The open oval window in the baby should close as it grows (the valve grows to the oval fossa). This can happen immediately or after a year, two, several years.
This is due to the fact that as the child grows, his heart grows, while the valve retains its previous size. The oval window does not close tightly, although it should. Thus, blood moves between the atria, loading them.
Another reason is diseases that increase pressure in the right atrium. As a result, the window opens slightly and allows blood to circulate freely. Such diseases include chronic pulmonary disease, vein disease, and more.
Physiologically, the main human organ has a septum that divides it into the atria. In the center of the septum tissue there is an oval-shaped depression. Under this recess is the smallest open passage with a valve that opens toward the left atrium. The diameter of this open hole is slightly larger than 2 mm.
When a baby develops in utero, blood circulation functions without affecting the lungs. But, as you know, the fetus breathes. It is this open hole, called the window, designed to communicate both atria. Through it, venous blood (in adults it passes through the pulmonary arteries) can freely participate in blood circulation, while bypassing the lungs.
The cardiovascular system in the newborn is still very weak, and its vital functions impose heavy loads on it. For example, when a newborn cries, coughs, pouts, blood pressure in the right side of the heart (right atrium) rises. The body, in order to reduce this pressure, resorts to opening an oval window in the newborn. When this happens, you may notice a bluish color around the baby’s mouth.
It should be noted immediately that in many newborns, the process of tightening the valve takes a year, or even two.
- Atrial lumen that did not close: mechanism of occurrence, normal and pathologically significant sizes
- Reasons for not closing the oval window of the heart
- clinical picture
- The reason for the development of an open oval window
- How to find out that a child has an open oval window?
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- Diagnosis of the disease
- An open oval window in a newborn: norm or pathology? What it is? Causes and treatment
- Treatment: do I need surgery?
- Complications of the failure of the oval window in the heart
- Forecast with an open oval window
Atrial lumen that did not close: mechanism of occurrence, normal and pathologically significant sizes
An open oval window (hereinafter – LLC) in the heart of children is represented by a micro-hole that provides a connection between both atria (right and left). A rounded window appears in the main circulatory organ in the perinatal period. This armhole is necessary during embryogenesis for the passage of blood from the vena cava through the heart chambers, bypassing the still not functioning pulmonary pathway.
At the time of birth, the baby’s lungs straighten from the very first breath, and the full-fledged work of not only the respiratory, but also the cardiovascular system begins.
The importance of this anastomosis in a newborn baby disappears, and it decreases in size, and then overgrows altogether. The timing of its closure in each individual child is strictly individual. They can vary from 2 weeks to 5 years. Window growth in a child who has recently reached the age of five is also considered normal. In ⅓ small patients with the aforementioned phenomenon, an oval window may not be closed.
It is important to know: an open oval window is not a heart defect. A functionally active atrial window becomes a pathological condition only in the following cases.
- Uneven growth of the organ itself and the valve covering the lumen, when the latter is significantly behind and does not have the ability to fully close the message. In this case, there is an active bypass of the blood flow and, as a result, an increase in the mode of operation of the cardiac apparatus, leading to a failure in the circulatory system.
- The development of ailments and physiological situations that increase the blood load on one of the atria (right). These include:
- pathology of the venous network of the legs;
- pathology of the bronchopulmonary system with chronicity;
- combined pathologies of the cardiovascular system;
- state of pregnancy and physiological birth.
The size of the gap in the wall of the atria in a child under 2 years old can be different. The limits of the age norm are considered to be sizes that fall in the range of 2-5 mm. Averaged can be considered a value of 4,5 mm. However, there were cases when the message exceeded the diameter of 19 mm, which is already a significant deviation from the norm.
Reasons for not closing the oval window of the heart
The hole in the cardiac septum is predominantly inherited. Sometimes the occurrence of the anomaly is influenced by factors affecting the mother carrying the child:
- drug or alcohol use;
- the use of medicines contraindicated during pregnancy;
- stay in stressful situations;
- poorly prepared diet;
- adverse environmental conditions.
The stated reasons can provoke not only this anomaly, but also many other defects. According to statistics, the most likely chances are for children born prematurely or having a developmental delay.
An open window in the heart of a newborn is an abnormality and may occur due to:
- prematurity of the baby;
- connective tissue dysplasia;
- congenital heart defects;
- adverse environmental impact.
In addition, the behavior of the mother during pregnancy also affects the occurrence of such a problem in the baby:
- use of drugs and alcohol;
- drug poisoning;
- frequent stress;
- poor nutrition.
In the first place in the structure of the causes of morbidity is a genetic predisposition, especially on the maternal side. Also, the factors that have a negative effect on the fetus during the gestation period can be noted as unfavorable environmental conditions, insufficient nutrition of the pregnant woman, stress, the use of toxic substances (alcohol, drugs, nicotine, and drugs forbidden for use by pregnant women).
There is more than one theory and assumption on this score. But there are no reliable ones yet. In the event that the valve does not grow together with the circumference of the oval window, they talk about the features of the body. This confirms the number of random findings during echocardiography.
It happens that the valve is initially small and is not able to completely close the window. The cause of this underdevelopment can be any factor that affects the formation of the fetal organs:
- mother smoking and drinking
- work with harmful and toxic substances
- ecology, stress.
Therefore, an open oval window in children is often combined with prematurity, immaturity and other pathologies of intrauterine development.
As already mentioned, the clinic with this pathology is absent, and the anomaly itself is detected randomly. Complications and consequences usually do not happen.
The combination of an open oval window with other diseases. Symptoms appear with hemodynamic disorders (proper blood flow through the chambers of the heart). This happens when there are combined heart defects, for example:
- open arterial duct;
- defects of the mitral or tricuspid valves.
The heart chambers are overloaded, the interatrial septum is stretched, and the valve cannot perform its functions. Right-bypass bypass appears.
Modern science has gone so far that it can diagnose small anomalies at an early stage. The birth of a child is a wonderful event in the life of every woman. But very often the “newly minted” mothers, having heard the diagnosis of an open oval window in a newborn, in a panic do not have a clue what to do? Let’s try to figure out what this anomaly is, where it comes from and is it dangerous?
Doctors find it difficult to unequivocally answer the question of what causes the development of such an anomaly.
Two main theories are put forward:
- The physiological feature of the human body, if the valve does not overgrow throughout life, without concomitant diseases.
- If the valve is small (underdeveloped) and does not completely cover the oval window, then violations have occurred still in utero. They could be caused by internal and external factors.
Internal causes of the anomaly:
- heart disease;
- heredity of the genome;
- diabetes in the mother;
- preterm birth (preterm birth), why this happens, read “The threat of premature birth”;
- the mother suffered an infectious disease or severe poisoning during pregnancy; What to do if a pregnant woman has been poisoned, the article “Poisoning during pregnancy. Help to the expectant mother. “
External factors that increase the risk of valve underdevelopment:
- drinking alcohol during pregnancy;
- taking preparations containing insulin, lithium, phenobarbital.
In order to avoid the development of pathologies and check whether the fetus is developing normally, a pregnant woman should undergo a special examination. About such an examination is written in the articles “The first screening during pregnancy, what it is and why it is needed” and “The second screening during pregnancy”.
The exact etiological factors contributing to the timely non-closure of the oval window are not fully known. However, doctors note a higher percentage of detection of such an anomaly, if there were possible reasons:
- On the part of the mother:
- hereditary nature of a small anomaly;
- difficult pregnancy (gestosis, frequent infections, threatened termination);
- alcohol abuse;
- tobacco smoking;
- diffuse connective tissue diseases;
- radiation and radiation exposure;
- chronic diseases that worsen the course of pregnancy (diabetes mellitus).
- From the fetus:
- individual anatomical features – the valve of the oval hole is small;
- congenital malformations and deformities;
- chronic hypoxia;
- lung pathology, including pneumonia of the newborn.
Thus, the formation of an open window occurs in two ways:
- Inconsistency of the small size of the valve to the larger diameter of the hole when it is “slamming”.
- Insufficient pressure in the vessels of the pulmonary circulation and the left atrium, which is accompanied by the lack of valve closure.
If LLC is formed in 1 way, then such a small anomaly persists for many years, right up to old age. In 2 cases, spontaneous closure occurs in childhood.
For many years, the oval window in the heart can be asymptomatic. Anomaly in a newborn and older children can be suspected by the following signs:
- weak sucking reflex;
- small gains in weight;
- profuse regurgitation;
- bluish nasolabial triangle during crying, straining, coughing, bowel movements;
- some lag in physical development;
- frequent respiratory infections;
- shortness of breath during physical education at school;
- reduced load tolerance.
In pregnancy, a functioning open oval opening is accompanied by:
- frequent changes in blood pressure;
- interruptions in the work of the heart;
- shortness of breath with minimal load;
- recurrent ARI.
In an adult, there are no complaints without concomitant diseases. Symptoms are noted with severe physical and emotional stress.
In such cases, the patient with a functioning oval window is concerned about:
- long-term passing dyspnea at rest;
- discomfort behind the sternum;
- piercing pain in the heart;
- increased blood pressure;
- cyanosis of the lips.
The patient usually does not pay attention to these symptoms due to the fact that they quickly pass. In such cases, LLC is often a diagnostic finding for other diseases.
The reason for the development of an open oval window
In the process of fetal development, some “imperfections” of embryogenesis are often observed. Such deviations are referred to as small anomalies (MARS).
They are not regarded as congenital malformations. One of the widely diagnosed options is the oval open window (LLC).
How to find out that a child has an open oval window?
Since diagnostic methods in the form of ultrasound studies became available for general use, interesting findings have appeared in medicine. Namely: various small anomalies that were not previously diagnosed, and were not even suspected of them. One of these finds is an open oval window.
- This can be manifested by frequent diseases of the lungs and bronchi.
- During the load (crying, coughing, physical exertion, asthma attacks), the nasolabial triangle area becomes cyanotic, the lips turn blue.
- The child is somewhat behind in physical development and growth. Physical education causes fatigue and inadequate exertion of dyspnea.
- Spontaneous, inexplicable fainting appears. This is especially true for young people with diseases of the veins of the lower extremities.
A special examination to detect a small abnormality in the heart is not prescribed, an exception if the mother has such a pathology. In other cases, the problem becomes known, quite by accident at the next or extraordinary examination.
Symptoms that may indicate the presence of an abnormality may be:
- in young children, when coughing, crying, trying, a blue appears around the mouth. In a calm state, she passes;
- there are noises (of an extraneous nature) in the child’s heart;
- older children have rapid fatigue with little physical exertion, causeless fainting, dizziness;
- often recorded a tendency to colds.
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- With age, the study reveals signs of pulmonary hypertension, overload of the right heart.
- This, in turn, leads to changes in the ECG: impaired conduction along the right leg of the His bundle, signs of an increase in the right heart.
- An open oval window in an adult, according to statistics, increases the incidence of migraines.
- Data on the possible development of a stroke or heart attack appeared long ago. The case when a blood clot, a piece of a tumor or a foreign body penetrates from the venous system into the arterial system and clog the vessel there is called a paradoxical embolism. Getting into the vessels of the heart, it causes myocardial infarction. In the vessels of the kidney – a heart attack of the kidney. Into the vessels of the brain – ischemic stroke or transient ischemic attack.
- Also, adults may experience a paradoxical syndrome such as platypnea-orthodeoxia. A person has shortness of breath when rising from the bed, and disappears when he again takes the supine position.
- The peritoneal region or nasolabial triangle acquire a bluish tint or sharply turn pale when the baby is pushing, screaming, crying, coughing, taking a bath.
- Frequent manifestation of the symptoms of colds and bronchial diseases.
- The child practically does not gain weight.
- In older children, the problem also manifests itself in the form of shortness of breath and a rapid pulse during even minor physical exertion.
Usually, the clinical manifestations of an isolated oval window in babies (without the presence of congenital heart defects) are rather scarce. You can suspect this structural anomaly in a newborn baby on the basis of the following complaints: palpitations, shortness of breath, and cyanosis (gray or blue color) of the nasolabial triangle during crying and feeding.
During a period of intensive growth, as well as hormonal changes in the body (adolescence, pregnancy), the load on the cardiovascular system as a whole increases, which can cause fatigue, weakness, and sensations of interruptions in the work of the heart, especially during physical exertion or sports.
In situations where the oval window does not overgrow even after five years of age, most likely, it will accompany a person throughout his life, which, however, does not affect his everyday life and work. But at an older age (after forty to fifty years), when a person can develop diseases such as arterial hypertension and coronary heart disease, the oval window can complicate the recovery period after myocardial infarction and the course of chronic heart failure.
Often the defect does not have obvious clinical symptoms, and a person accidentally learns with surprise that a problem occurs during a routine examination. But sometimes the following symptoms may slip:
- the blue color of the so-called nasolabial triangle, which appears during coughing, severe bowel movements, or when the baby cries for a long time; in the normal state, the blue tones go away;
- the child often has a cold respiratory illness;
- noises are heard during auscultation of the lungs and heart;
- palpitations, shortness of breath;
- the baby is poorly gaining weight, not happy with appetite;
- in older children, the ailment can manifest itself in rapid fatigue during physical training, additional stress; frequent dizziness is characteristic up to loss of consciousness.
Diagnosis of the disease
By a routine examination, it is unrealistic to reveal a hole in the heart septum. Parents may, for prevention, examine the child or suspect an abnormality in blue skin (diffuse cyanosis) while still in the hospital. A similar sign does not always occur and is often a consequence of other pathological processes. For an accurate diagnosis, you will need to undergo an examination:
- Ultrasound (ultrasound) of the heart muscle, also called echocardiography, is performed along with dopplerography. The essence of this diagnostic method is to determine the direction of movement and the amount of blood pushed into the hole on the septum and identify other anomalies. The results will help the doctor know the severity and course of the pathological process.
- Echocardiography of a contrast type is used to more effectively find defects and holes in the septum. The patient will be given an injection of saline, which was shaken in advance. If there is a window in the heart, the vesicles will penetrate into it, passing from one atrium to another.
- Transesophageal echocardiography is used extremely rarely as an ultrasound scan 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, and also to see the presence of complications (myocarditis, blood clots, aneurysms, and others).
- Chest x-ray is used to determine the size of the heart and the thickness of its vessels, as well as to identify stagnant processes. In the presence of anomalies of the septum, the volume of the organ is slightly increased, and blood stasis is observed in the lungs.
- Electrocardiography (ECG) allows you to learn about violations in the work and structure of the heart, which are characteristic of a window in the septum, for example, arrhythmia or hypertrophy of the left ventricle. The anomaly itself cannot be detected by such a hardware method.
As complications caused by a hole in the septum develop, other diagnostic methods may be required. The most relevant cardiac catheterization, magnetic resonance imaging and computed tomography and ultrasound examination of the kidneys.
Suspicion of the presence of an open oval window in the heart of a newborn can arise already during auscultation of tones by systolic murmurs of different intensities.
Confirm the assumption using diagnostic methods such as:
Invasive and aggressive diagnostics are used only if there is a need for surgical intervention.
The diagnosis is based on auscultation (listening) of the chest during examination of the child (systolic murmurs are heard), as well as on the basis of instrumental research methods.
The main method for detecting an oval window is imaging using echocardiography (ultrasound of the heart). Ultrasound of the heart must be performed for all children aged 1 month in accordance with the new medical diagnostic standards in pediatrics.
If the oval window accompanies congenital heart defects, then, if necessary, the doctor prescribes transesophageal echocardiography, an angiographic study (the introduction of an radiopaque substance into the cavity of the heart through the vessels), performed in a specialized cardiosurgical hospital.
Usually an external examination of the patient does not bear any data for a congenital anomaly. An oval open window in the heart of a child can sometimes be suspected in the hospital when diffuse cyanosis of the entire skin appears. But this symptom needs to be differentiated with other pathologies.
Most often, an open window between the atria is found during an ultrasound scan of the heart. It is better to conduct echocardiography with a doppler. But with small window sizes, these techniques will not be able to determine the anomaly.
Therefore, the “gold standard” for detecting LLC is transesophageal echocardiography. It allows you to see the window itself, closing its casement, to evaluate the volume of shunting blood, and also to conduct differential diagnostics with a defect in the atrial septum – a real heart defect.
As an invasive method, angiocardiography is also very informative. The last two methods are used only in specialized cardiology clinics.
A comprehensive examination is necessary when the above symptoms have been noticed and the diagnosis needs to be clarified. The most informative is considered an ultrasound examination of the heart.
During the ultrasound, the valve is visible in the left atrium, located in the oval pit. Hole sizes range from 2 to 5 mm, the walls of the interatrial septum are thinned (this is the difference from a septal defect in which the valve is not visible, and the walls are thicker than usual).
Echocardiography allows you to estimate how much blood is moving in the wrong direction, what is the additional load on the heart and whether there are additional pathologies (in many cases, in addition to the open oval window, a number of concomitant cardiac abnormalities are found, which complicates the treatment).
In some cases, they may offer to undergo echocardiography through the esophagus or with bubble contrast. In the latter case, shaken saline is admitted through special catheters inserted into the ulnar vein. If the vesicles immediately fall from the right atrium to the left, then the oval window is open.
With the help of an x-ray of the chest, the borders of the heart and the thickness of the great vessels are evaluated.
An open oval window in a newborn: norm or pathology? What it is? Causes and treatment
If a deviation from the norm is detected in the form of an open oval window in a child, the doctor determines the treatment method taking into account the symptoms that are manifested.
If there are no violations as such, the doctor gives advice on the current regime of the day, physical activity and nutrition. If there is an anomaly, but the symptoms are completely absent, the baby is prescribed a sanatorium treatment.
It is also recommended to temper and engage in physical therapy. In this case, the doctor does not prescribe any medication.
If the manifestation of symptoms is insignificant, children are recommended to drink vitamins and restorative drugs (for example, Panangin, Ubiquinone and others). In addition, parents should limit the physical activity of the baby and increase the frequency of procedures that strengthen the body.
With pronounced symptoms, the threat of blood clots and the discharge of blood between the atria, a mandatory measure is to stay under the supervision of a cardiologist or cardiac surgeon. Antiplatelet agents and anticoagulants may also be taken.
In addition, endovascular treatment is used. In order to prevent endocarditis, it is recommended to take a course of taking antibiotics. After carrying out all the above activities, the child continues to live fully, without any restrictions.
In the absence of significant symptoms and complaints from the circulatory and respiratory tract, the child does not need to treat an open oval window.
A regular visit to the pediatrician and cardiologist, as well as monitoring the dynamics by ultrasound, should be mandatory.
In the case when a person is predisposed to thrombosis, it is necessary to prescribe drugs that have an anticoagulant effect (WARFARIN). When using them, regular monitoring of the coagulogram, INR should be carried out. If necessary, it is possible to prescribe pharmaceutical preparations that stimulate the strengthening of myocardial structures (ELKAR, PANANGIN, etc.)
If the hole reaches an exorbitant diameter, and there is a place for excessive regurgitation, a question arises about the operation, the essence of which is to close the window by cardiac catheterization.
A catheter is inserted through the femoral artery under x-ray control. Having reached the defect, the device at the end of the catheter (occluder) opens, completely blocking the lumen of the message.
There is a similar method, when instead of an occluder, a specialized self-destructive sticker is attached to the defect, which regenerates muscle tissue for 30 days, and then dissolves.
Indications for surgical treatment are determined not only by the extent to which the gaping area is closed by the valve, but also the ability of the latter to compensate for the arising loads.
In the absence of clinical symptoms and hemodynamic disorders (pronounced changes in the work of the heart), which is most often found in the practice of a pediatrician, neither drug therapy nor hospitalization in a hospital are indicated. General strengthening procedures are prescribed – hardening, walking in the fresh air, maintaining a balanced regime of work and rest, proper nutrition, physiotherapy exercises.
When minor complaints from the cardiovascular system appear, the appointment of vitamins and drugs that provide additional nutrition to the heart muscle – Magne B6, panangin, analogues of L-carnitine (elkar), coenzyme Q (ubiquinone) can be justified.
In cases of combination with heart defects, the tactics of observation and treatment are determined by the cardiologist and cardiac surgeon with the choice of the optimal method for the operative correction of defects. In recent years, London scientists have developed an operation in which a probe with a patch is inserted through the femoral vein into the cavity of the right atrium, which is applied to the window and resolves within 30 days.
In most cases, medical intervention with LLC is not required. However, in any case, treatment begins with general recommendations:
- Limitation of heavy physical exertion.
- It is forbidden to engage in professional sports.
- Efficient nutrition and maintaining ideal body weight.
- Exclusion of bad habits: smoking, alcohol, strong coffee.
- For children on artificial feeding – mixtures with high calorie content.
- Monitoring blood pressure and heart rate.
- Exercise therapy.
- Decrease in stressful and psychoemotional situations.
Symptomatic treatment includes the appointment of:
- pressure normalizing drugs;
- drugs for blood thinning with thrombosis and thromboembolism – anticoagulants, antiplatelet agents.
Surgical treatment is indicated at any age with severe hemodynamic impairment, a high risk of complications and a severe clinical picture.
The essence of the operation is that the defect is closed with a special patch.
Intervention is well tolerated. Conducted percutaneously – through the femoral or radial artery using a special probe with the introduction of a contrast medium. Complications are rare. After the operation, the patient is allowed to play sports.
LLC – non-congenital heart disease (CHD). The prognosis for life and ability to work with such an anomaly is favorable. It is not necessary to treat it. The main thing is to visit a specialist for dynamic monitoring in order to prevent the development of undesirable consequences.
We found out that the baby LLC is absolutely normal, and up to 2 years it is enough to be observed by a cardiologist and do an echocardiography every year. In principle, a person can live with a similar defect all his life. If concomitant cardiac abnormalities were not found, there are no symptoms of cyanosis, there are no chronic diseases of the lungs and venous system, and the size of the opening is small, nothing can be done.
On the other hand, in adulthood, difficulties can arise in women during gestation, in individuals prone to increased thrombosis, as well as in the development of severe pulmonary insufficiency.
The greatest risk to life is paradoxical embolism – a condition where emboli through the LLC penetrate into the left atrium, and then into the large circle of blood circulation. Traveling through the vessels towards the brain, they provoke the development of ischemic and cardioembolic stroke. Sadly, young people of 30–40 years old become victims of embolism, and the process itself begins suddenly.
For reference. An embolus is any foreign substance or particle that is in solid, liquid or gaseous form in the bloodstream that can cause a blockage of the vessel. It can be a detached blood clot or part of it, drops of fat or cholesterol, air bubbles, etc.
Due to the seriousness of the complications, each case of an unclosed open window should be considered individually by a good cardiologist, or rather several, in order to determine whether an operation is necessary in a particular case or not.
And finally, there are situations when surgery is a direct indication: the large size of the oval window, the absence of a valve, which considers the anomaly as a defect of the atrial septum, a person suffered a stroke. How is surgery done?
Treatment: do I need surgery?
Treatment of an abnormal window in the heart muscle, which does not manifest 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.
- Have more rest, taking breaks at work every hour (for 5-10 minutes) and observing the sleep regimen (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 strain his heart.
- Properly compose a diet, removing fatty dishes from it and saturating vegetables and fruits. It is necessary to cook steamed or by cooking, and eat food in small portions 5-6 times a day.
If the patient complains of attacks of tachycardia and other disorders of the cardiovascular system, the doctor may advise combining the above measures with medication. It is based on taking pills to stabilize the condition:
- Antiarrhythmic medicines (sodium, calcium and adrenaline blockers, cardiac glycosides, diuretics, sedatives), designed to eliminate arrhythmias.
- Vitamin complexes based on magnesium, potassium and B vitamins (Panangin, Magne B6) improve the state of the nervous and cardiovascular systems.
Surgical intervention is possible only with a pronounced clinical picture, which significantly reduces the patient’s quality of life. It is no less relevant with a high chance of blood clots. The specialist will recommend endovascular treatment. Its essence is the introduction of a catheter into the femoral artery. Then it is promoted to the right atrium and a special patch is applied to the hole, which stimulates the overgrowth of the area with connective tissue. After 3-4 weeks, he will resolve without repeated intervention.
Combination of surgery is necessary with the use of antiplatelet agents and anticoagulants to reduce the risk of blood clots. During the recovery period, the patient should undergo antibiotic 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.
If hemodynamic disturbances are not present, then the doctor recommends conducting general strengthening and wellness procedures, such as:
- daily walk;
- Exercise therapy;
- balanced diet.
If there are slight deviations in the functioning of the cardiovascular system, the doctor may additionally prescribe vitamins and drugs designed to support the heart muscles.
In cases where the anomaly proceeds with a heart defect, surgical intervention is necessary. Today, there are operations that allow you to penetrate the heart through the femoral artery and fix the valve for a while so that it can grow to the heart muscles.
When the open valve does not fulfill its function of restraining blood constantly, pathology is called an atrial septal defect. With this diagnosis, babies after 3 years of age are assigned the II health group.
The diagnosis of an open oval window in a newborn, this is not a sentence. If the valve does not grow before the age of 5, the hole will remain open, most likely, a person will live with a small anomaly all his life. Until diseases associated with an increase in blood pressure in the right atrium (develop after 50-60 years), such an anomaly will not have any effects on human life.
All manipulations are performed by the endovascular method (also called transcatheter closure). A catheter is placed on the right thigh, through which the occluder is delivered to the heart through the vessels with special tools – a device like an umbrella on both sides. After the occluder opens, 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 cardiopulmonary bypass, use deep anesthesia.
For a child who underwent surgery in the first 6 months, antibiotic therapy is prescribed to prevent bacterial endocarditis.
So, the open oval window found in newborns does not present any cause for alarm at all. If the window does not close after 2-5 years, it is necessary to observe and consult a cardiologist. Discussions about what is the “norm” and what is the “pathology” are still ongoing. Therefore, each case will be individual. However, most situations do not pose a threat to life, and do not require treatment.
Complications of the failure of the oval window in the heart
Among the extremely rare, almost isolated cases of complications is the “paradoxical” embolism – a dangerous, life-threatening condition. Emboli are tiny particles that carry gas bubbles, blood clots, or pieces of adipose tissue. These substances should not normally be in the bloodstream, but they enter the bloodstream under various pathological conditions, for example, gas bubbles during an air embolism, sometimes accompanying complex chest injuries with damage to the lung tissue;
thrombi – with thrombophlebitis (vein diseases with the formation of parietal thrombi); adipose tissue – with open bone fractures. The danger of these emboli is that with an open oval window they can get from the right to the left atrium, then into the left ventricle, then through the vessels to the brain, where, by blocking the lumen of the vessel, they will cause the development of a stroke or cerebral infarction.
Such a complication can be fatal. It manifests itself suddenly developing brain symptoms at the moment either immediately after the injury, or during a period of prolonged immobilization, when the patient is forced to observe bed rest for a long time after serious operations, injuries, serious illnesses.
As already mentioned, this complication is quite rare, but nevertheless, a patient with an open oval window should always warn his attending physician that he has this particular structure of the heart.
Forecast with an open oval window
A window in the heart in children most often does not lead to the development of consequences. Kids actually do not feel any discomfort. Parents are required to lead the child for examination to the pediatrician at the time indicated by him and to conduct ultrasound examination of the heart muscle every six months to assess its condition.
Usually, the anomaly grows 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 developing complications will increase. At school, the child will have a separate physical education program, and when he reaches 18 he will receive category B from the medical commission, which stands for the presence of restrictions during service.
The oval window in the heart of a newborn is a minor abnormality. It is not able to have a significant effect on the health of the child and only occasionally manifests itself with heart symptoms. Treatment is prescribed in the presence of disturbing symptoms. In other cases, correction of rest and nutrition is sufficient. If the window in the heart provokes serious complications and becomes life-threatening, then surgery is performed.
Children with such a problem can live quite normal, engage in labor and social activities. Extreme sports and other activities that are associated with increased stress on the circulatory and respiratory systems should be avoided.
The diagnosis of an “open oval window” is not a sentence. This anomaly does not prevent the baby from growing and living fully. But do not forget that you need to see a doctor. Do not self-medicate, follow all instructions of a competent doctor.
The prognosis for life, social and labor activity is generally favorable, however, patients with an open oval window are contraindicated in extreme sports, as well as professions associated with increased stress on the circulatory and respiratory system – pilots, astronauts, divers.
Summing up all the above, it should be noted that in modern medicine, doctors have decided to attribute the open oval window more to the structural features of the heart than to serious malformations, since in most cases the functional load on the heart remains within normal limits.
Detonic – a unique medicine that helps fight hypertension at all stages of its development.
The complex effect of plant components of the drug Detonic on the walls of blood vessels and the autonomic nervous system contribute to a rapid decrease in blood pressure. In addition, this drug prevents the development of atherosclerosis, thanks to the unique components that are involved in the synthesis of lecithin, an amino acid that regulates cholesterol metabolism and prevents the formation of atherosclerotic plaques.
Detonic not addictive and withdrawal syndrome, since all components of the product are natural.
Detailed information about Detonic is located on the manufacturer’s page.