Congenital heart defect oval window how to treat. Foramen ovale in the heart in children: characteristics, causes of pathology, symptoms and treatment

If a child over 2 years old has a hole in the interatrial septum, then this is probable sign open oval window (OOF). Normally, it functions in the fetus and then heals. Children with this pathology are stunted, they often experience cyanosis, shortness of breath, headache And sudden losses consciousness. Treatment depends on the size of the defect. Use medications and surgical methods.

Read in this article

What is a patent oval window?

LLC during the period of fetal formation is necessary, since through it the placental blood enters from the right to left atrium, and not into the lungs. In this way, the blood supply to the brain is carried out, as well as spinal cord. The hole is located in the center of the septum and is equipped with a valve that inhibits the reverse flow of blood.

Fetal circulation

After birth, all children have an LLC. But after the child begins to breathe on his own, the need for his existence disappears. Higher pressure in the left atrium presses the valve, and it gradually grows to the septum.

If there is an unclosed part, or the window is not completely covered, then, when severe cough or screaming, blood is dumped from right to left. The window may be open in half of children after one year and in a quarter of adults.

Causes of an open oval window

There is a hereditary predisposition to the formation of an LLC. If there is a violation of the structure of the chromosome or defects in genes, the valve is smaller in size than the size holes. This pathology also occurs due to unfavorable factors:

premature birth;
structural damage connective tissue;
congenital anomalies of heart development: valve defects and;
bad habits of the mother: smoking, drug addiction, alcoholism.

The window can open during scuba diving when diving to great depths (divers, divers), professional weightlifters, wrestlers, and when engaging in high-intensity strength sports. With vein thrombosis with blockage of the pulmonary artery, the pressure in the right side of the heart increases, this provokes the opening of the hole.

Blood circulation with an open oval window

The LLC is about 5 mm in size and has the appearance of a slit. Sometimes you can find a hole with a diameter of about 2 cm. Unlike birth defect partitions, the window is covered with a valve. Therefore, a small discharge of blood may not manifest itself in any way, and most people are unaware of its existence.

If the pressure in the pulmonary artery system is high, then LLC compensates for it and is considered a favorable sign for life expectancy. With significant flow venous blood from the right atrium in patients, the oxygen content in the tissues decreases, circulatory disorders of the brain and myocardium occur.

Signs and symptoms of a patent oval window

Manifestations of LLC are not specific, in most cases they do not have clinical symptoms, so the diagnosis is made late.

Symptoms in children

Indirect evidence of pathology may be severe pallor or bluish color skin when the baby is crying, screaming or bathing. Due to insufficient
oxygen supplies to tissues occur:

frequent bronchitis, colds;
weak appetite;
lag in weight gain;
physical development is slow;
dyspnea;
episodes of loss of consciousness.

Signs of LLC in adults

Patients are worried about headaches, migraine attacks, and dizziness. At the same time, in a standing position, shortness of breath and palpitations intensify, and with the transition to a horizontal position, they weaken. Young people show signs of impaired blood supply to the brain, including strokes.

Why did the open foramen ovale not close in the child?

If, as the heart grows, the valve that closes oval window, does not increase, then tight closure of the hole does not occur. Ultimately, blood flows from one atrium to another, creating increased stress.

Pathology can be caused by conditions that contribute to increased pressure in the right atrium: lung diseases, combined defects heart, developmental disorders of the venous system.

The danger posed by an open oval window

Minor defects do not pose a threat to health, but if the patient has other abnormalities of the heart valves or vascular development, then a venoarterial blood shunt can worsen the movement of blood inside the heart.

Kidney infarction

This condition is especially dangerous in the presence of increased thrombus formation in the veins lower limbs. Microthrombi, entering the left atrium, with arterial blood spread throughout all organs and, under the influence of pressure, clog the lumen of blood vessels, causing acute disorder blood supply - ischemia. This increases the risk of severe complications:

stroke;
cardiac ischemia varying degrees heaviness;
kidney infarction.

To learn about the dangers of LLC for children and adults, diagnosis and patient management tactics, watch this video:

When does a patent foramen ovale close normally?

Usually, in a newborn, the window valve is pressed high blood pressure in the left atrium. This occurs after the lungs have fully opened - within 3 to 5 hours. Overgrowth of the hole often lasts from 2 to 11 months. In some children, the oval window closes only by age two. This is considered one of the normal options. If after five years there is an LLC, then self-closure does not occur.

Diagnosis of an open oval window in a child

In order to make a diagnosis, they study the history of the appearance of complaints and their severity, but since they do not have characteristic features, then the assumption of LLC can be confirmed using instrumental methods.

Inspection

The child may be stunted, weight loss, pale skin, and when crying or straining the nasolabial triangle and lips turn blue. Usually, auscultation can reveal a murmur due to the passage of blood between the cavities of the heart: from more high pressure to low.

Ultrasound

When examining, you can identify the hole and the valve that covers it. The volume and direction of blood movement and the presence of other anomalies of the heart and blood vessels are determined. The following signs are typical for an LLC:

Size from 2 to 4.5 mm.
The valve is visible in the left atrium.
The window is located in the middle of the partition.
The walls near the opening are thin (in case of a septal defect, they are thickened).

EchoCG

A two-dimensional echocardiogram shows the diameter of the open window and the movement of the valve, it will help distinguish this pathology from other heart defects. This method helps to detect the presence of turbulent blood flow, its volume and speed. This is the most informative method for diagnosing LLC.

If there are circulatory disorders, then you cannot take part in competitions; the loads must be determined by a cardiologist after performing functional tests.

We can conclude that the presence of an open window does not lead to poor health when small size and the absence of excessive physical activity, so treatment is not required. If there large defect, then it is eliminated using endovascular methods.

When is such a condition a physiological norm?

The foramen ovale is located between the two atria - right and left. An open foramen ovale in a child’s heart is normally observed during intrauterine development. During this period, the fetus receives oxygen through the umbilical cord; the child’s lungs are not yet working, so he does not need large quantity oxygen. Consequently, while the pulmonary circulation is closed, part of the blood from the right atrium is discharged through the open foramen ovale in the child. This window in the child’s heart is covered by a valve that works like a door on a spring and opens exclusively towards the left atrium.

However, an unclosed foramen ovale in the heart in children is the norm only during the period of intrauterine development. When a baby is born, after his first breath, the lungs are cleared of intrauterine fluid. They are filled with air and blood, flowing through the pulmonary circulation. This completes the functions of this hole. Due to the increase in pressure in the left atrium, the valve of the window is pressed very tightly against the interatrial septum, and the oval window in the heart of a newborn closes, since all conditions contribute to the fact that it gradually becomes overgrown. However, anomalies are recorded in which the open oval window in newborns does not close in a timely manner.

What should be considered normal?

The process of closing the oval window normally occurs in a baby between the ages of 3 months and 2 years. But if we talk about variants of the norm, then such a “hole” in the heart of a 5-year-old child is also not considered an anomaly.

According to statistics, approximately half of children and 10-25% of adults have a patent oval window. This condition is not defined as a defect. In medicine, it is defined by the abbreviation MARS, which stands for minor anomaly of the heart. In this case, the structure of the heart differs from the anatomical norm, but this pathology does not threaten health.

Scientists conducted a study on this issue back in 1930. The structure of 1,100 hearts was studied, and in the end, scientists obtained the following results: in 35% of volunteers the oval window was open, in 6% of them the diameter was 7 mm (half of them were children who were not yet 6 months old). Scientists have recorded a large hole diameter in adults in 3% of cases.

The normal dimensions of the oval window can be different - ranging from 3 to 19 mm. Most often this size is 4.5 mm. It directly depends on the age of the person, as well as the size of his heart. But if the doctor determines the indications for surgical intervention, then it is not the size of the hole that is taken into account, but how much it is covered by the valve, and the degree of compensation.

An open foramen ovale in the heart in an adult or a child, as such, pathological condition is not. After all, it does not cause disruption of blood flow, but only manifests itself if a person is subjected to severe physical exertion or if he is bothered by coughing attacks.

Problems in a child and an adult patient are observed in the following cases:

If the baby's heart becomes larger with age, but the valve does not grow. In this case, the oval window is not covered as tightly as it should be. As a result, blood can flow from the atrium to the atrium, as a result of which the load on them will increase.
If diseases or conditions develop in which the pressure in the right atrium increases. As a result, the valve door opens slightly towards the left atrium. This is possible with diseases of the veins of the lower extremities, chronic illnesses lungs, concomitant heart pathology, etc.

In such situations, the doctor must constantly monitor the patient’s condition so as not to miss the moment when the compensated state turns into a decompensated one.

In some cases, this anatomical feature even alleviates the condition and can prolong a person’s life. This is observed during primary pulmonary hypertension. In this state, the blood is under pressure in the vessels of the lungs. The patient suffers from weakness, coughing, and fainting. If the oval window is open, then part of the blood enters the left atrium from the pulmonary circulation. As a result, the blood vessels of the lungs are unloaded, and the severity of unpleasant symptoms decreases.

Why doesn't the oval window close?

Currently, there are many assumptions and theories about why the “hole” in the heart of a newborn does not close in normal timing. However, there is still no clear information on this matter. If the valve does not fuse with the circumference of the oval window, then doctors define this condition as a feature of the body. This is very often confirmed by echocardiography of the heart, since during this procedure this is detected very often.

Sometimes the valve is small to begin with, so it cannot completely close the hole. Such valve underdevelopment may be associated with various factors, affecting the fetus during its formation:

drinking alcohol and smoking during pregnancy;
contact with harmful toxic substances;
bad ecology;
chronic stress.

That is why babies in whom the foramen ovale is open are often born premature, immature, and they are diagnosed with various pathologies of intrauterine development.

How does this pathology manifest itself?

Expressed clinical manifestations with such pathology are absent, and its presence is discovered, as a rule, by chance. In most cases, with this condition there are no consequences or complications.

Certain signs may appear if this condition is combined with other diseases. This is possible if there are hemodynamic disturbances (that is, proper blood flow through the chambers). This happens with combined heart defects, for example:

defects of the mitral, tricuspid valves;
open ductus arteriosus.

The chambers of the heart are overloaded and the interatrial septum is stretched. As a result, the valve does not perform its functions, and right-to-left shunting is noted.

Signs of this condition in children

This condition in children can provoke frequent illnesses bronchi and lungs. When there is a period of stress, that is, when the child cries, coughs, physically strains, suffers an attack, etc., his nasolabial triangle becomes cyanotic and his lips turn blue. By the way, sometimes it is this anomaly that explains why the lips of an adult turn blue.
A child with this pathology may be slightly behind in development and grow more slowly. When a child engages in physical education, he develops extreme fatigue and shortness of breath inadequate to exertion.
Fainting occurs spontaneously and is unexplained. Most often, this symptom appears in young people with diseases of the leg veins.

Signs in adults

In an adult, with age, signs of pulmonary hypertension and overload of the right side of the heart are observed. This is discovered during the research.
Such signs lead to ECG violation: conduction along the right bundle branch is impaired, the size of the right parts of the heart increases.
If this hole is open in an adult, he is more likely to develop, which is confirmed by statistics.
There is evidence that with such an anomaly the likelihood of developing or . The condition when from the venous to arterial system hits foreign body, a blood clot or part of a tumor, is called a paradoxical embolism. When such particles enter the blood vessels of the heart, myocardial infarction occurs. When they end up in the vessels of the kidneys, a kidney infarction occurs. And when these elements enter the blood vessels of the brain, an ischemic stroke or transient ischemic attack occurs.
It is also likely that this paradoxical symptom, How platypnea-orthodeoxia. In this condition, a person suffers from shortness of breath when getting out of bed. The shortness of breath disappears when he returns to a lying position.

During the inspection

During an external examination, it is impossible to determine the presence of such a pathology. Sometimes still in maternity hospital doctors suspect that the baby has an open foramen ovale in the heart - this happens if the newborn has diffuse cyanosis skin. However, it is important to differentiate this symptom from other diseases.

Echocardiography of the heart

Often, during an ultrasound of the heart, an open window between the atria is detected. It is advisable to perform echocardiography with Doppler. But if the window size is small, then it will not be possible to determine such a pathology using this technique.

Transesophageal echocardiography is performed to detect a patent foramen ovale. During this study, it is possible to detect the window, the flap that closes it, and determine the volume of shunted blood. This study makes it possible to conduct differential diagnosis with the present heart defect .

Also informative method is angiocardiography. However, this method, like the previous one, is used only in specialized cardiology clinics.

Is it possible for people with this anomaly to choose certain professions?

If a person is diagnosed with such a pathology, he should not practice certain types of activities, as they are life-threatening.

Diver

This profession is dangerous because fast dive to an impressive depth, gases in the blood become bubbles. They enter the arteries through the right-left shunt of the oval window. This may provoke and, accordingly, death. Such persons should not engage in amateur diving either.

Other professions associated with overload

For a similar reason, people with an open foramen ovale should not choose the profession of a pilot, astronaut, driver, dispatcher, operator, machinist, submarine crew member, etc.

Military service

With such a pathology, prizes for military service are limited, since with increased loads the right-left shunt increases and the likelihood of death due to embolism increases. During military service, soldiers undergo training that involves serious workloads. Therefore, people with such a pathology are classified as a risk group and are assigned to category “B” with limited suitability for military service.

How to treat this condition?

Treatment tactics are determined by the presence or absence of symptoms.

If there are no symptoms

There is no treatment. Observation by a therapist, cardiologist and pediatrician is practiced, and ultrasound is performed to assess the dynamics of the condition of the oval window.

Provided that the symptoms are not severe, but there is a risk of developing a stroke, ischemic attack, heart attack, diseases of the lower extremities, you should take courses of blood thinning medications -, Clopidogrel , .

If symptoms occur

Held surgical treatment to close this defect with an occluding device. This treatment is practiced if there is a pronounced shunt of blood from right to left, if there is increased risk paradoxical embolism . Also practiced as a preventive measure if the foramen ovale is open in divers.

A special device is attached to the catheter, after which it is femoral vein it is inserted into the cavity of the heart. During surgical intervention Visual X-ray control is practiced. After inserting the occluder into the oval window using a catheter, this device opens like an umbrella and closes the hole. With this treatment method, the quality of life of people with this problem can be significantly improved.

Currently, scientists are practicing other treatment methods - for example, a special absorbable patch. It is attached to the oval window, and over the course of a month it stimulates the natural healing process of tissue deficiency. After this, the patch dissolves. This method is positive in that it makes it possible to avoid inflammatory process tissue around the occluder.

Heart defects are quite common in children. Most of them are equated to individual developmental characteristics. Basically, they should not be eliminated, but you will have to change your lifestyle and be regularly examined. An open foramen ovale in a child’s heart is included in the group mentioned above. Mostly it is harmless, but parents will have to be on guard in order to take timely measures to prevent the development of complications.

An open window in a child’s heart is a feature of intrauterine development. The fetal body is still developing, so many organs are not yet functioning at full capacity. Other systems are starting to work actively. The appearance of a hole in the heart septum is associated with an improvement in their nutrition. Explained similar phenomenon there is no need to fully supply blood to the idle lungs, so it partially flows through the window of the right atrium into the left. Then it enters the active organs.

A valve separates the open window into the child’s heart from the left ventricle. It completes its formation closer to childbirth. A newborn, taking his first breath, opens his lungs. In this case, the pressure in the left atrium rapidly increases. Thanks to the activation of a chain of natural processes, the hole is closed by a valve, which over time completely fuses with the septum. If the window had become overgrown during prenatal development, many organs would not have received the necessary nutrition due to the inability of the heart muscle to fully perform its functions. Usually such a deviation leads to terrible complications and death.

The oval window in the heart in children can even last up to 5 years or more. This process is individual. Normally, the valve grows in immediately after birth. Sometimes by 12 months, and in more rare cases - by five years. The inability to completely heal is due to the valve being too small. It is not able to completely block the hole, as a result of which blood gradually leaks from one atrium to another. This anomaly occurs in 25% of cases.

According to research results, the oval window in the heart of a newborn generally does not exceed 4-5 mm. The largest figure reached almost 2 cm.

Symptoms

If the window in the child’s heart is the only anomaly, and there are no other pathologies, then the symptoms are usually mild or absent. You can find out about the problem by the following signs:

attacks of tachycardia (increased heart rate);
change in color of the nasolabial triangle when crying or feeding;
the appearance of shortness of breath;
decreased appetite;
insufficient increase in body weight as the baby develops.

A 5-6 year old child begins to show low physical activity and rapid loss of strength compared to other children. He may often suffer from respiratory diseases. Closer to adolescence, in the background hormonal changes associated with puberty, the following clinical picture arises:

dizziness;
feeling of general weakness;
sudden loss of consciousness;
attacks of arrhythmia;
low performance.

Doctor Komarovsky's opinion

The famous pediatrician and TV presenter, Evgeniy Olegovich Komarovsky, claims that a window in the heart is characteristic of virtually all newborns. In every second case it does not heal until 2 years. Closer to 5 years, the anomaly mostly disappears without causing any harm to the child. The doctor also emphasizes that a hole in the septum is not a life-threatening defect. It is considered individual feature development, and in most cases closes without the intervention of doctors.

Causes

A hole in the heart septum is predominantly inherited. Sometimes the occurrence of an anomaly is influenced by factors affecting the mother carrying the child:

drug or alcohol use;
smoking;
use of medications contraindicated during pregnancy;
being in stressful situations;

poorly designed diet;
unfavorable environmental conditions.

The stated reasons can provoke not only this anomaly, but also many other defects. According to statistics, children born prematurely or with developmental delays have the greatest chance.

Diagnostics

It is impossible to identify a hole in the heart septum through a routine examination. Parents can, for preventive purposes, conduct an examination of the child or suspect the presence of an anomaly due to blue discoloration of the skin (diffuse cyanosis) while still in the maternity hospital. This symptom does not always occur and is often a consequence of other pathological processes. To make an accurate diagnosis, you will need to undergo an examination:

Ultrasound ( ultrasonography) of the heart muscle, also called echocardiography, is performed in conjunction with Doppler ultrasound. The essence this method diagnostics consists of determining the direction of movement and the amount of blood pushed into the hole on the septum and identifying other anomalies. The results obtained will help the doctor find out the severity and course of the pathological process.
Contrast echocardiography is used to more effectively locate defects and holes in the septum. The patient will receive an injection saline solution, which was shaken in advance. If there is a window in the heart, the bubbles will penetrate it, passing from one atrium to another.
Transesophageal echocardiography is used extremely rarely as an ultrasound examination of the heart. Despite the unpleasantness of the procedure, it is able to determine the exact location and size of the window in the septum, as well as see the presence of complications (myocarditis, blood clots, aneurysm and others).
Radiography thoracic used to determine the size of the heart and the thickness of its vessels, as well as to identify congestive processes. In the presence of septal abnormalities, the volume of the organ is slightly increased, and blood stagnation is observed in the lungs.

Electrocardiography (ECG) allows you to learn about disturbances in the work and structure of the heart that are characteristic of a window in the septum, for example, arrhythmia or left ventricular hypertrophy. The anomaly itself cannot be detected using such a hardware method.

As complications caused by a hole in the septum develop, other diagnostic methods may be required. The most relevant are cardiac catheterization, magnetic resonance imaging and CT scan And ultrasound examination kidney

Danger of anomaly

IN calm state The foramen ovale does not appear in the cardiac septum. Disruptions in blood supply occur mainly when coughing and physical activity. Special attention You need to pay attention to the child’s health when the following dangerous factors occur:

Sometimes the valve that closes the hole in the septum lags behind the growth of the heart muscle. The window is no longer obscured, and blood flows from one atrium to another. A large load falls on them, which leads to various complications.
Pathological processes leading to an increase in pressure in the right atrium can open the hole slightly. Often the cause is respiratory diseases, of cardio-vascular system and veins, as well as the period of pregnancy and childbirth.

Such problems require urgent intervention. Parents should take the child to the doctor to prevent the abnormality from transitioning from the compensation phase to decompensation. The latter type of course is characterized by the occurrence of various complications. Their full list can be seen below:

stroke;
disruptions in cerebral circulation;
myocardial infarction;
necrosis of a section of the kidney caused by ischemia (lack of nutrition).

Failures are mainly caused by embolism, that is, blockage of a vessel by a detached blood clot. It develops rarely, but due to its severity possible consequences The patient is recommended to be observed by a doctor and undergo periodic examinations.

According to statistics, in people over 45 years of age, an oval window in the septum provokes the development of hypertension and coronary disease hearts. It is no less dangerous after a myocardial infarction, when the recovery period has begun. An unclosed hole slows it down significantly. This anomaly also often provokes migraine attacks and shortness of breath after getting out of bed, which disappears if the patient lies back down.

This anomaly has small advantages that will improve the quality of life in certain situations, for example, with pulmonary hypertension. Due to the manifested pressure, a person experiences constant shortness of breath, cough, general weakness and periodically loses consciousness. The oval window in the septum helps remove part of the blood from pulmonary arteries. The severity of the pathology decreases and the patient’s condition improves.

Course of therapy

Treatment of an abnormal window in the heart muscle, which does not manifest itself with a characteristic clinical picture and does not contribute to the development of complications, is usually not carried out. The doctor will only give the following recommendations:

Engage in physical therapy to strengthen the heart muscle and keep the body in good shape.

Rest more, taking breaks at work every hour (5-10 minutes) and maintaining a sleep schedule (sleep at least 7-8 hours).
Avoid conflicts and stressful situations. It is advisable for the patient to devote more time to hobbies and listen to his favorite music in order to relax and not overstrain the heart.
Prepare your diet wisely, removing fatty foods and filling it with vegetables and fruits. It is necessary to cook by steaming or boiling, and eat small portions 5-6 times a day.

If the patient complains of attacks of tachycardia and other disorders of the cardiovascular system, then the doctor may advise combining the above measures with drug treatment. It is based on taking pills to stabilize the condition:

Antiarrhythmic medications (sodium, calcium and adrenaline blockers, cardiac glycosides, diuretics, sedatives), designed to eliminate arrhythmia.
Vitamin complexes based on magnesium, potassium and B vitamins (Panangin, Magne B6) improve the condition of the nervous and cardiovascular systems.

Surgical intervention is possible only in pronounced clinical picture, which significantly reduces the patient’s quality of life. It is no less relevant if there is a high chance of blood clots. The specialist will recommend endovascular treatment. Its essence is to insert a catheter into the femoral artery. Next, it is advanced into the right atrium and a special patch is applied to the hole, which stimulates the area to become overgrown with connective tissue. After 3-4 weeks it will resolve on its own without repeated intervention.

The operation must be combined with the use of antiplatelet agents and anticoagulants to reduce the risk of blood clots. During the recovery period, the patient should undergo antibacterial therapy to prevent the development of myocarditis. A successful surgical intervention will allow the patient to live without any restrictions, since the anomaly will be completely eliminated.

Sports activities

Sport is useful in the treatment of any pathological processes. With an oval window on the septum, physical overload is contraindicated, but exercise at a moderate pace is allowed. Swimming, all types of wrestling and weightlifting are definitely not suitable, but you can run, do exercises and exercises from the course physical therapy to strengthen the heart. It is advisable to conduct several sessions with a specialist in order to know all the features of the process and not harm your health.

Forecast

A window in the heart in children most often does not lead to the development of consequences. Babies actually do not feel any discomfort. Parents are required to take the child for examination to the pediatrician at the time specified by him and every six months to conduct an ultrasound examination of the heart muscle to assess its condition.

Usually the anomaly heals over time, but if this does not happen, then it is enough to remember the existing restrictions. The child will be able to calmly do everything, but without fanaticism, as the likelihood of complications will increase. At school, the child will have a separate physical education program, and upon reaching 18 years of age, he will receive category B from the medical commission, which stands for the presence of restrictions during military service.

An oval window in the heart of a newborn is a minor anomaly. It is not able to have a significant impact on the child’s health and only occasionally manifests itself with cardiac symptoms. Treatment is prescribed in the presence of interfering symptoms. In other cases, correcting rest and nutrition is sufficient. If a hole in the heart provokes serious complications and becomes life-threatening, then surgical intervention is performed.

An open foramen ovale in a child’s heart is a problem that is quite common in modern pediatrics. But what exactly is such a disorder and how dangerous is it to health?

What is wrong with the child?

During intrauterine development, the child's body is made only from the mother's blood. Moreover, between the two atria there is this very oval window, due to which the cells of the central nervous system get maximum amount oxygenated and nutrient-rich blood. Immediately after birth, the edges of the oval window grow together. In most children, its closure occurs in the first days of life. In about 30% of babies, the oval window remains at least partially open until one year of age. But sometimes this hole between the atria does not close - in this case, the baby needs qualified help.

Open foramen ovale in the heart of a child and its causes

Unfortunately, it is not always possible to find out the causes of such a pathology - and to this day active research is being conducted on this issue. However, it has been proven that such a disorder is associated with the presence of other pathologies. The risk increases if a woman abuses alcohol and tobacco during pregnancy.

Open foramen ovale in the heart of a child: main symptoms

In fact, the presence of an open hole in the heart in most cases does not cause any visible symptoms. Quite often, pathology is discovered completely by accident during an ultrasound examination. circulatory system. However, there are a number of signs that are still worth paying attention to:

For example, quite often when screaming, crying or physical stress You may notice bluish skin in the area of the nasolabial triangle.
Often, an open oval window in children leads to a slowdown in normal physical development.
Signs may also include frequent colds and diseases of the respiratory system.
As parents notice that the baby is almost incapable of physical activity, for example, during active play, respiratory failure may develop.
Children with this diagnosis may often lose consciousness due to lack of blood circulation in the brain.

Open oval window and treatment

If you have any disturbing symptoms, you should show your baby to a doctor and tell him about all your suspicions. As a rule, in order to confirm the diagnosis, it is enough to do After the pathology has been discovered, the child must be constantly under the supervision of a cardiologist and undergo regular examinations. As a rule, experts recommend that parents wait until radical measures treatment, since in most cases the oval window closes on its own. In addition, statistics claim that in almost 25% of the adult population, the oval window never closes completely. Only in especially severe cases, if the pathology poses a threat to the child’s life, does the doctor prescribe surgery, during which the hole is closed artificially.

Modern diagnostic methods make it possible to identify diseases whose presence was not previously even suspected. An open foramen ovale in the heart of a child is a disorder of the heart muscle, which is increasingly observed in medical practice.

While the fetus is in the mother's womb, there is a functioning window in the heart, and this is a natural manifestation. After the baby is born, it usually closes.

Purpose of a window in the heart

During intrauterine development, the fetus is nourished by the mother's blood. On the heart muscle between the atria there is a small oval window, it is thanks to it that the cells of the central nervous system receive blood from the blood. nutrients And sufficient quantity oxygen.

After birth, the child begins to work respiratory system, the oval window, having fulfilled its function, tends to close. Most often this happens in the first few days of life.

Approximately 30% of children live with it until they are 1 year old; in some situations, the hole cannot close for certain reasons, then the child needs professional medical help.

When should the foramen ovale close?

Parents who are faced with a similar anomaly have a question: when does the foramen ovale close normally? If the development of the newborn is observed without certain disturbances, then the valve begins to close in the first few hours of life, the closure of the oval window continues longer.

On average, complete overgrowth is completed between the ages of two months and a year; in certain groups of children it can last up to two or even five years. For some people, the hole does not heal until the end of their lives; this is already a pathology.

An incompletely closed hole after 5 years of age is more often diagnosed in premature infants and in children with congenital diseases.

This type of disorder is not classified as an organ defect, but as a minor anomaly in the development of the heart (). In this case, it is necessary to constantly monitor the doctor.

The presence of these disorders does not pose a major threat to health. Often people live with them and have no idea about the presence of such a pathology. The disorder is discovered by chance when diagnosing other diseases.

Another problem is determined when completely open window when the interatrial valve is unable to perform the necessary functions.

This disease is called “atrial septal defect”. After 3 years of age, children are given disability group II, young people of military age are assigned fitness category “B”, which exempts them from military service.

Causes of pathology

Statistics show that last years the number of diseases has increased. More often, the disorder occurs in premature babies and with a genetic predisposition.

An unclosed oval window can be caused by:

Poor closure due to anatomical features valve structure (it is smaller than normal).
Unfavorable conditions of intrauterine development (reception medicines, exposure to increased radiation, hypoxia).
Heart defects.
Abnormal development of myocardial connective tissue.
Severe lung diseases.
Regular physical activity.
Thromboembolism of the pulmonary artery.
Unfavorable environmental conditions.
Maternal abuse of alcoholic beverages and tobacco products while carrying a child.

Symptoms

If the hole is not completely closed, then the pathology may not manifest itself with certain symptoms. The degree of danger is determined by the treating specialist.

In an infant, an abnormal phenomenon can be suspected by the following symptoms:

Cyanosis is a bluish discoloration of the lips, nose, and fingers, especially when coughing, straining, or crying.
Pale skin.
Increased heart rate in a newborn.

In case of disorders in adults, blue lips appear when exposed to a number of factors:

Severe physical overload, sports.
Loads that contribute to an increase in pressure in pulmonary vessels(holding your breath, swimming).
Pulmonary pathologies (pneumonia, emphysema, asthma).
Heart defects.

If the opening exceeds 7 mm, this is manifested by a number of external signs:

Regular fainting conditions.
Manifestation of cyanosis skin even with minor physical activity.
General malaise.
Frequent dizziness.
Physical development disorders.

Normally, the size of the window should not exceed the head of a pin and be blocked by a valve, which becomes a barrier to the release of functioning blood into the systemic circulation from the pulmonary circulation.

When the patent oval window measures 4.5-19 mm, as well as when the valve is not completely closed, disturbances in blood flow in the brain and a decrease in the oxygen content in the blood often appear.

More often the pathology proceeds without certain symptoms, or the signs are blurry. Indirect manifestations that indicate the presence of pathology have been identified:

A sudden appearance of pallor, cyanosis of the skin during crying or bathing.
Decreased appetite, anxiety.
Bad set weight.
The appearance of symptoms of heart failure (lack of air, shortness of breath, rapid contraction of the heart muscle).
Frequent diseases of the respiratory system.
Fainting states.
When listening to the heart, murmurs are detected.

Diagnosis of pathology

A specialist may suspect something is wrong when conducting a physical examination, detecting bluish skin, abnormalities in physical development, and also when noise is detected after listening. The doctor relies on the identified symptoms: frequent illnesses ARVI, acute respiratory infections, fainting conditions.

Most precise method The study is considered to be an ultrasound examination of the myocardium, which is carried out not through the chest, but through transesophageal echocardiography.

ECHO signs are determined by introducing ultrasonic sensor into the esophagus, and is clearly visible structural structure hearts. This is especially helpful in diagnosing pathology in obese people, when visual examination is difficult.

Except for ultrasound of the heart, precise setting diagnosis occurs after the following diagnostic methods:

Electrocardiogram. She identifies symptoms heavy load to parts of the heart muscle.
Radiography chest, which determines the enlargement of the myocardium.
Probing of the cardiac cavities. Prescribed before surgery.

Treatment

Application therapeutic measures This is not always required; in children under five years of age, the window can close on its own.

The need for treatment is determined by the attending physician, and it is necessary to regularly do a cardiogram and Echo-CG.

If the formation of blood clots is diagnosed, medications that have a thinning effect on the blood are prescribed; exposure to heavy loads is not recommended.

In some cases, an operation is required, which consists of inserting a tube with a special valve at the end, which closes the hole between the atria. For six months after surgery, it is necessary to take antibiotic drugs, which will make it possible to prevent the formation of bacterial endocarditis.

Many experts advise maintaining a daily routine for children and avoiding strong physical and psycho-emotional stress. The diet must include rich in proteins food, eat more fresh vegetables and fruits, natural freshly squeezed juices.

It is important to avoid infection entering the child’s body, since any disturbances can adversely affect the functioning of the heart.

Danger of pathology

Medical scientists have proven that the risk of developing pathology increases in people with constant physical activity and active swimming.

The danger of this condition is that it leads to disorders in the physical and mental development children.

Thromboembolism poses a threat to the patient's health, for this reason it is necessary to urgently take measures to prevent it.

What complications can there be?

The consequences of the disease are rare, but if the foramen ovale is not closed, serious complications can occur:

Thromboembolism. A clot from a venous vessel penetrates the aorta great circle due to an open foramen ovale, which can cause blockage of blood vessels important organs(heart, kidneys, brain). This often becomes the cause of human death.
Endocarditis is inflammation of the inner lining of the heart.
Infarction, renal infarction.
Stroke.

Minor anomalies do not pose a threat to the health and life of patients. But in order to avoid any complications and consequences, it is necessary to be observed by a specialist.