • genetic predisposition,
  • connective dysplasia.

When is a symptom normal, when is it a pathology?

If the oval window does not heal completely and remains open, occasional circulatory problems may occur. For any disturbance of pressure in the heart with increased tension abdominal muscles(during crying, coughing or active play) the valve opens, allowing blood to flow directly into the left atrium. This process occurs invisibly and, as a rule, has no external manifestations.

A patent foramen ovale is not a heart defect. If it is present, deviations in the structure of the cardiac system from the physiological norm are noted, but do not pose a threat to the patient’s life. Experts regard it as MARS - a minor anomaly in the development of the heart and do not classify it as a pathology.

This deviation occurs quite often: in children under 5 years of age it occurs in 50% of cases of complaints of cardiac disorders, in adults - up to 25%.

The results of a study of 1100 hearts conducted in 1930, organized by T. Thompson and W. Evans, are surprising. According to them, this anomaly is characteristic of 35% of those examined. Of these, 6% of the hearts had a diameter of the open foramen ovale measuring up to 7 cm (3% were newborns up to 2 months old, the remaining 3% belonged to adult subjects).

The diameter of the patent foramen ovale can range from 3 mm to 19 mm, depending on the age of the person and the size of his heart. But this anomaly is not classified as a pathology on this basis.

The main indicators for establishing pathological processes are dangerous symptoms in the form of causeless fainting and heart failure, as well as an increase in pulmonary blood flow.

Features of blood circulation with a functioning open oval window

The oval window is located on the inner left wall of the right atrium, has the shape of a slit and an average diameter of 4.5 cm. Due to its valve structure, the open oval window ensures the direction of blood flow only from the small circle of hemodynamics to the large one; the septum prevents the back shunt of blood from left to right.

Direct discharges of blood into the left atrium are not constant and occur in the form of relapses and isolated cases.

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This window symptom usually does not cause inconvenience to its bearer in childhood; complications can occur only in adulthood. In a calm state of the body, it does not lead to circulatory disorders. The release of blood from one atrial chamber to another is possible only with increasing physical activity on the abdominal muscles.

  • violation of the pressure of the valve closing the window, with its slower growth relative to the entire heart;
  • accompanying illnesses, characterized by increased pressure in the right atrium. In this case, the pressure on the valve from the side of this atrium becomes higher than from the part of the left one, the pressure on the valve weakens and the window opens mechanically.

Diseases that can lead to increased right atrial pressure include the following:

  1. chronic lung diseases,
  2. leg vein diseases,
  3. combined heart pathology.

In addition, this phenomenon is possible during pregnancy and childbirth.

In such cases, constant medical supervision is necessary.

In other situations, an open oval window is harmless and, surprisingly, sometimes even necessary.

Thus, in cases of primary pulmonary hypertension, characterized by high blood pressure in the lungs, part of the blood from the pulmonary circle is released into the left atrium. This unloads the blood vessels and alleviates the symptoms of the disease: shortness of breath, cough, weakness, fainting. Sometimes opening the oval window saves life in this disease.

Symptoms and diagnosis

In children, the opening of the oval window often has no manifestations, is an asymptomatic deviation from the norm and proceeds latently.

But in some cases, this cardiac anomaly is accompanied by scanty symptoms and manifests itself in the following complaints:


In some cases there are frequent migraines and pastoral hypoxemia syndrome (the appearance of shortness of breath in a standing position, and its disappearance when moving to a horizontal position).

Detection of such symptoms in a child is the basis for contacting a cardiologist to determine accurate diagnosis.

Diagnosis of an open oval window is carried out in several ways:

  1. Visual inspection. The method is ineffective, since only an experienced physician can notice the external manifestations of a minor anomaly. This method serves only to establish a suspicion of deviation, taking into account complaints about the above symptoms. A blood shunt, manifested as a heart murmur, is determined by auscultation. Find out more about
  2. EchoCG. This method is used to diagnose an open window not only when a specialist suspects an anomaly, but also often completely by accident during general examinations. This is a common case when the opening of the oval window is latent.
  3. ECG is performed in two positions of the body: in a calm state and after performing physical exercises.
  4. Radiography. With the help of this instrumental study, cardiac dysfunction associated with increased blood pressure in the right atrial chamber, as a consequence the possibility of the oval window starting to function.
  5. Transthoracic two-dimensional echocardiography. Used to diagnose a patent foramen ovale in newborns. Helps visualize the movement of the valve leaflets and determine the absence of concomitant cardiac pathologies. The method allows not only to determine the presence of an open foramen ovale, but also to determine the speed and volume of blood flow during a shunt from one atrium to another.
  6. Transnutritive echocardiography. Used to diagnose a functioning window in older children and adolescents. The method is carried out by immersing the probe into the esophagus, in the closest position to the heart, in order to visualize it as accurately as possible.
    To improve the diagnosis of an open window, bubble contrast is used: determination of the presence of bubbles in the left atrium after their appearance in the right in a relatively short period of time, indicating a blood shunt between the atria.
  7. Probing of the heart. The method is considered the most accurate, but also the most aggressive. It is used before surgery in specialized centers and involves advancing the probe through the artery to the heart directly for detailed visualization and diagnosis.
  8. allows you to determine the exact boundaries of the open window and its size. Suitable for both newborns and older children.

Treatment of an open oval window in the heart

If the functioning of the open oval window does not manifest itself in the above symptoms, then it does not require treatment and a minor anomaly is not considered a deviation from the norm. Treatment with anticoagulants and antiplatelet agents is prescribed only after transient ischemic attack or for the prevention of thromboembolic complications in adult patients.

Among the methods of treating pathological cases is surgery.

The indicator for prescribing an operation is the volume of shunted blood and its negative impact on the functioning of the cardiovascular system - if the volume is small and no complications are observed, heart surgery is not needed.

If blood discharges from the left atrium to the right are regular, then experts determine the patient’s condition as pathological.

In such cases, indications for surgical intervention are following reasons:

  • heart failure,
  • pulmonary hypertension,
  • frequent pneumonia with complications,
  • physical retardation of the child.

Most often, in such cases, a low-traumatic operation is prescribed - x-ray endovascular occlusion. It is performed by inserting an occluder through a vein, which opens into the heart and covers the open window like a patch. To introduce the instrument into the body, the pelvic arteries are used, elbow joint or neck, after performing a puncture in them.

The advancement of the occluder to the open foramen ovale is carefully monitored radiographically and echocardioscopically.

This method allows you to perform rational intervention without the use of widely used techniques:

  • opening the chest,
  • temporary stop of heartbeat,
  • artificial respiration and blood circulation,
  • without the introduction of general deep anesthesia.

After such an operation, the child returns to the normal rhythm of life. There are no restrictions or contraindications.

Complications, consequences

  1. The main danger with an open foramen ovale can be paradoxical embolism. This phenomenon threatens the patient with concomitant venous diseases: a detached blood clot passes through an open window into a large hemodynamic circle and a blockage of an artery important for life can occur, which will certainly lead to death.
    The disease is accompanied by neuralgic disorders that appear unexpectedly.
  2. Also dangerous septic endocarditis , often found in patients with functioning oval window.
  3. TIA - transient ischemic attack. This is a temporary disturbance of blood circulation in the cerebral center. TIA is accompanied by neuralgic disorders that resolve within 24 hours.
  4. There is danger violations cerebral circulation.

Parents whose children have been diagnosed with a patent foramen ovale should follow these recommendations:

  • Even in the absence of pronounced symptoms It is necessary to register the child with a cardiologist. The doctor should monitor the child regularly.
  • Patent foramen ovale in the heart and sports accompanied by heavy loads are incompatible. Physical exercises should not contain strength exercises or excessive tension of the abdominal muscles. The child should be protected from running, squats, jumping and anything that could provoke a shunt.
  • You should properly organize your daily routine to balance the child’s periods of activity and rest. Must be included in schedule nap.
  • Every 2 hours you need to do a little exercise, stretch your leg muscles to prevent the possibility of developing vein diseases in the future. Pay attention to the positions in which the child sits. Teach him to sit with the correct position of his legs: they should not be tucked in or folded crosswise.
  • The best way to prevent in the future of a stroke - lead an active lifestyle to prevent blood stagnation in lower limbs and prevent vein diseases.
  • Experts recommend hardening and restorative procedures.
  • Children with this diagnosis an annual holiday at the resort and regular walks on the fresh air.
  • Take care of sufficient quantity drinking, which the child should consume every day.

Do not let your child notice your concerns about his health - this can lead to panic and increased nervousness. This will not help improve his condition.

– incomplete closure of the foramen ovale in the interatrial septum, which normally functions during the embryonic period and closes in the first year of the child’s life. An open foramen ovale can be manifested by cyanosis of the nasolabial triangle, slow physical development, shortness of breath and tachycardia, sudden fainting, headache, frequent acute respiratory viral infections and bronchopulmonary diseases. Diagnosis of an open foramen ovale includes an ECG (at rest and after exercise), conventional and Doppler echocardiography, radiography, and probing of the cardiac cavities. With an open foramen ovale, anticoagulant therapy can be used, and, if necessary, surgical treatment (endovascular occlusion of the defect).

General information

Patent foramen ovale is a congenital communication between the right and left atria, representing a residual element of the foramen ovale of the fetal heart. The interatrial foramen with the valve is formed in utero and is a necessary condition functioning of the cardiovascular system during this period of development. Thanks to the open foramen ovale, part of the placental, oxygenated blood flows from the right atrium to the left, bypassing the undeveloped, non-functioning lungs, and ensures normal blood supply to the neck and head of the fetus, the development of the brain and spinal cord.

In healthy full-term children under normal developmental conditions, the patent foramen ovale usually closes and ceases to function within the first 12 months after birth. But its closure occurs individually for each person: on average, by the age of 1 year, the oval window remains open in 40-50% of children. The presence of an open foramen ovale after 1-2 years of a child’s life is classified as minor anomalies of cardiac development (MARS syndrome). In patients mature age a patent foramen ovale is detected in approximately 25-30% of cases. The fairly high prevalence of patent foramen ovale determines the relevance of this problem in modern cardiology.

Causes of a patent oval window

All children are born with a patent foramen ovale. After the first independent breath, the newborn’s pulmonary circulation turns on and begins to fully function, and there is no need for an open foramen ovale. An increase in blood pressure in the left atrium compared to the right leads to the closure of the oval window valve. In most cases, the valve closes tightly and is completely overgrown with connective tissue - the open oval window disappears. Sometimes the hole closes partially or does not close at all, and under certain conditions (during excessive coughing, crying, screaming, tension in the anterior abdominal wall), blood is discharged from the right atrial chamber to the left (functioning oval window).

The reasons for incomplete closure of the oval window are not always clear. It is believed that a hereditary predisposition, prematurity, congenital heart defects, connective tissue dysplasia, and exposure to adverse factors can lead to an open foramen ovale. external environment, smoking and drinking alcohol by a woman during pregnancy. By virtue of genetic characteristics the diameter of the valve may be smaller than the diameter of the oval hole, which will prevent it from completely closing.

A patent foramen ovale may be accompanied by congenital defects of the mitral or tricuspid valves, or a patent ductus arteriosus.

Risk factors for the opening of the oval window valve may include significant physical activity in athletes involved in weightlifting, wrestling, and athletic gymnastics. The problem of an open oval window is especially relevant for divers and divers who dive to significant depths and have 5 times more high risk development of decompression sickness. In patients with thrombophlebitis of the lower extremities or pelvis with a history of episodes of pulmonary embolism, contraction of the pulmonary vasculature can cause increased pressure in the right side of the heart and the appearance of a functioning patent foramen ovale.

Features of hemodynamics with an open oval window

The open foramen ovale is located at the bottom of the fossa oval on the inner left wall of the right atrium, often has a small size (about the size of a pinhead) and a slit-like shape. The size of a patent oval window averages 4.5 mm, but can reach 19 mm. An open foramen ovale, in contrast to an atrial septal defect, has a valve structure that ensures the variability of interatrial communication and the ability to discharge blood in only one direction (from the pulmonary circulation to the large one).

The clinical significance of a patent foramen ovale is controversial. A patent foramen ovale may not cause hemodynamic disturbances and may not have negative impact on the patient’s health due to its small size and the presence of a valve that prevents blood from shunting from left to right. Most people with a patent foramen ovale are unaware of this anomaly and lead normal lives.

The presence of a patent foramen ovale in patients with primary pulmonary hypertension is considered prognostically favorable in terms of life expectancy. However, excess pressure in the right atrium compared to the left with an open foramen ovale leads to the periodic occurrence of a right-to-left shunt, which allows a certain volume of blood to pass through and leads to hypoxemia, transient cerebrovascular accidents (TIA), and the development of life-threatening complications: paradoxical embolism, ischemic stroke , myocardial infarction, kidney infarction.

Symptoms of an open oval window

A patent oval window does not have specific external manifestations; in most cases it occurs latently, and can sometimes be accompanied by scant symptoms. Indirect signs an open oval window may be: severe pallor or cyanosis of the skin in the area of ​​the lips and nasolabial triangle during physical stress (crying, screaming, coughing, straining, bathing a child); tendency to frequent colds and inflammation bronchopulmonary diseases; slower physical development of the child (poor appetite, insufficient weight gain), low endurance during physical activity, combined with symptoms of respiratory failure (shortness of breath and tachycardia); sudden fainting and symptoms of cerebrovascular accident (especially in patients young, with varicose veins, thrombophlebitis of the lower extremities and pelvis).

Patients with a patent foramen ovale may experience frequent headaches, migraines, postural hypoxemia syndrome - the development of shortness of breath and a decrease in arterial blood oxygen saturation in a standing position with an improvement in the condition upon transition to horizontal position. Complications of a patent oval window occur rarely. Paradoxical embolism of cerebral vessels, aggravating this anomaly, is characterized by the sudden development of neurological symptoms and a fairly young age of the patient.

Diagnosis of an open oval window

Studying the medical history and physical examination of the patient often does not immediately allow one to determine the presence of an open foramen ovale, but can only assume the possibility of this anomaly of the interatrial septum (cyanosis of the skin, fainting, frequent acute respiratory viral infections, developmental delay in the child). Auscultation helps identify the presence of a heart murmur as a result of an abnormal shunt of blood from a higher-pressure chamber to a lower-pressure chamber.

To establish an accurate diagnosis of an open foramen ovale, instrumental studies and visualization methods are used: ECG (at rest and after exercise), conventional and Doppler echocardiography, chest radiography, probing of the cardiac cavities.

When the foramen ovale is open, changes appear on the electrocardiogram indicating an increased load on the right parts of the heart, especially on the right atrium. In older people with a patent foramen ovale, radiological signs of enlargement of the right chambers of the heart and an increase in blood volume in the vascular bed of the lungs may be detected.

In newborns and children early age transthoracic two-dimensional echocardiography is used, which makes it possible to visually determine the presence of an open oval window and its diameter, obtain a graphic image of the movements of the valve leaflets over time, and exclude an atrial septal defect. Doppler echocardiography in graphical and color mode helps to clarify the presence and size of an open oval window, identify turbulent blood flow in the area of ​​the oval foramen, its speed and the approximate volume of the shunt.

In older children, adolescents and adults, a more informative transesophageal echocardiography, supplemented by a test with bubble contrast and a test with straining (Valsalva maneuver), is used to diagnose a patent foramen ovale. Bubble contrast improves the visualization of the open oval window, allows you to determine its exact dimensions, and assess the pathological blood shunt.

The most informative, but more aggressive method Diagnosis of an open foramen ovale is cardiac probing, which is performed immediately before surgical treatment in a specialized cardiac surgery hospital.

Patients with varicose veins, thrombophlebitis, cerebrovascular accident, chronic lung diseases, who are at risk of developing paradoxical embolism, must be examined for the presence of an open foramen ovale.

Treatment of open oval window

With an asymptomatic course, a patent oval window can be considered a normal variant. Patients with a patent foramen ovale and a history of a transient ischemic attack or stroke are prescribed systemic therapy with anticoagulants and antiplatelet agents (warfarin, acetylsalicylic acid) to prevent thromboembolic complications. The method for monitoring anticoagulant therapy is the international normalized ratio (INR), which should be in the range of 2-3 when the foramen ovale is open.

The need to eliminate a patent foramen ovale is determined by the volume of shunted blood and its effect on the functioning of the cardiovascular system. If there is a small discharge of blood, there are no concomitant pathologies and complications, surgery is not required.

In case of pronounced pathological discharge of blood from the right atrium to the left, low-traumatic X-ray endovascular occlusion of the open foramen ovale is performed. The operation is carried out under X-ray and echocardioscopic control using a special occluder, which, when opened, completely plugs the hole.

Prognosis of open oval window

For patients with a patent foramen ovale, regular monitoring by a cardiologist and echocardiography are recommended. Endovascular occlusion of the patent foramen ovale allows patients to return to their normal rhythm of life without restrictions. In the first 6 months after surgical treatment of an open oval window, antibiotics are recommended to prevent the development of bacterial endocarditis. The greatest effect from endovascular closure of the patent foramen ovale is observed in patients with platypnea who had a pronounced right-to-left shunt.

Science does not stand still, and new diagnostic methods make it possible to identify pathologies that were not even known about before. Today, many parents are told that the oval window in children’s hearts is open.

Many begin to worry and think about what could cause this illness. People should have these thoughts, because the little ones are our life, and their health is the most important thing.

Women need to know that a patent foramen ovale in the baby's heart is normal if they are in their womb, it closes after the baby is born. The fetus needs it to receive the necessary blood circulation and oxygen supply to the still developing organism. What kind of window this is, the reasons for its development, possible complications and treatment methods, you will learn in this article.

Oval window in the heart in children - description


Foramen ovale in the heart in children

This is the name given to the structural feature of the septum inside the heart, which is present in all children during intrauterine development and is often detected in a newborn. The thing is that the heart of a fetus functions somewhat differently than that of an infant or an adult.

In particular, in the septum separating the atria there is an opening called the oval window. Its presence is due to the fact that the fetal lungs do not work, and therefore little blood enters their vessels.

The volume of blood that in an adult is ejected from the right atrium into the veins of the lungs, in the fetus passes through the hole into the left atrium and is transferred to the more actively working organs of the baby - the brain, kidneys, liver and others. This window is separated from the left ventricle by a small valve that matures completely by the beginning of labor.

When the baby takes his first breath and his lungs open, blood flows into them, which is accompanied by an increase in pressure inside the left atrium. At this moment, the oval window is closed by the valve, and then it gradually fuses with the septum.

If the window closes prematurely, while still in utero, this threatens heart failure and even the death of the child, so the presence of an opening is important for the fetus. Closing the window occurs differently for different children. In some, the valve grows to it immediately after birth, in others - during the first year, in others - by the age of 5.

In some cases, the size of the valve is not sufficient to close the entire oval window, which is why the hole remains slightly open for life, and a small volume of blood is periodically discharged from the pulmonary circle into the systemic circulation.

This situation is observed in 20-30% of children. A foramen ovale that does not close completely after birth is not considered a defect in the septum that divides the atria, since the defect is a much more serious problem. It is considered a congenital defect, and LLC is classified as a minor anomaly, representing only an individual feature.

With a septal defect, the valve is completely absent and blood can be discharged from left to right, which poses a health hazard. There are open foramen ovale and other septal defects. The difference is that such a window always has a valve that regulates blood flow.

If there is a defect, the valve is absent, but there is a hole in the septum, which is visible during ultrasound examination. The oval window is not considered a heart defect; it is classified as a minor anomaly in the development of the cardiovascular system. In infants this is not yet a cause for concern, but in older children the anomaly should not lead to complications.

A serious complication is the so-called “paradoxical embolism” in the case of prolonged non-closure of the window. Emboli are small blood clots, bacteria, even bubbles leaking from venous blood into the arterial through the window.

If they enter the vessels connecting to the brain, they can provoke bacterial complication or even a stroke. If the child is not at risk for blood clots, a fenestra abnormality may be relatively safe. Window dimensions:

  1. If the window size is around 2 - 3 mm, then this is normal, this does not mean any deviations, so there will be no problems.
  2. Small window size - up to 5 - 7 mm. Windows of 4.5 - 5 mm are more common. A hole of 7 mm or more is considered large, or “gaping,” and is treated surgically.
  3. The maximum size can reach 19 mm. According to research, large windows are much less common among adults.


To understand the meaning of this window, let’s briefly consider what sections the child’s heart consists of. Please note that the human heart consists of four cavities, which are called “heart chambers”. These are two atria: right and left; and two ventricles: right and left.

One of the main functions of the heart is to provide D.C. blood in the body (this function is called pumping). This occurs due to the constant contraction of the heart muscles. When the heart muscle contracts, blood from the chambers of the heart is pushed into the vessels that extend from the ventricles of the heart (arteries), and when it relaxes, the atria are filled with blood that comes from the vessels that flow into the heart (veins).

In adults, the right (atrium and ventricle) and left (atrium and ventricle) sections do not communicate with each other. The atria are divided by the interatrial septum, and the ventricles by the interventricular septum.


Blood circulation in a fetus occurs differently than in an adult. During the prenatal period, the baby has so-called “fetal” (fetal) structures in the cardiovascular system. These include the oval window, the aortic and venous ducts.

All these structures are necessary for one simple reason: the fetus does not breathe air during pregnancy, which means its lungs do not participate in the process of saturating the blood with oxygen. But first things first:

  • So, oxygenated blood enters the fetal body through the umbilical veins, one of which flows into the liver, and the other into the inferior vena cava through the so-called ductus venosus.

    • Simply put, pure arterial blood reaches only the fetal liver, because in the prenatal period it performs an important hematopoietic function (it is for this reason that the liver occupies most baby's abdominal cavity).

  • The two streams of mixed blood from the upper and lower torso then flow into the right atrium, where, thanks to the functioning foramen ovale, the bulk of the blood flows into the left atrium.

The remaining blood enters the pulmonary artery. But the question arises: why? After all, we already know that the fetal pulmonary circulation does not perform the function of oxygenation (oxygen saturation) of the blood. It is for this reason that there is a third fetal communication between the pulmonary trunk and the aortic arch - the aortic duct. Through it, the remaining blood is discharged from the small circle to the large circle.

Immediately after birth, when the newborn takes his first breath, the pressure in the pulmonary vessels increases. As a result, the main role of the oval window to dump blood into the left half of the heart is leveled out. During the first year of life, as a rule, the valve completely independently fuses with the walls of the hole.

However, this does not mean at all that an unclosed foramen ovale after 1 year of a child’s life is considered a pathology. It has been established that the communication between the atria can close later. There are often cases where this process is completed only by the age of 5 years.

Purpose of an open oval window

The baby's heart develops in utero in such a way that communication between the right and left atrium is simply necessary to ensure the life of the fetus. Therefore, there is an open oval window in the fetal heart. When the baby is born and begins to breathe on its own, saturating the blood with oxygen (O2) in the lungs, the communication of the two atria is not vital and the oval window in the heart begins to gradually close.

The timing of its complete closure varies, but in most children the oval window closes by about a year of age; in some children (not always), it is allowed for the oval window in the heart to close at more late dates.
Thus, a patent foramen ovale is one of the normal stages in which a baby's heart develops.


The human heart normally consists of two parts. Each of them has partitions made of connective tissue. The diagnosis of “patent foramen ovale” means that the hole in the septum between the atria has not completely closed. If the fetus does not have a patent foramen ovale or is not open enough, this can lead to intrauterine death.

Even if it was possible to survive in the womb of the mother, the child dies after birth, less often he develops right ventricular heart failure. Every newborn is born with a patent foramen ovale, which should normally close within one year.

Very rarely the closing process lasts two or more years. The defect can be diagnosed using ultrasound. The mechanism of development of the anomaly has not yet been thoroughly studied, and its causes have not been fully established. Doctors believe that the factors contributing to the appearance of this defect are:

  • the birth of a child before the predetermined date when the baby is premature;
  • poor ecological state of the environment;
  • hereditary predisposition to diseases of the cardiovascular system;
  • exposure to chemicals on the body of a pregnant woman;
  • frequent stress and instability psycho-emotional state mother of a child during pregnancy.

It is believed that the highest chances of developing an anomaly are in children whose mothers abused alcoholic drinks or narcotic substances. U healthy child The window is closed with a valve. This process happens slowly.

If, as a result of genetic predisposition, the size of the valve is smaller than the size of the window, the latter remains open, but the function of the heart is not impaired. If a child nevertheless develops this anomaly, most likely it will not be possible to get rid of it, but there is no need for this, because an open oval window in the heart in children has almost no effect on their life.

It has been noted that the anomaly is more often observed in premature infants. There is an opinion that the reasons may be smoking and abuse of alcohol or drugs by a woman during pregnancy. Other factors:

  • bad ecology;
  • heredity;
  • chemical exposure;
  • stress.

Due to genetic characteristics, the valve that closes the window is slightly smaller in size in millimeters compared to the hole, which is why it is not able to completely close it. As you can see, some of these reasons depend on the woman herself and her behavior.

If she wants her child to be born and be healthy, she will protect herself from any unfavorable factors. If it was not possible to avoid the anomaly, it is important to remember that it will most likely accompany him throughout his life, but in rare cases it affects work and everyday activities.


With normal development of a newborn, valve closure occurs already in the first 3 to 5 hours of life. Overgrowing of a window in children is a longer process, requiring from two months to two years. However, there have been cases where the window did not become overgrown for five years and even throughout life.

So a baby’s window is not yet a reason for concern and immediate treatment. It has been proven that an oval window is present in 35% of people, and in 6% of them, ultrasound revealed a diameter of more than 7 mm. Of these 6%, half are children under six months old.


What to do if the window has not closed, and by the age of 5-10 years the doctor announces: “the oval window is open”? In a child, the hole may not close tightly due to the structural features of the valve: genetically, it may be smaller than usual.

This happens in premature babies and in those who have been diagnosed with intrauterine developmental pathologies. A defect such as a patent foramen ovale in newborns does not refer to heart defects, but to minor anomalies of cardiac development (abbreviated MARS).

This means that the existing damage does not pose a major threat. People live for years without even suspecting that something is wrong with their hearts.

Another problematic situation is a completely open foramen ovale, when the valve between the atria does not perform its functions at all. This pathology is called atrial septal defect. If a diagnosis has been made, from the age of 3 the child is assigned health group II, and young men of military age are given fitness category “B”, which means limited suitability for military service. military service.

How does the disease manifest itself?

At small size oval window, external manifestations may be absent. Therefore, the attending physician can judge the severity of the nonunion. For children infancy with an open oval window it is characteristic:

  1. Blue lips, tip of the nose, fingers when crying, straining, coughing (cyanosis);
  2. Pallor skin;
  3. Increased heart rate in infants.

Adults with pathology may also experience bluish lips with:

  1. Physical activity, which is fraught with an increase in pressure in the pulmonary vessels ( long delay breathing, swimming, diving);
  2. Heavy physical labor(weightlifting, acrobatic gymnastics);
  3. For lung diseases (bronchial asthma, cystic fibrosis, emphysema, pulmonary atelectasis, pneumonia, with hacking cough);
  4. In the presence of other heart defects.

With a pronounced oval hole (more than 7-10 mm), the external manifestations of the disease are as follows:

  • Frequent fainting;
  • The appearance of bluish skin even with moderate physical activity;
  • Weakness;
  • Dizziness;
  • Child's delay in physical development.

Normally, the size of the oval window in a newborn does not exceed the size of a pinhead and is securely covered with a valve that prevents the discharge of blood from the pulmonary circulation to the large one.

With an open foramen ovale ranging in size from 4.5-19 mm or incomplete closure by the valve, the child may experience transient cerebrovascular accidents, signs of hypoxemia and the development of such severe complications as ischemic stroke, renal infarction, paradoxical embolism and myocardial infarction.

More often, a patent foramen ovale in newborns is asymptomatic or accompanied by mild symptoms. Indirect signs of this anomaly in the structure of the heart, by which parents may suspect its presence, may be:

  • the appearance of severe pallor or cyanosis during strong crying, screaming, straining or bathing the child;
  • restlessness or lethargy during feeding;
  • poor weight gain and poor appetite;
  • fast fatiguability with signs of heart failure (shortness of breath, increased heart rate);
  • the child's predisposition to frequent inflammatory diseases bronchopulmonary system;
  • fainting (in severe cases).

During the examination, while listening to heart sounds, the doctor may register the presence of “murmurs.”


The main diagnostic techniques are:

With their help, you can confirm or refute the diagnosis, determine the size of the open window. These methods do not pose any danger to either the newborn or older children. They allow you to get a detailed picture of the anomaly, after which the doctor decides whether to simply monitor the condition of the heart or prescribe therapy.

When determining a treatment algorithm, the doctor must take into account the following indicators:

  • age of the child;
  • the health status of the little patient;
  • accompanying illnesses;
  • are there any allergies to drugs;
  • are there any contraindications?

Only an experienced doctor who has previously encountered similar cases in his practice can accurately diagnose. Since the disease does not manifest itself specifically, it can be detected by studying other pathological disorders.

The following signs should prompt you to consider referring a doctor to a cardiologist:

  1. With exertion, cyanosis of the skin in the lip area appears.
  2. Up to 10 years of age, a child may be behind in development, both physically and mentally.
  3. Children aged 13 to 15 years are less resilient than their peers.
  4. Due to poor blood flow and insufficient supply to the respiratory system, the child develops diseases such as pneumonia and bronchitis.

If the defect is found in a newborn child, no therapy is carried out and no intervention is required.
Echocardiography is the gold standard and the most informative method diagnosis of this pathology. The following signs are usually detected:

  1. Unlike ASD, when the foramen ovale is open, it is not the absence of part of the septum that is revealed, but only its wedge-shaped thinning is visible.
  2. Thanks to color Doppler ultrasound, you can see “swirls” of blood flow in the oval window area, as well as a slight discharge of blood from the right atrium to the left.
  3. With a small size of the foramen ovale, there are no signs of enlargement of the atrium wall, as is typical for ASD.

The most informative is ultrasonography hearts not conducted through chest, and the so-called transesophageal echocardiography. In this study, an ultrasound probe is inserted into the esophagus, as a result of which all the structures of the heart are visible much better.

This is explained by the anatomical proximity of the esophagus and the heart muscle. The use of this method is especially relevant for obese patients, when visualization of anatomical structures is difficult.

In addition to cardiac ultrasound, other diagnostic methods can be used:

  • An electrocardiogram may show signs of bundle branch block, as well as conduction disturbances in the atria.
  • With a large foramen ovale, changes in the chest x-ray are possible (slight enlargement of the atria).


Most often, MARS syndrome does not cause any complaints or complications. In these cases, no treatment is required. Some specific loads pose a risk of complications. In children who are many years old, blood may be shed when diving, paroxysmal cough, exercises that are accompanied by holding your breath and straining.

Such children should not be exposed to scuba diving, weightlifting, or deep-sea diving year after year. Therefore, parents should not worry if their child has a PFO, but there are no other heart disorders, chronic diseases, or interference with blood circulation, no matter how old he is, everything is going well and the prognosis is favorable.

A patent foramen ovale in newborns is not a cause for concern! But for this to really be the case, doctors advise avoiding serious physical activity and monitoring your health and doctors. If the risk of blood clots is high, doctors prescribe anticoagulants.

If the size of the hole is large and blood is discharged from one atrium to another, surgery may be prescribed. It is based on inserting a catheter into the artery. At its end there is a special device that completely covers the oval window.

Depending on how old the child is, the doctor decides to perform such an operation or not. Antibiotics must be taken for six months after surgery to prevent the development of bacterial endocarditis. So, if the baby is only a year old and has OOO, you should wait, this condition may disappear.

If it persists, there is no need to worry either; today there are modern methods of treating this anomaly. There is every chance that the child’s health will not suffer! Treatment of PFO is not always required: in children under the age of 4 - 5 years, the window can close on its own.

At an older age, you should also not panic; medical supervision, ECG and EchoCG are necessary. Cardiologists recommend being examined every six months.

  • If the doctor detects a risk of blood clots, treatment under his supervision and the use of special blood thinning medications are recommended. Also in such cases, doctors advise avoiding excessive stress.
  • If the hole is larger than normal, surgical treatment may be required. It consists of inserting a tube with a special “closer” at the end, which completely removes the lumen between the atria.

According to experts, you need to monitor the child’s daily routine, nutrition, and not overload him (including psycho-emotionally). You should stick to protein foods in your diet, eat vegetables and fruits. You should also not run any infections, even the most seemingly insignificant ones. Any malfunction in the body can potentially affect the functioning of the heart.


An open oval window poses a danger to the life and health of a child if he is diagnosed with the following concomitant diseases:

  • pulmonary hypertension;
  • pathologies of the respiratory system;
  • thromboembolism.

Thromboembolism poses a particular danger to the health and life of a child, so it is necessary to take all measures to prevent its occurrence.

When blood clots get into pulmonary artery, they are distributed throughout all internal organs:

  1. Blood clots entering the brain vessels can cause a stroke.
  2. If clots accumulate in the coronary vessels, myocardial infarction occurs.
  3. When the arteries of the limbs become blocked, ischemia occurs and they can die.

Blood clotting increases, and at the same time the risk of blood clots increases if the patient has undergone massive surgical interventions, has been in an inactive state for a long time, and the following disorders have been diagnosed:

  • atrial fibrillation;
  • aneurysms of blood vessels and heart.

If these factors are present, the patient is prescribed blood thinning medications (anticoagulants). The dose and regimen are determined in each case individually.

Drug therapy can only be indicated for children with signs of heart failure, transient ischemic attack ( nervous tic, asymmetry of facial muscles, tremors, convulsions, fainting) and, if necessary, the prevention of paradoxical embolism.

They may be prescribed vitamin-mineral complexes and drugs for additional nutrition of the myocardium:

  • Panangin,
  • Magne B6,
  • Elkar,
  • Ubiquinone,
  • antiplatelet agents (Warfarin).

The need to eliminate a patent window in newborns is determined by the volume of blood discharged into the left atrium and its effect on hemodynamics. At minor violation blood circulation and the absence of concomitant congenital heart defects, surgical treatment is not required.


There are cases when it is shown surgical solution defect, but there must be good reasons for this. Surgery is prescribed in the following cases:

  • the diameter of the open window is more than 9 mm;
  • more blood is released than normal;
  • complications from the respiratory or cardiovascular systems appear;
  • the patient has limited activity;
  • there are contraindications for use medicines.

Surgery may be required if the oval window has a large diameter with blood flowing into the left atrium.
IN currently Endovascular surgery has become widespread. The essence of the intervention is that through femoral vein a thin catheter is installed, which is vasculature carried to the right atrium.

The movement of the catheter is monitored using an X-ray machine, as well as ultrasonic sensor installed through the esophagus. When the area of ​​the oval window is reached, so-called occluders (or grafts) are inserted through the catheter, which are a “patch” that covers the gaping hole.

The only drawback of the method is that occluders can cause a local inflammatory reaction in the heart tissue. In this regard, in Lately use BioStar absorbable patch. It is passed through a catheter and opens like an “umbrella” in the atrium cavity. A special feature of the patch is its ability to cause tissue regeneration.

After attaching this patch to the hole in the septum, it dissolves within 30 days and the oval window is replaced own tissues body. This technique is highly effective and has already become widespread.

All manipulations are performed using the endovascular method (also called transcatheter closure). A catheter is installed on the right thigh, through which an occluder - an umbrella-like device on both sides - is delivered to the heart through the vessels using special instruments. Once the occluder is opened, the hole is securely plugged and the problem disappears.

The advantage of such interventions is obvious: there is no need to cut the chest, stop the heart, resort to artificial circulation, or use deep anesthesia. For a child who has undergone surgery in the first 6 months, antibiotic therapy is prescribed to prevent bacterial endocarditis.

So, an open oval window found in newborns is not a cause for alarm at all. If the window has not closed after 2-5 years, it is necessary to observe and consult a cardiologist. Discussions about what is “normal” and what is “pathology” are still ongoing.

Therefore, each case will be individual. However, most situations are not life-threatening and do not require treatment.


Many parents worry that the “hole in the heart,” as they call it, will endanger the child’s life. In fact, this problem is not dangerous for the baby and most children with an open window feel quite healthy.

It is only important to remember some restrictions, for example, in relation to extreme sports or professions in which the load on the body increases. It is also important to have your baby examined by a cardiologist every 6 months with an ultrasound examination.

If the foramen ovale remains open after the child's fifth birthday, it is most likely that it will not heal and will be with the child for the rest of his life. Moreover, such an anomaly has almost no effect on labor activity. It will become an obstacle only to obtaining the profession of a diver, pilot or astronaut, as well as to strong sports loads, for example, weightlifting or wrestling.

At school, the child will be classified in the second health group, and when conscripted, a boy with LLC will be counted in category B (there are restrictions during military service). It is noted that at the age of over 40-50 years, the presence of PFO contributes to the development of coronary and hypertension.

In addition, during a heart attack, an unclosed window in the septum between the atria negatively affects recovery period. Also, adults with an open window experience migraines more often and often experience shortness of breath after getting out of bed, which immediately disappears as soon as the person goes back to bed.

Among the rare complications of LLC in childhood embolism may occur. This is the name for the entry into the bloodstream of gas bubbles, particles of adipose tissue or blood clots, for example, during injuries, fractures or thrombophlebitis.

When emboli enter the left atrium, they travel to vessels in the brain and cause brain damage, sometimes fatal. It happens that the presence of a patent foramen ovale helps improve health.

This is observed in primary pulmonary hypertension, in which shortness of breath, weakness, chronic cough, dizziness, and fainting occur due to high pressure in the vessels of the lungs. Through the oval window, blood from the small circle partially passes into the large circle and the vessels of the lungs are unloaded.


Parents whose children have been diagnosed with a patent foramen ovale should follow these recommendations:

  • Even in the absence of pronounced symptoms, it is necessary to register the child with a cardiologist. The doctor should monitor the child regularly.
  • An open foramen ovale in the heart and sports accompanied by heavy loads are incompatible. Physical exercises should not contain strength exercises or excessive tension of the abdominal muscles.
  • The child should be protected from running, squats, jumping and anything that could provoke a shunt. The daily routine should be properly organized to balance the child’s periods of activity and rest. You need to include naps in your schedule.
  • Every 2 hours you need to do a little exercise and stretch your leg muscles to prevent the possibility of developing vein diseases in the future. Pay attention to the positions in which the child sits. Teach him to sit with the correct position of his legs: they should not be tucked in or folded crosswise.
  • The best way to prevent future stroke is to lead an active lifestyle to prevent blood stagnation in the lower extremities and prevent venous disease.
  • Experts recommend hardening and restorative procedures.
  • Children with this diagnosis need an annual holiday at a resort and regular walks in the fresh air.
  • Make sure your child has enough fluids to drink every day.

Do not let your child notice your concerns about his health - this can lead to panic and increased nervousness. This will not help improve his condition. Always be calm, good-natured and attentive to your child.

Take care of his mental comfort. And over time, transformations in the oval window of his heart will lead to its overgrowth. The main thing is to follow the recommendations of specialists.


There are no special methods for preventing an open oval window. To prevent a person from developing a patent oval window, his pregnant mother needs to lead a healthy lifestyle:

  • quit smoking and alcohol;
  • eat rationally and balancedly (limit consumption of fried, spicy, smoked foods, eat more products With high content fiber (vegetables, fruits, greens).

Prevention of heart defects in the fetus (disorders of heart structures) includes several principles. A woman needs:

  • avoid contact with ionizing radiation (from X-ray machines, thermonuclear reactions);
  • with different chemicals(pairs of varnishes, paints, some medicines);
  • avoid occurrence infectious diseases(a disease such as rubella is especially dangerous, which in most cases leads to congenital defect heart, deafness and cataracts (damage to the lens of the eye)

Congenital heart disease (CHD) is a developmental abnormality of the heart that develops between 2 and 8 weeks of pregnancy. According to statistics, heart disease in newborns occurs in 5-8 cases out of 1000.

Pathology Cause Under normal conditions
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One of the most common cardiac defects is patent foramen ovale (PFO), a minor anomaly in which communication between the right and left atria is partially or completely preserved. As a matter of fact, such a hole in the heart is necessary for the full development of the fetus, therefore all newborns are born with it, and during the first year of life, sometimes several years, it closes up.

However, it happens that the hole does not close. Depending on its size, the degree of disruption of the circulatory process depends. If the opening is too large and there is no connecting valve between the atria, an atrial septal defect occurs.

In addition to this vice, there are many others, including:

  • patent ductus arteriosus (PDA) in newborns, in which oxygenated blood enters the lungs;
  • defect of the aortopulmonary trunk - incomplete fusion of the septum between the aorta and the pulmonary trunk;
  • ventricular septal defect (VSD) - an opening that separates the right and left ventricles;
  • coarctation (narrowing) of the aorta;
  • stenosis (narrowing) of the pulmonary or aortic valves.

The cause of the disease is abnormal development organ inside the womb

It is important to note that in many cases, heart defects do not appear individually, but together. For example, the most common reason cyanosis in a newborn – tetralogy of Fallot, combining VSD, aortic displacement and ventricular hypertrophy.

Causes of cardiac abnormalities

The nature of the disease remains unclear today, however, doctors identify the following causes of congenital heart disease:

  • genetic predisposition, i.e., a history of congenital defects in the baby’s relatives;
  • chromosomal disorders;
  • gene mutations;
  • infectious and viral diseases suffered by a woman in the first trimester of pregnancy;
  • unhealthy lifestyle (drug addiction, smoking, alcoholism);
  • taking certain medications during pregnancy (anticonvulsants, amphetamines, antibiotics);
  • external factors (exposure to radiation).

The father's health is of no small importance. Risk factors also include:

  • late pregnancy;
  • endocrine diseases in parents;
  • severe pregnancy and threat of miscarriage in the first trimester;
  • history of stillbirths.

According to recent studies, children of obese women have an increased risk of being born with congenital heart disease and other pathologies of the heart and blood vessels.

Pathology is congenital or acquired changes in the structures of the heart

Clinical manifestations and diagnostic methods

Congenital heart disease in newborns has different signs. They depend on the type of pathology and how it affects the health of the newborn.

An open oval window may not manifest itself for a long time, without causing any concern to parents. If the hole is not closed and the size is significant, difficulties with breathing, pale skin or cyanosis appear, and there is a delay in physical development.

With more severe defects, parents immediately notice that something is wrong with the child. The most common symptoms of heart defects are.

  1. Cyanosis is a bluish discoloration of the skin that develops due to a lack of oxygen in the blood. Depending on the type of congenital heart disease, only the nasolabial triangle, as well as the limbs and even the whole body, may turn blue.
  2. Dyspnea. It is observed not only during activity, but also when the child is inactive.
  3. Heart rhythm disturbances. The most common symptom of heart defects is rapid heartbeat, tachycardia. But with some defects, a decreased pulse and bradycardia also occur.
  4. Other symptoms include a general weak condition of the child, lack of appetite, drowsiness, and screaming during sleep. In severe pathologies, lack of air and loss of consciousness are possible.

A cardiac surgeon diagnoses defects. If there is a suspicious heart murmur in a newborn, he will certainly undergo an ultrasound examination. Ultrasound of the heart (echocardiography) allows you to examine the condition of the valves and muscles of the heart.

As additional methods diagnostics are used:

  • X-ray examination, including the use of a contrast agent (ventriculography);
  • electrocardiogram (ECG), as well as its varieties (treadmill test, bicycle ergometry).

Dr. Komarovsky recommends that you undergo a thorough examination if suspicious heart murmurs do not go away within 3-4 days after the birth of the child, and blueness of the skin, pale and cold extremities are also observed.

Why is LLC dangerous?

Under normal conditions, the oval window usually closes between 2 and 12 months after the baby is born.

For a long time, this defect was considered by doctors to be quite safe, with which people could live full life and even actively engage in sports. Today, doctors' opinions are divided. We can definitely say that children with foramen ovale and heart murmurs need careful medical supervision.

One of the most dangerous complications that can occur with patent foramen ovale is paradoxical embolism, which is accompanied by an increased risk of blood clots, stroke, or bacterial diseases.

It is important to note that often a patent foramen ovale is combined with another defect - cardiac aneurysm in newborns, and this is fraught with the risk of developing cardioembolic complications.

Thus, children with congenital heart disease require special attention and careful care. They are contraindicated in certain sports:

  • scuba diving;
  • weightlifting;
  • diving to great depths;
  • other exercises that involve holding your breath or straining.
Treatment of heart disease

The treatment method for congenital heart disease depends on its severity. If the child, in addition to the LLC, has no other anomalies, the hole does not exceed 5 mm, no significant circulatory disturbances are observed, his state of health does not cause concern.

A pediatric cardiologist will help in treating the disease

Mostly over time, the size of the oval ring decreases. To reduce the risk of blood clots, you may be prescribed anticoagulants - blood thinning drugs.

If the foramen ovale is large (7-10 mm), one should speak of an atrial septal defect. Such holes are called “gaping”; in this case, the issue of surgical removal of the anomaly is decided.

Modern surgical treatment of LLC involves inserting a special tube (catheter) into the artery, at the end of which there is a valve that completely occludes the oval window. Find out what causes blood clots after childbirth

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Attention!

The information published on the website is for informational purposes only and is intended for informational purposes only. Site visitors should not use them as medical advice! The site editors do not recommend self-medication. Determining the diagnosis and choosing a treatment method remains the exclusive prerogative of your attending physician! Remember that only full diagnostics and therapy under the supervision of a doctor will help you completely get rid of the disease!