Congenital or acquired atrial septal aneurysm is characterized by a bag-like protrusion of tissue that separates the right and left atria.
Pathology appears as a result of thinning of tissues and can occur in acute or chronic form. Its untimely elimination leads to rupture of the septum, which increases the risk of stroke due to increased thrombosis.
The main reason for the development of MPP aneurysm is weakening of the heart wall, which has a clear localization and appears due to structural or functional disorders.
In the first case, the layers of the septum are affected, followed by the death of healthy tissues or their replacement with foreign formations.
Functional disorders are characterized by the inability of the local site of the myocardium to contract along with the entire heart muscle.
As a result of high pressure inside the hollow organ, the weakened place begins to protrude, eventually turning into an aneurysm.
Most often, pathology is diagnosed on the walls of the ventricles, less often – in the atria.
Despite the long process of education, its development can rapidly accelerate due to increased physical activity, in which the heart muscle has to pump a larger volume of blood.
The following types of aneurysms are distinguished:
- True All layers of the vascular walls undergo stretching. In most cases, pathology does not manifest itself until tissue rupture occurs. Launched cases are fraught with the development of thrombosis, stratification of blood vessels, embolism, as well as stroke.
- False. It develops after injury to the vascular walls. As a result, blood begins to leak through the thinned place, which accumulates in the septum with a pulsating hematoma. The main difference from a true aneurysm is that one layer of tissue undergoes stretching. A great danger is a pathology that affects vital vessels.
- Exfoliating. It is characterized by leakage of blood into the space between the walls of the aorta, which under certain conditions leads to rupture of the external septum. This type of aneurysm is dangerous with a high risk of death during tissue breakthrough.
In the prenatal period of development in the septum of the heart there is an “oval window” – an opening that normally grows after birth.
But if tissue cells share with disorders, they acquire an excessively thin structure.
With the advent of the baby, the circulatory system begins to function in full, the heart pressure rises and the wall protrudes, stretching inward.
- tobacco abuse
- alcohol consumption even in small quantities,
- toxic fumes from production or from household chemicals,
- uncontrolled drug treatment,
- transfer of certain diseases (rubella, measles, mumps).
Often an aneurysm of the heart goes away by itself. This is explained by the fact that, due to the growth of the newborn, a decrease in the area of the pathology is proportional to the whole organ.
Important! When making an accurate diagnosis, the child must regularly conduct cardiological examinations for the re-development of the defect.
Acquired aneurysm is the result of a number of diseases that affect the tissue of the heart muscle or act on it indirectly through the organ conduction system. With their inadequate treatment, the development of complications is possible, among which weakening of the septum of the heart.
The following causes of acquired aneurysm are distinguished:
- Myocardial infarction. During a heart attack, the heart muscle receives oxygen in an amount insufficient for normal functioning. Cardiomyocytes, which undergo rapid destruction, are not able to recover in full. Instead, connective tissue is growing, which does not have the necessary elasticity and the ability to contract. Aneurysm develops in the first weeks after a heart attack, when the new tissue did not coarsen and did not gain strength to contain high blood pressure.
- Infections of various etiologies (streptococcus, Coxsackie virus, Epstein-Barr virus, candidiasis). Once in the body, the infection is carried with the flow of blood to the heart. Its tissues begin to become inflamed, which leads to serious consequences – part of the cariid myocytes is destroyed. Even after recovery, areas that have been adversely affected are overgrown with scar tissue. With the confluence of certain factors against the background of an intense inflammatory process, further development of the heart aneurysm is possible.
- Complications after surgery. During the operation to eliminate heart defects, surgical sutures are applied. For a number of reasons, tissues can grow together incorrectly, scars are heavily coarsened, which ultimately leads to focal cardiosclerosis. At risk for such a complication are elderly people and children, as well as patients who underwent surgery on the left ventricle.
- Mechanical injuries. If the heart muscle is damaged by a stabbing weapon, its overgrowing is often accompanied by the formation of scar tissue. Further, the aneurysm develops as a result of focal sclerotic changes. When injured by a blunt object, vascular destruction occurs with fluid seeping out. This leads to myocarditis with the subsequent development of cardiosclerosis.
- Exposure to toxins (alcohol, thyrotoxins, uric acid, artificial chemical compounds). When substances with a high degree of toxicity enter the circulatory system, inflammation of the intercardiac tissue with damage to the myocardial cells is observed. In some cases, dying and uncontrolled proliferation of connective tissue is possible.
Perhaps you want to know about the new medication - Cardiol, which perfectly normalizes blood pressure. Cardiol capsules are an excellent tool for the prevention of many heart diseases, because they contain unique components. This drug is superior in its therapeutic properties to such drugs: Detonic. If you want to know detailed information about Cardiol, go to the .There you will find answers to questions related to the use of this drug, customer reviews and doctors. You can also find out the Cardiol capsules in your country and the delivery conditions. Some people manage to get a 50% discount on the purchase of this drug (how to do this and buy pills for the treatment of hypertension for 39 euros is written on the official website of the manufacturer.), ,
- Symptoms of pathology
- Treatment of pathology
- Concept and description
- Causes of
- Folk methods
- Proper nutrition
- Symptoms of atrial septal defect
- Atrial septal aneurysm (MPP): what is it and is it dangerous?
- How to treat?
- What is the treatment of pathology in women and men?
- Why does aneurysm develop?
- Clinical manifestations in children
- What could be subsequently: disease prediction
- Forecasts and Possible Consequences
- Natural course
- Factors affecting the development of heart aneurysm
- Benefits of Echocardiography
- Stress Echocardiography
- Types of Research
- Atrial septal defect classification
- Atresia of the right atrioventricular foramen
Symptoms of pathology
Congenital atrial septal aneurysm, as a rule, does not manifest itself as pronounced changes in the body. Symptoms may vary depending on age.
From birth to three years, the child has a lag in psychophysical development. He gains weight poorly and is prone to frequent viral diseases.
When diagnosing, there is an excessive load on the pulmonary circle of blood circulation and a volume increase in one of the parts of the ventricle.
With growing older, growth retardation becomes more noticeable, the child cannot tolerate physical activity along with peers, often gets tired and feels pain in the heart. During a physical examination, pallor of the skin, structural changes in the chest in the area of the pathology (protrusion), tachycardia and increased blood pressure are established.
After establishing an accurate diagnosis, patients should regularly visit a cardiologist to identify changes in pathology through specific examinations. Such actions are aimed at preventing aneurysm rupture, which is most often observed in adolescent children.
Important! The diagnosis of chronic aneurysm is chronic, having an ICD code of 10 (international classification of diseases of the tenth revision) 125.3 is the basis for one of the disability groups depending on the severity of the disease and the degree of disability.
In adults, the signs of aneurysm are diverse, which is associated with both localization and the size of the neoplasm. Since in the post-infarction period the development of heart aneurysm is observed quite often, the patient needs to monitor changes in health and do not miss examinations by a cardiologist.
The main symptoms of cardiac muscle aneurysm in adulthood:
- pain in the area of the heart,
- regular weakness
- rhythm disturbances, a feeling of increased heartbeat,
- shortness of breath after minor physical exertion,
- pallor of the skin,
- cough without the appearance of other signs of colds.
Treatment of pathology
Aneurysm of the septum of the heart requires cardinal treatment only in case of rapid growth. Surgical intervention is resorted to if the risk of developing pulmonary hypertension due to the release of a large amount of blood into the interstitial space, with the threat of a sudden breakthrough of the thinned septum and with rapid progression of the formation, is established.
In the preoperative period, the patient is prescribed taking anticoagulant drugs and cardiac glycosides, as well as undergoing oxygenobarotherapy and oxygen therapy. During the operation, the formation is sutured or covered with a patch of hypoallergenic material of synthetic origin.
Post-infarction aneurysms that have not undergone timely treatment have the least favorable prognosis. Without eliminating the pathology within two to three years after suffering a heart attack, patients die from complications. Other cases of the disease are benign, but they can significantly reduce the quality of human life.
To reduce the risk of complications that can develop against the background of even a small aneurysm, the patient must follow medical treatment. In addition, a moderate lifestyle and a certain diet are mandatory.
For the timely detection of atrial septal aneurysm in children, it is necessary to monitor their health status and, if there is any suspicion, consult a cardiologist. The basis for the prevention of pathology in adulthood is the adequate treatment of myocardial infarction and strict adherence to rehabilitation recommendations.
(No ratings yet) Loading .
One type of heart pathology is an atrial septal aneurysm – a disease that can lead to death.
Most often, this heart defect occurs in children, developing even in the prenatal period.
MPP aneurysm in a small child is difficult to determine, since it is difficult to identify symptoms, which is why medical diagnosis with subsequent treatment is required.
MPP aneurysm is a small anomaly of the heart, which is a protrusion of the vessel wall. In this case, blood circulation is disturbed, and the neoplasm presses on the walls of the atrium. In adults, the disease is less common than in children. Several of its forms are distinguished:
- Protrusion from left to right atrium;
- Swelling of the septum of the heart to the left;
- Spindle-shaped pathology, when the upper part protrudes in one direction, the right – in the other.
Atrial septal defect
Aneurysm MPP (Type R)
Ultrasound scan of an MPP aneurysm
The formation of the defect is associated with the underdevelopment of the primary or secondary atrial septum and endocardial ridges in the embryonic period. Organogenesis disorders can be caused by genetic, physical, environmental, and infectious factors.
The risk of developing an atrial septal defect in an unborn child is significantly higher in those families where there are relatives with congenital heart defects. Cases of familial atrial septal defects in combination with atrioventricular block or with maldevelopment of the bones of the hand (Holt-Oram syndrome) are described.
In addition to hereditary conditionality, a viral disease of the pregnant woman (rubella, chickenpox, herpes, syphilis, etc.), diabetes mellitus and other endocrinopathies, the use of certain medications and alcohol during pregnancy, occupational hazards, ionizing radiation, can lead to the occurrence of an atrial septal defect. gestational complications (toxicosis, the threat of miscarriage, etc.).
An objective examination of a patient with an atrial septal defect reveals pallor of the skin, a “heart hump”, and a moderate lag in height and weight. Percussion is determined by an increase in the boundaries of the heart left and right; during auscultation to the left of the sternum in the II-III intercostal space, a moderately intense systolic murmur is heard, which, unlike a defect in the interventricular septum or pulmonary stenosis, is never gross. Splitting of the II tone and accentuation of its pulmonary component is revealed over the pulmonary artery. Auscultatory data are confirmed by phonocardiography.
With secondary defects of the atrial septum, ECG changes reflect an overload of the right heart. Incomplete blockade of the right bundle branch block, AV block, and sinus node weakness syndrome may be recorded. X-ray of the chest allows you to see an increase in pulmonary pattern, bulging of the trunk of the pulmonary artery, an increase in heart shadow due to hypertrophy of the right atrium and ventricle. During fluoroscopy, a specific sign of an atrial septal defect is detected – increased pulsation of the roots of the lungs.
Echocardiography – a study with color Doppler mapping reveals left-right blood discharge, the presence of an atrial septal defect, allows you to determine its size and location. When probing the cavities of the heart, an increase in blood pressure and oxygen saturation in the right heart and pulmonary artery is detected. In case of diagnostic difficulties, the examination is supplemented by atriography, ventriculography, jugular vein venography, angiopulmonography, and heart MRI.
The atrial septal defect should be differentiated from the defect of the interventricular septum, open ductus arteriosus, mitral insufficiency, isolated pulmonary stenosis, Fallot triad, abnormal flow of pulmonary veins into the right atrium.
The treatment of atrial septal defects is only surgical. Indications for cardiac surgery are the detection of hemodynamically significant arteriovenous blood discharge. The optimal age for the correction of defects in children is from 1 to 12 years. Surgical treatment is contraindicated for high pulmonary hypertension with venoarterial discharge of blood due to sclerotic changes in the pulmonary vessels.
With defects in the atrial septum, they resort to various methods of closing them: suturing, grafting with a pericardial flap or a synthetic patch under hypothermia and IR. X-ray endovascular occlusion of the atrial septal defect allows the closure of openings of not more than 20 mm.
Surgical correction of atrial septal defects is accompanied by good long-term results: in 80-90% of patients normalization of hemodynamics and the absence of complaints are noted.
Concept and description
- Atrial septal aneurysm – what is it?
- Aneurysm is a deformation of a muscle located in the region of the heart.
- As a result of such negative changes, a protrusion of a separate section of the muscle towards the right or left atrium is formed.
- The exact reasons for the development of this defect have not yet been established, however, it is believed that anomalies develop, most often, in the prenatal period.
- Intrauterine infections, abnormalities in the development of the cardiovascular system of the fetus, hereditary predisposition can provoke this phenomenon.
- Aneurysm is considered a rather insidious disease, since for many years it may not manifest itself in any way, having, nevertheless, the most negative effect on the state of human health.
Pathology develops gradually. At the first stage, deformation processes are insignificant, appearing in the thinning of the heart septum.
Over time, the changes become more pronounced, a characteristic sack-shaped protrusion appears in the region of the heart muscle. As a rule, it occurs on that part of the septum where its tissues are thinned the most.
The main reason for the development of aneurysm of the interventricular septum in newborns and young children is considered a hereditary factor and pathology of the development of the cardiovascular system in the prenatal period.
Among the negative factors that can contribute to the appearance of anomalies include:
- birth defect in the form of connective tissue weakness;
- damage to the connective tissue as a result of diseases such as, for example, Marfan syndrome;
- decreased vascular tone, developing as a result of diseases such as atherosclerosis, syphilis;
- a sharp increase in blood pressure;
- vascular injury;
Improper nutrition (in particular, eating large amounts of fatty foods), some infectious diseases can also lead to the development of an ailment.
What happens with aneurysm? There are 3 forms of aneurysm, depending on how the protrusion is located, on its shape. Distinguish:
- Right protrusion, that is, protrusion from the left atrium to the right. This form is considered the most common.
- Left protrusion when the protrusion is directed to the left atrium.
- S-shaped aneurysm, the lower part of the muscle protrudes in one direction, the upper – in the opposite.
Depending on the course of the disease, 3 forms of its development are distinguished:
- chronic The clinical picture of the pathology is similar to the manifestations of heart failure;
- acute form. It is characterized by the severity of symptoms, their rapid onset and development;
- subacute. It manifests itself in the form of shortness of breath, general weakness. Accompanied by the development of heart failure.
At the initial stage of development of aneurysms, MPP in most cases has an asymptomatic course, that is, it does not manifest itself clinically.
However, over time, certain changes in the health status of the child occur. The nature of these changes depends on many factors, including the age of the small patient.
So, in children under the age of 3 years, the following symptoms are noted:
- Delays in physical and mental development.
- Deviations from the norm of weight gain in a smaller direction.
- Susceptibility to viral infections, weak immunity.
- Pallor (or cyanosis) of the skin.
In older children, such manifestations of MPP aneurysm are observed as:
- Backlog in terms of growth, weight.
- Weakness of the body, intolerance even of light physical exertion.
- General deterioration.
- Deviations in the development of the reproductive system.
- Disorders in the work of the cardiovascular system, arrhythmia, pain in the heart.
- When listening in the region of the heart, the presence of noise is noted.
Read about the causes, symptoms and treatment of accommodation spasm in children here.
To make a diagnosis, the doctor evaluates the set of symptoms that bother the patient, collects a family history (to determine the possibility of a hereditary factor), and performs a visual examination of the patient.
In addition, the following studies will be required:
- Ultrasound of the chest. It allows to detect the presence of aneurysm, establish the size of the heart;
- ECG. Allows you to determine the type and location of the pathology;
- MRI scan Allows you to determine the state of the vessels of the heart, the degree of development of the aneurysm.
When making a diagnosis in a newborn baby, the Doppler method is also used.
This is necessary to clarify the diagnosis, assess the state of blood flow in the heart.
- At the initial stage of the development of the disease, any specialized treatment is not required (unless, of course, the pathology does not grow and does not cause any inconvenience to the patient).
- It is important to remember that a child who is given the appropriate diagnosis needs constant monitoring by a doctor – cardiologist and pediatrician.
- If the disease progresses, manifests itself with characteristic signs, a small patient needs treatment (conservative, or, in especially serious cases, surgical).
This method of therapy is suitable for small aneurysms that do not pose a serious danger to the health and life of the child.
The following measures are referred to this treatment method:
- Compliance with a special diet (exclusion of salty foods, foods high in cholesterol).
- Special gymnastics involving light physical activity.
- Taking medications necessary to eliminate the symptoms of pathology (if necessary).
- Oxygenobarotherapy (high pressure oxygen treatment).
- Consultations with a cardiologist once every six months.
How to treat aphthous stomatitis in children? You will find the answer on our website.
The following groups of drugs are used to treat MPP aneurysms:
- Glycosides. Necessary to increase the intensity or decrease the number of heart contractions.
- Anticoagulants – drugs that regulate the process of blood coagulation (blood thinners).
- Beta-blockers to reduce heart rate.
- Antiarrhythmic drugs designed to prevent the development of arrhythmias.
Surgery for the treatment of MPP aneurysm is used in exceptional cases, for example, if the aneurysm reaches a large size, significantly affects the functioning of the entire cardiovascular system, or if there is a risk of rupture of the aneurysm.
Therefore, in such cases, the child is shown urgent surgical intervention. The operation is carried out in one of the following ways:
- Artificial reinforcement of the walls of the aneurysm using polymer materials. This method is used to prevent rupture and proliferation of aneurysm.
- Resection (excision of aneurysm). After removal of the pathology, the wall of the septum is restored.
It is important to remember that folk recipes can only be used with small aneurysms. In all other cases, the child will need more serious conservative or surgical treatment.
As a folk remedy, use a decoction of rosehips, calamus swamp, hawthorn, valerian. Each ingredient must be taken in equal proportions (1 tbsp), pour 500 ml. boiling water, insist half an hour.
The resulting product is diluted in 300 ml. warm boiled water, give the child throughout the day. In the early days, it is recommended to breed 1 tsp. funds, gradually this amount is increased to 2 tbsp.
In order to reduce the risk of developing MPP aneurysm, it is necessary to monitor the physical and emotional health of the child, protect him from infectious diseases, feed him healthy foods, strengthen his immune system, and protect him from stress and anxiety.
Pay attention to physical activity. They should be moderate but regular.
To prevent the occurrence of aneurysm of MPP, parents must follow the diet of their child.
It is good if the child consumes in sufficient quantities such foods as:
- fruits (avocado, apples, grapefruits, bananas, pomegranate);
- legumes (e.g. beans);
- linseed oil (enough 2 grams per day);
- pumpkin, garlic, broccoli;
- berries (strawberries, cherries, raspberries, currants and others);
- fish (salmon, trout, salmon, tuna, mackerel, sardine);
- dark chocolate (in a small amount if there is no allergy);
- nuts (walnut, almonds).
Aneurysm – a disease that, depending on its development, may not cause the child any inconvenience, but may seriously threaten his health.
Aneurysm rupture is a dangerous condition that threatens the life of a child.
A significant increase in aneurysm can provoke embolism, and rupture of the septum increases the risk of a torn embolus entering important internal organs. This, in turn, leads to the development of dangerous diseases, such as gangrene, renal infarction.
Symptoms of atrial septal defect
- Heart rhythm disturbance.
- Thromboembolic complications. This complication is often observed when an atrial septal aneurysm is combined with the presence of a message between the atria. Conditions are created for the swirling blood flow in the area of the hole. This leads to the formation of blood clots, which with the flow of blood can enter the brain. As a result, a life-threatening condition may develop – a blockage of the cerebral vessels and, as a result, a stroke.
- Rupture of aneurysm. Such a complication can occur when the disease is accompanied by high blood pressure. This, of course, is an unfavorable fact. As a result of various emotional and physical overloads against the background of hypertension, a septum rupture can occur.
Given that the pressure in the atria is much lower than in the ventricles, rupture does not lead to the death of the patient. However, this condition can significantly worsen the condition of the patient. There are signs of heart failure, which reduce the patient’s quality of life.
1) Congenital. Genetic (hereditary) disorder, which is manifested by a violation of the development of connective tissue in the prenatal period. It occurs in 80% of young people and can have both a systemic and local (isolated) character.
With systemic involvement of connective tissue, changes can be observed in many organs and systems – kidneys, eyes, nervous system, cardiovascular system. Often an aneurysm is combined with vegetovascular dystonia. With the local nature of the involvement, the process affects only the interatrial septum. The second option is much less common.
The main methods for diagnosing aneurysm are:
- Echocardiographic examination. Ultrasound of the heart reveals protrusion of the atrial septum.
When an aneurysm is supplemented by the existence of an open oval window, the following methods may be informative:
- ECG is the easiest method. Electrophysiological examination of the heart helps to see the overload of the right heart. Heart rhythm disturbances are also detected. In this case, you can detect signs of atrial fibrillation.
- X-ray of the chest. An aneurysm with an open oval window is characterized by the presence of a specific symptom on the x-ray – “pulsation of the roots of the lungs”.
- Echocardiographic examination. As in the case of an aneurysm without a message, this method is very important in the diagnosis of an open oval window. Thanks to this method, you can see the turbulence of the blood flow in the hole. Valve abnormalities can also be detected.
Instrumental diagnostics can also be supplemented with the following methods:
- Transesophageal ultrasound.
- Transthoracic ultrasound.
- CT scan.
- Cardiac catheterization.
- Congenital – atrial septal aneurysm in children appears even in the womb as a result of transferred infectious diseases or hereditary signs. If a pathology has already occurred in the child’s relatives, the baby may also develop again;
- Acquired – appear in adults, for example, after a heart attack. They can also affect the development of trauma due to accidents or strokes in the chest area.
In any case, the nature of the atrial septal aneurysm has not yet been clarified, which means that everyone is at risk, and when the first signs appear, you should seek help.
Signs of aneurysm may be mild or completely absent. Often the disease proceeds without any symptoms. The size of the protrusion, the age of the person, the size of the oval window affects the nature of the patient’s sensations. In most cases, the symptoms are similar to manifestations of heart failure, heart attack, or overwork, and the patient does not seek timely help.
The following symptoms should be alarming:
- Pain in the heart – are paroxysmal in nature;
- Fatigue, as blood circulation is disturbed and the body is provided with oxygen;
- A feeling of discomfort in the chest area – such a symptom can tell about many pathologies;
- Heart rhythm disturbances;
- Inability to endure prolonged physical activity – shortness of breath and fatigue appear.
In addition, breathing problems may occur, including coughing – an increased volume of blood enters the lungs, and the load on blood vessels and capillaries increases.
But already at the initial appointment, the specialist puts forward hypotheses regarding the probable cause of violations.
What manifestations is the cardiologist guided by:
- Pain The expressed syndrome is atypical for an atrial septal defect, more often it does not exist at all, because the presence of the symptom can become an informative differential moment.
- Arrhythmias. The severity of tachycardia, other phenomena is also minimal. Although a deviation may be present, it is not key in the clinical picture.
- Shortness of breath, problems with pulmonary activity. The main point to be evaluated. The presence of pronounced violations of such a plan suggests thoughts about ASD. After instrumental diagnostics, the hypothesis is confirmed or disproved.
- An atrial septal defect in a newborn is detected by echocardiography. This method is sufficient in most cases. Enough of a cursory inspection to state the fact.
- Additionally, MRI can be performed, according to indications. But this is not enough. The size of the oval window does not indicate the severity of the process; functional tests are required. In the case of children, it is difficult to carry them out.
Up to 3 years in a child suffering from aneurysm, manifestations of inhibition of mental and physical development are possible. Such children gain weight very poorly and often suffer from colds and viral diseases. A little at an older age there are growth retardation, problems of the development of the reproductive system. It is difficult for a child with an aneurysm to perform prolonged physical activity.
At a doctor’s appointment, a sick child is diagnosed with too pale skin, anatomical changes in the chest area (heart protruded). This factor is due to muscle atrophy and a noticeable increase in the right ventricle of the heart. Usually the border of the heart in a sick child is extended to the right. This occurs with a noticeable increase in the pulmonary trunk and right atrium.
Children are diagnosed with an isolation secondary defect of MPP in the presence of symptoms such as non-intense transient cyanosis during the first months of life, frequent respiratory diseases up to 2 years of life. In the 2nd year of life, the child may appear the first signs of excessive load on the right atrium, an increase in the volume of the right ventricle, and symptoms of overload of the pulmonary circulation.
The average life expectancy with secondary aneurysm of MPP is 40-45 years, however, some patients survive to 80 years. But even in this case, after 50 years they become disabled. This is due to increased pressure in the lungs. Positive exceptions also occur – in about 3-5% of children, an involuntary restoration of the MPP defect occurs.
In patients with aneurysm, chronic pneumonia is often diagnosed, which occurs against the background of frequent respiratory diseases. Some newborns with aneurysm die in infancy. Fatal outcome is recorded in 10% of patients with the addition of rheumatism or secondary pneumonia. Aneurysm rupture is possible if the operation is delayed too long.
- Visible pulsation of the anterior abdominal wall;
- Crying, chest abandonment;
- Screaming during massage of the abdomen or back;
- Lack of stool or urine;
- Pallor of the skin;
- Cooling hands and feet.
The clinic can mimic the picture of an acute abdomen or intestinal colic, accompanied by fever.
Symptoms of aortic aneurysm in children:
- Pulsation of the anterior abdominal wall;
- Exercise intolerance;
- Local or diffuse edema of the lumbar region;
- Decrease in the amount of urine;
- Symptoms of compression of the mediastinum (pain during eating, coughing, shortness of breath);
- Heart palpitations and shortness of breath at rest.
Aortic aneurysm is dangerous in that it can occur without symptoms. And the first signs can be noticed only when the dilated vessel begins to compress neighboring organs. We suggest learning more about this dangerous disease:
- Stratification of this formation.
- Aneurysm of the aortic arch.
- Aneurysm of the ascending, descending and thoracic.
- Aneurysm of the abdominal aorta and its possible rupture.
In newborns, heart aneurysms are often combined with other congenital malformations. In this case, the symptoms are determined by heart disease. Clinic with an isolated lesion:
- Cyanosis of the lips, fingers, tip of the nose;
- Blueing and cooling of the skin;
- Frequent breathing;
- Slow weight gain
- Breast rejection.
Aneurysms up to 3 mm do not have a clinical manifestation.
Symptoms in children and adolescents:
- Dyspnea-cyanotic syndrome;
- Tendency to fainting;
- Heart palpitations;
- Deterioration in the supine position and during physical exertion;
- Pain and feeling of heaviness behind the sternum.
Clinic of aneurysm of the brain in newborns:
- Squinting eyes and tilting the head (a sign of concomitant meningitis);
- Crimson cyanosis of the face and neck;
- Hydrocephalus (an increase in the head due to the accumulation of cerebrospinal fluid).
Often, clinical manifestations are absent.
Symptoms of cerebral aneurysm in children and adolescents:
- Loss of consciousness;
- Tilting the head;
- Rarely – strabismus, decreased vision and hearing.
You can read more about the classification, diagnosis and treatment of cerebral aneurysms in separate materials on the pages of our portal. There we will talk about what are the causes and consequences of rupture of such a formation and what is saccular aneurysm of the brain artery.
Atrial septal defects can occur with prolonged hemodynamic compensation, and their clinic is very diverse. The severity of symptoms is determined by the size and location of the defect, the duration of the presence of CHD and the development of secondary complications. In the first month of life, the only manifestation of an atrial septal defect is usually transient cyanosis with crying and anxiety, which is usually associated with perinatal encephalopathy.
With defects in the interatrial septum of medium and large sizes, symptoms appear already in the first 3-4 months. or by the end of the first year of life and is characterized by persistent pallor of the skin, tachycardia, moderate lag in physical development, insufficient weight gain. For children with atrial septal defects, a frequent occurrence of respiratory diseases – recurrent bronchitis, pneumonia, with prolonged wet cough, persistent dyspnea, profuse moist rales, etc., caused by hypervolemia of the pulmonary circulation. In children of the first decade of life, frequent dizziness, a tendency to fainting, fatigue and shortness of breath during physical exertion are noted.
Small defects of the interatrial septum (up to 10-15 mm) do not cause a violation of the physical development of children and characteristic complaints, so the first clinical signs of the disease can develop only in the second or third decade of life. Pulmonary hypertension and heart failure with an atrial septal defect form around the age of 20, when cyanosis, arrhythmias, and rarely hemoptysis, occur.
- Follow a diet low in cholesterol and high in fiber.
- Refuse bad habits, especially smoking.
- Exercise regularly with moderate exercise. Particular attention should be paid to cardio exercises.
- Timely treat diseases of the cardiovascular system.
Atrial septal aneurysm (MPP): what is it and is it dangerous?
Aneurysm of MPP (the abbreviation MPP stands for – Atrial septum) is an anomaly characterized by the formation of protrusion in the septum between the atria. It refers to small vices.
”Alt =” ”>
This pathology occurs in adults and children, may not manifest clinical symptoms for a long time and may be detected by chance during an objective instrumental study.
The longer this pathological change remains undiagnosed, the higher the likelihood of negative consequences.
The main diagnostic criterion for atrial septal aneurysm is a protrusion greater than 10 mm. The diagnosis can be established with the size of education and less than 10 mm on the basis of a detected hemodynamic disturbance (blood flow), as well as combinations with other heart defects (prolapse or deflection of the valves). The prognosis of the disease is favorable.
With small sizes of protrusion, special therapeutic measures are not carried out, since there are no hemodynamic disorders. Against the background of the implementation of preventive recommendations regarding the prevention of the development of cardiovascular disease, there are no restrictions on the life expectancy of patients with pathology.
Spontaneous (spontaneous) rupture of protrusion is recorded in 10% of cases in adults, usually after myocarditis or other heart diseases that provoked a decrease in the strength of the tissue of the septum.
Congenital heart disease (CHD) in the form of MPP aneurysm is rare (less than 1% of cases in newborns). It is recorded equally often in boys and girls. Separately, an acquired pathology is distinguished, which is diagnosed in adults after a heart pathology (myocardial infarction, myocarditis, cardiomyopathy).
Depending on the origin, a congenital and acquired aneurysm of the septum between the atria is distinguished. Congenital anomaly is formed already in childhood, and acquired develops due to exposure to provoking factors in an adult.
The formation of aneurysm in the fetus has certain features. It can be combined with impaired ovarian window obstruction (message in the interatrial septum), which provides blood discharge from the right circle of blood circulation to the left. This is due to the fact that the lungs do not yet perform their function.
After the first breath, the right circle of blood circulation turns on.
During the first few days or weeks after birth, the diameter of the oval window decreases, overgrowth occurs (the length of the period of overgrowth of the oval window is individual for each person), in place of which there remains a small depression. Under the influence of various causes, the healing process is disturbed, as a result of which the connective tissue has less strength, where a protrusion forms over time.
A reliable reason for the development of aneurysm today remains unclear.
Several provoking factors are highlighted, which include:
- hereditary predisposition;
- bad habits of parents;
- transferred infectious diseases during pregnancy (toxoplasmosis), exposure to adverse environmental factors (ionizing radiation, toxins).
Congenital aneurysm may have an isolated origin. Moreover, the localization of the oval fossa and protrusion in the septum often do not coincide. The development mechanism is usually associated with a primary violation of hemodynamics in the heart, the consequence of which is the formation of a protrusion in the area of high blood pressure.
The mechanism of development of acquired septal aneurysm includes weakening of septum tissue with subsequent formation of protrusion. It is a consequence of exposure to provoking factors (myocardial infarction, myocarditis, cardiomyopathy).
|Isolated Congenital Anomaly||The protrusion is formed due to hemodynamic impairment in childhood|
|Anomaly combined with malformations of the oval window||Violation of the oval window overgrowth provokes the formation of protrusion|
|Acquired Aneurysm||It develops in adults due to weakening of septum tissue, which provokes myocardial infarction, myocarditis, cardiomyopathy|
Since the acquired aneurysm of the septum between the atria in most cases is the result of a transferred myocardial infarction, it is divided into several types:
- Acute aneurysm – the formation forms within 14 days after a heart attack. It is accompanied by a deterioration in the condition of a person with fever, arrhythmia (impaired rhythm of contractions), an increase in the number of leukocytes per unit volume of blood.
- Subacute aneurysm – an anomaly develops within 3-6 weeks, protrusion is a consequence of a violation of the process of formation of connective tissue scar in the area of dead myocardiocytes. It is characterized by the gradual development of heart failure with shortness of breath, increased fatigue, swelling of soft tissues with predominant localization on the legs.
- Chronic aneurysm – the formation of protrusion in the septum between the atria occurs in a period of time exceeding 6 weeks, and is accompanied by a gradual increase in the symptoms of congestive heart failure.
Dividing into species makes it possible to predict the further course of the pathology, as well as select the most appropriate therapy.
The atrial septum normally should not have a curvature greater than 5 mm.
Accordingly, if the aneurysm is larger than this size, then its appearance can lead to the following violations:
- Compression of the valvular apparatus – with localization of the protrusion in the lower parts of the atrial wall, the tricuspid or mitral valve may be compressed.
- Insufficient blood outflow with incomplete emptying of the atrium, increased pressure in it, leading to a change in hemodynamics in the left or right ventricle.
- Increased blood pressure in the right circle of blood circulation with a deterioration in blood oxygen saturation and the development of hypoxia. It usually develops due to an aneurysm, combined with incomplete overgrowth of the oval window.
- The formation of blood clots, provoked by a change in blood flow in the aneurysm – blood clots can break off, enter the general bloodstream, clog arterial vessels with the development of serious complications, which include myocardial infarction, cerebral stroke.
According to the pathogenesis of the consequences, an aneurysm is distinguished with the discharge of blood (usually in combination with an unclosed oval window) and without it (hemodynamics in the heart has a slight change).
Depending on the direction of protrusion, several forms of anomaly are distinguished:
- L-type – the deflection is directed to the left (towards the left atrium).
- R-type – protrusion is directed to the right.
- S-type – protrusion has an S-shape, it is simultaneously partially directed to the left and right atria.
Depending on the direction of protrusion, the doctor can predict the possible development of changes in the mitral or tricuspid valve.
Separately, a form of aneurysm is distinguished, combined with other abnormalities (valve defects, oval window defect). With it, hemodynamic disturbances are more pronounced, the risk of complications increases, and the manifestations of the development of heart failure also increase.
With small aneurysms, often no symptoms are observed. As the formation with a change in hemodynamics in the heart increases, the following clinical manifestations may appear that will help suspect the presence of pathology:
- Tachycardia is an increase in heart contractions, which is more often recorded when protruding into the right atrium.
- Signs of stagnation of blood in a small circle that develop regardless of age and are the result of a combination with incomplete fusion of the oval window. These include shortness of breath, arrhythmias, cyanosis (cyanotic staining) of the skin, frequent development of inflammation of the bronchi and lungs.
- Signs of hemodynamic disturbances, which often develop in adolescence and are provoked by body growth, a change in the functional state of the endocrine system – increased fatigue, the appearance of a feeling of discomfort in the chest, arrhythmia, and frequent dizziness.
- Symptoms of heart failure in adults – shortness of breath, edema of peripheral tissues (mainly develop on the legs in the late afternoon), periodic wet cough, which is paroxysmal in nature. Signs usually appear against the background of the development of a subacute or chronic aneurysm after myocardial infarction.
The appearance of signs of changes in the functioning of the heart and blood vessels requires consultation with a doctor.
Since the clinical manifestations of aneurysm may be absent or non-specific, the main role in identifying the pathology belongs to the methods of objective diagnosis:
- Echocardiography (echocardiography) or ultrasound of the heart is a reference research technique that allows you to visualize the septum and changes in it. An option is transesophageal echocardiography (PE Echocardiography), which makes it possible to visualize minimal changes. Echocardiography is necessarily prescribed to newborn children when a doctor listens to heart sounds.
- Dopplerography is an ultrasound examination with which hemodynamic disturbances are detected.
- ECG (electrocardiography) – a functional study of the heart.
- Computed tomography – an X-ray imaging technique in the structures of the heart, has a high resolution.
Also, the doctor, if necessary, prescribes other methods of laboratory, instrumental and functional research.
How to treat?
When defect is formed without a blood discharge, as well as with a protrusion of less than 10 mm, special therapeutic measures are not prescribed. The patient is observed by a cardiologist (dispensary registration) with the implementation of general and dietary recommendations.
In case of more serious protrusion, complex treatment is prescribed, which includes drug therapy, surgical intervention.
What is the treatment of pathology in women and men?
With heart defects, you must necessarily adhere to a healthy lifestyle, eat right. If possible, it is necessary to prevent respiratory pathologies in the first year after the intervention, as well as before its implementation. Moderate physical activity is indicated for all operated patients – gymnastics, walking, swimming, etc.
Due to the difference in pressure in the left and right atria, with an atrial septal defect, arteriovenous blood shunting occurs from left to right. The amount of blood discharge depends on the size of the interatrial communication, the ratio of the resistance of the atrioventricular openings, plastic resistance and the volume of filling of the ventricles of the heart.
Left-right blood bypass surgery is accompanied by an increase in the filling of the pulmonary circulation, an increase in the volume load of the right atrium and increased work of the right ventricle. Due to the mismatch between the area of the valve opening of the pulmonary artery and the volume of ejection from the right ventricle, the development of relative stenosis of the pulmonary artery occurs.
Long-term hypervolemia of the pulmonary circulation gradually leads to the development of pulmonary hypertension. This is observed only when pulmonary blood flow exceeds the norm by 3 or more times. Pulmonary hypertension with an atrial septal defect usually develops in children over 15 years of age, with late sclerotic changes in the pulmonary vessels. Severe pulmonary hypertension causes right ventricular failure and a shunt change, which is manifested first by transient venoarterial discharge (during physical exertion, straining, coughing, etc.), and then persistent, accompanied by constant cyanosis at rest (Eisenmenger syndrome).
Often, the disease manifests itself in the baby immediately after birth. It happens that an aneurysm acquires a complicated course when the connective heart tissue undergoes dysplasia. Mitral valve prolapse is observed. A defect is formed by the type of aneurysm by bulging the septum:
- to the right;
- to the left;
- in different directions from below and from above, assuming an S-shape.
Normally, the intercardiac valve between the right and left atria is even, without noticeable distortions. With aneurysm, there is a curvature towards the left or right atrium, the reason for which is a violation of the process of forming connective tissue inside the heart at the time of development of the fetus in the womb.
Signs of ASD in children include:
- blue shade of the nasolabial triangle;
- shortness of breath during meals, bathing, gameplay;
- tachycardia in the first months of life;
In infants, there is a high risk of pneumonia, bronchitis. With the abnormal structure of MPP, there is a slow weight gain, incomparable with age, frequent seasonal viral diseases, a violation of the blood supply to the heart valves, an excessive load on the right atrium.
Atrial septal aneurysm in older children and adolescents is manifested by symptoms:
- hormonal fluctuations;
- frequent dizziness;
- a feeling of fading of the heart rhythm and soreness in the sternum;
- disorders of the autonomic system;
- temperature increase to subfebrile marks;
- headaches and abdominal pains;
- constant tiredness, drowsiness;
- decreased appetite;
- bouts of tachycardia;
- lethargy, tearfulness, excessive excitability.
Diagnosis of pathology in the fetus during pregnancy
Children with aneurysm often suffer from diseases of the bronchial and pulmonary system (ARI, SARS) against the background of impaired pressure in the pulmonary circulation. In older adolescents, disorders can become more noticeable when aneurysm is observed:
- intolerance to physical exertion;
- constant weakness, discomfort in the heart;
- pallor of the skin;
- swelling in the region of the heart upon visual inspection;
- an increase in the size of the zone of the right atrium;
- decrease or jumps in blood pressure.
Aneurysm with a small hole in the MPP for a long time may not manifest itself. With age, the body adapts to such loads and, until adulthood, the heart works normally, and functional disorders are not detected. But with pathology, children may experience signs of lag in physical development, excessive fatigue.
In adults, aneurysm manifests itself in the form of:
- shortness of breath;
- difficulty breathing in;
- increased heart rate due to lack of oxygen against the background of physical exertion;
- excessive blood flow to the left atrium in the presence of a large open oval window;
- fatigue after minor physical exertion.
The abnormal structure of MPP is fraught with complications for children, when an expansion breakthrough can be provoked. It is important for doctors to timely identify pathology and establish a diagnosis. Despite the fact that many children live happily with such a defect for many years and are not aware of the disease, the danger may lie in the development of emboli, the separation of a blood clot.
Aneurysm is considered a congenital anomaly and it happens that it is detected in infants by accident. If the opening of the LLC begins to overgrow with connective muscle fibers, and the thin septum sags towards the left (right) direction, then the aneurysm is obvious.
Sometimes in the case of a window stretch, the pathology begins to progress with age, when primary symptoms appear in adults. Aneurysm is fraught with extensive heart attack, damage to the myocardium, ventricles, and atrial structures.
Chest pain is a sign of aneurysm
- transthoracic and transesophageal catheterization of the heart chambers.
The main research method is ultrasound and cardiac echocardiography, which can detect protrusion of the atrial septum.
Additional diagnostic methods include:
- chest x-ray, when pulsation of the roots of the lungs is traced in the picture;
- An ECG to determine how many strokes the heart makes per minute and how much the obtained indicators differ from the established norms, in order to identify signs of atrial fibrillation.
Regardless of how old the patient is, the following groups of drugs are prescribed:
- trace elements (magnesium, zinc, copper);
- drugs to normalize heart rhythm, prevent thrombosis, stimulate collagen synthesis.
The operation is recommended to be done with a high probability of rupture of the heart muscle, acute (subacute) course of the disease, and with aneurysm of the cardiac aorta. It is performed on an open heart valve using cardiopulmonary bypass. The type of operation directly depends on the size of the curved septum, the degree of deformation. The choice of therapy depends on age. Patients should not refuse surgery if the surgeon insists on carrying out.
The treatment is not specific. If surgery is not indicated, then patients should be monitored periodically, at least 2 times a year, by a physician or cardiologist, once a year the patient must undergo an ultrasound of the heart.
Surgical elimination of pathology
To monitor the condition, cardiological medicine recommends that patients adhere to preventive measures:
- combine work and rest;
- Do not overload yourself emotionally;
- go in for sports;
- to control the level of blood pressure;
- timely fight infection, acute respiratory infections;
- maintain normal immune system;
- Do not use folk remedies, which is dangerous for heart pathologies.
The operation is indicated for aneurysm, if its size reached 10 mm in diameter and above, when dysfunctions of the heart are expressed. The main technique in surgery is aimed at strengthening the aneurysm by closing the opening in the septum with the application of synthetic material in the form of a patch. For this, special devices are used for endoscopy to close the window or suture in the presence of a small hole.
Pathology of the chronic form often occurs two months after a heart attack. It is characterized by swelling, shortness of breath, pain in the right hypochondrium.
The acute form occurs a few weeks after a heart attack. The body temperature rises, the heart rate goes astray, the level of leukocytes in the blood is increased.
Subacute pathological process begins to develop one and a half months after damage to the heart muscle. At this time, scarring of the tissue structure of the organ occurs in the body. Complaints of periodic shortness of breath, heart rhythm disturbance have been reported.
The defect appears in several forms. With a protrusion in two directions (S-shaped), protrusion to the left side (C-shaped), protrusion to the right side (C-like).
When it comes to treatment in a subacute or acute form, doctors must respond promptly. There is a risk of rupture of the heart muscles.
Patients are shown surgery on an open heart valve. During the procedure, specialists use an apparatus that provides artificial blood circulation.
The type of surgery depends on the size of the curved septum. During the procedure, enlarged areas of the aneurysm are removed. Artificial materials used to strengthen are used, corrugating seams are applied.
Therapeutic therapy depends on how old the patient is. But if the surgeon’s intervention is inevitable, doctors recommend agreeing. A patient of any age – a child, a teenager or an adult – can be on the operating table.
An approximate list of symptoms in this case:
- Chest pain of varying degrees of intensity. From slight tingling for unbearable attacks resembling angina in nature. The duration of each episode is not more than 5-15 minutes. Passes without a trace. Relapses become more frequent as the underlying disease progresses.
- Arrhythmias of various types. From simple when heart rate reaches 150-200 beats per minute to others. The ventricular form is especially life threatening. Other options are,. As the process moves forward, restoring a normal rhythm becomes more difficult. Moreover, the patient ceases to pay attention to the manifestations, which complicates the diagnosis at the initial appointment. Everything is decided by routine methods.
- Chest discomfort. The symptom is directly related to the previous one. A sharp beat, fluttering of the heart, skipping iterations, unequal time intervals between contractions. Here are the options.
- Shortness of breath and other disorders of normal gas exchange. It occurs spontaneously, sometimes in a state of complete rest. In the early stages of anatomical abnormalities only with intense physical activity. Catching the process from the first moments is difficult, perhaps through stress tests.
- Cyanosis of the nasolabial triangle. Indicates tissue ischemia. It is characterized by a blue area around the mouth. A visiting card of pathologies of the cardiovascular system in general. Nonspecific symptom.
- Blanching of the skin. The dermal layer becomes like marble. More often, this is noticeable in patients with weak pigmentation.
- Increased sweating, especially at night.
- Running cardiac pathologies are characterized by hemoptysis. This is a relatively rare sign, it is required to differentiate processes of cardiac origin with tuberculosis and lung cancer.
- Dizziness of unknown origin.
- Nausea and vomiting. They are reflex in nature. Therefore, relief after episodes as in case of poisoning does not occur.
Why does aneurysm develop?
If the baby’s main cause of pathology is the result of intrauterine damage and the development of infectious diseases in the mother, then the atrial septal aneurysm in adults with manifestation in adulthood is the result of myocardial infarction, heart failure.
The causes of the defect at the LLC site have not been fully studied, but the mechanism of the occurrence of heart disease has been determined. Usually this is a congenital defect with the presence of a window in newborns, which normally should close immediately after birth. The place with an anomaly does not overgrow, but is covered with a thin film, forming an aneurysm.
Aneurysm of the heart is associated in newborns with a violation in the structural formations of the connective tissue or improper nucleation of the vascular system in the embryo. Common causes of pathology:
- genetic factor;
- lack of vitamins, minerals in the body;
- intrauterine infection.
It happens that the disease manifests itself in adults due to toxic effects (alcohol, smoking) or against the background of the development of some heart diseases: myocardial infarction, atherosclerosis, hypertension.
Atrial septal aneurysm in a newborn: diagnosis
Clinical manifestations in children
Children with aneurysm prolapsing from left to right are more prone to arrhythmias. This is due to the fact that the protrusion contributes to stronger fluctuations in the myocardium of the right atrium, where the elements of the conducting system are located. Irritation to pacemakers also causes rhythm disturbances in heart contractions.
If the aneurysm is large, and, moreover, combined with other anatomical defects in the heart, then clinical manifestations will appear in a newborn baby. In other cases, the anomaly can manifest with increased physical activity, with increased growth in adolescence, hormonal changes.
Symptoms of an MPP aneurysm in a child can be:
- Tachycardia, cyanosis of the nasolabial triangle, shortness of breath during breastfeeding in newborns and children of the first months of life, fatigue and shortness of breath during physical activity, active play, swimming;
- In the adolescent period, due to accelerated growth, hormonal fluctuations, intense stress at school, sports sections, tachycardia, fatigue, dizziness, heart rhythm disturbances, a feeling of discomfort and freezing in the chest are possible, and heart pains are possible;
- With a combination of aneurysm and an open hole in the septum, signs of stagnation and increased pressure in the small circle come to the forefront – shortness of breath, frequent inflammatory diseases of the bronchopulmonary system, heart rhythm disturbances due to hypertrophy and stretching of the walls of the right half of the heart are not excluded.
In adolescence, the presence of MPP aneurysm may be accompanied by symptoms of autonomic dysfunction – sweating, nausea, dizziness, fainting, and low-grade fever appear. Older children may complain of abdominal pain, indigestion, headaches, frequent fatigue and drowsiness.
Large aneurysms without bleeding, protrusion against the background of septal defects, causing stagnation of blood in the pulmonary circle, provoke frequent inflammatory processes in the respiratory tract, which is manifested in children in the first years of life with bronchitis, pneumonia, and recurrent respiratory viral diseases.
MPP aneurysm can be accompanied by some complications, the most dangerous are its rupture and intracardiac thrombosis, which can cause embolism with blockage of other vessels (brain, for example).
Due to the rupture, blood will not flow, but it is thrown from one atrium to another. This condition does not pose a danger to life. Patients who have a defect larger than a few millimeters are advised to regularly see a specialist.
Regular examinations and related studies are required. For example, under conditions of physical exertion, which are carried out in a medical institution, systolic murmurs only increase.
For children in this state, a complication is dangerous, which provokes a gap in the expansion. In this case, it is important for the doctor to make a correct prognosis. Many can live with a similar defect for several years without even realizing it. At the same time, other patients have a greater risk of blood clots (emboli). If the problem is not detected in a timely manner, there is a risk of stroke (especially if the interventricular part of the heart has an abnormal structure).
- The size of the aneurysm.
- Dimensions of an unclosed oval window.
- The presence or absence of signs of heart failure.
- The age of the patient. As a rule, with age, the patient’s condition worsens, as the adaptive mechanisms of the body wear out.
- Concomitant diseases (especially diseases of the cardiovascular system).
For a long time, an aneurysm with the presence of a hole is asymptomatic in adults. This is due to the fact that for a long time the body can adapt to such a load. Functional disorders of the heart may be absent until adulthood. The only sign at this age may be a slight lag in physical development. In the third decade of life, mild fatigue may appear.
As a rule, an aneurysm of MPI of small sizes without communication between the atria does not manifest itself. If there is an open oval window of large sizes, there is a discharge of blood into the left atrium. This condition affects the functioning of the heart and is manifested by certain symptoms. However, the signs of the disease are not specific to the disease. These include:
- Dyspnea. It is difficult for the patient to take a breath – it is difficult. This condition occurs during physical exertion.
- Heartbeat A symptom that develops during physical activity, as a response of the heart to an increase in oxygen demand.
- Fast fatiguability. This condition also accompanies physical activity.
What could be subsequently: disease prediction
Occluder installed in the heart during surgery
In order to prevent pathology, patients are advised to direct efforts in order to prevent the development of ischemia and myocardial infarction. It is important to observe a healthy lifestyle, normalize food with the exception of spicy, fried and smoked foods from the diet, eradicate bad habits, and undergo regular medical examinations. When making a diagnosis of acute myocardial infarction, it is important to observe the regimen established by the doctor, to dose physical activity.
Atrial septal aneurysm is common in medical practice. This term refers to an abnormality in the heart structure. Aneurysm manifests itself in the form of a curved wall between the right and left atrium. Partitions with a thinned tissue are affected. The causes of the anomaly, symptoms, drug therapy, an indication for surgery – more on this later in the article.
MPP aneurysm – what is it? Dr. Komarovsky argues that such a condition is not a heart defect.
This is an anomaly that requires constant monitoring and can be diagnosed in both the infant and people of much older age. Pathology has an acquired and congenital character.
In many cases, it is not particularly dangerous. Much more cause for excitement is caused by the expansion of the aorta, blood vessels of the brain and heart. The code for 10 microbes depends on the cause of the anomaly. So, changes of an inborn nature belong to the category Q21. Acquired – to group I23.1.
Atrial septal aneurysm in adults is more pronounced, especially if it is due to birth defects.
Forecasts and Possible Consequences
Complications of an atrial septal defect may include:
- heart failure;
- recurrent pneumonia;
- septic endocarditis.
Complications of anomalies are a dangerous process. The heart begins to work poorly, in adults there is heart failure in a chronic form.
If an acute form of aneurysm was previously detected, rupture of the septum provokes a “migration” of the thrombus. There is a great risk of it moving to the area of the brain and to other organs, which can cause a physical crisis. Against this background, the patient is often diagnosed with gangrene, which affects the limbs. Cases of renal infarction are also known.
The outcome is generally favorable if the pathological defect is not complicated by the accompanying processes. Mortality is minimal and amounts to 3-8% in its pure form.
If there is coronary, heart failure, a previous heart attack, or other congenital or acquired malformations, mortality varies widely: 10-50% over the next several years. You need to look at the fact, in detail. There are no generally accepted calculations.
Complications leading to fatal consequences are as follows:
- Cardiac arrest or. Lack of pulse, breathing. Resuscitation measures are immediate. The probability of death is maximum.
- Cardiogenic shock.
- Hypertensive crisis and subsequent hemorrhagic or ischemic type stroke.
- Repeated or primary heart attack.
- Fainting. It entails a fall. Often an injury. Which is already dangerous.
- It is also possible the development of vascular dementia, heart failure with the prospects of other complications.
Overall, survival is good. Treatment is associated with an even better prognosis.
The most dangerous complication of aneurysm is its rupture.
Symptoms of rupture are severe pain, pallor of the skin, loss of consciousness. If during the break you do not provide medical assistance to the patient, then he will soon die.
Also, aneurysm can lead to a violation of the blood supply, which affects the work of internal organs, especially the heart. Often, MPP is followed.
Quite often, an atrial septal aneurysm is not distinguished by a severe course. People can live with it calmly (with certain restrictions), especially if the magnitude of the pathology does not differ in significant dimensions.
But in adult patients, the following health problems are possible:
- Change in heart rate (often arrhythmias).
- Thromboembolic complications. The likelihood of blood clots increases with communication between the atria, which leads to the formation of blood vortices. Blood clots are dangerous, when they are delivered to the brain, they provoke a stroke, which can lead to death.
- Arterial hypotension – a chronic decrease in pressure with large amounts of pathology.
- Violation of the integrity of the MPP.
|Negative factor||Clarification||The larger the area of the aneurysm, the higher the probable risks of violating its integrity.|
|The cause of such an injury is often a sharp heavy or intense load for an unprepared person. In individuals with regular dosed workouts, this happens much less frequently.|
|Tobacco smoking, addiction to alcoholic and energy drinks, frequent consumption of food cooked in fast food restaurants (overweight is also harmful) increase the risks of MPP perforation.|
|This is more typical for adolescents who are under stress during hormonal changes. To this is added excessive emotionality, intolerance in outdoor activities (sports, discos, etc.), chronic lack of sleep, and various experiences characteristic of the teenage period.|
|The natural processes of deterioration of tissue structures, changes in blood pressure, the presence of various chronic diseases (including thrombosis and cholesterol deposits) can cause MPP rupture in the aneurysm zone.|
Before treating a child, he must undergo certain diagnostic procedures:
- Auscultation – listening to the heart through a stethoscope. This device will allow you to hear noises if there is a possibility of anomalies;
- ECG. It is carried out in order to check the work of the heart, makes it possible to detect rhythm disturbances;
- Ultrasound This diagnostic method is safe and quite informative. It allows you to detect protrusion of the interatrial septum, as well as to determine fluctuations in the cardiac cycle.
Treatment depends on the growth rate and increase in the size of the formation. With the progression of the disease, the patient is shown surgical intervention, which involves replacing the damaged part of the vessel with an artificial transplant.
Small aneurysms rarely lead to rupture of the heart vessel, so their treatment can be carried out using medications. Drug therapy includes antihypertensive drugs, which are also used to stabilize blood pressure. Therapeutic measures should be aimed at normalizing the work of the heart muscle, establishing rhythm, improving metabolic processes in the myocardium.
Treatment is not complete without magnesium preparations. The role of this trace element in the processes of collagen fiber formation is difficult to overestimate. Magnesium has an antiarrhythmic effect, helps to reduce and relax heart cells. That is why it is included in complex therapy for rhythm disturbances.
Treatment with magnesium preparations consists in a three-time intake of “Magnerot” in a dosage of 0,5 g at a time. The duration of such therapy is 1 week. After that, take 25 g of this drug for 5 weeks. The use of Magne B6 is also required. The course of treatment is 1,5-2 months. In this case, the dosage depends on the weight of the child.
For antioxidant protection and membrane stabilizing effect, L-carnitine, Cyto-Mac, Coenzyme Q10 are used. Metabolic therapy can last about 1,5 months. Moreover, it must be repeated several times a year, as a rule, two or three are enough.
To improve metabolism, it is recommended to take vitamins PP and group B. Vitamin therapy is carried out in a two-month course, with repetitions up to 3 times a year.
Beta blockers, glycosides and anticoagulants are also possible. The former contribute to a decrease in heart rate. Glycosides and anticoagulants can be prescribed at the preoperative stage.
In addition, non-drug treatment should be adhered to, the essence of which is as follows:
- It is necessary to properly organize the regimen of a child’s day, provide him with a normal sleep, walks in the fresh air, and have a good rest.
- Particular attention should be paid to the nutrition of the baby, it should be balanced and as healthy as possible.
- It will be useful to carry out hydrotherapy or balneotherapy.
- Different types of massage have a very good effect.
- Physiotherapy will also benefit, especially when it comes to electrophoresis using magnesium.
Small aneurysms can be treated with folk remedies. But they must be used only under the supervision of the attending physician. In no case should you conduct experiments on your own, especially if the pathological formation has reached large sizes.
From the recipes of traditional medicine, the collection of herbs such as rosehip, medicinal valerian, hawthorn and calamus marsh has proven itself perfectly. To prepare the product, you need to take 1 tbsp. spoon of each component, and pour the raw materials with boiling water (0,5 l). After the infusion lasts for 2-3 hours, it is filtered, and 1 teaspoon of the broth is diluted in a glass of water. Treatment is carried out three times a day.
Secondary VSD rarely manifests itself as obvious symptoms in childhood, but, starting from an early adult period, the frequency of atrial arrhythmias (flutter or fibrillation) and intolerance to physical activity due to insufficiency of the right heart regions increase. In adults, damage to the vessels of the lungs can also develop.
Prevention of ASD includes careful pregnancy planning, prenatal diagnosis, and elimination of adverse factors. To prevent the development of pathology in a child, a pregnant woman must observe the following recommendations:
- Balanced and fully eat,
- Observe the regime of work and rest,
- Visit the antenatal clinic regularly
- Eliminate bad habits,
- Avoid contact with negative environmental factors that have toxic and radioactive effects on the body,
- Do not take medicine without a doctor’s prescription,
- Get vaccinated against rubella in time
- Avoid contact with sick people,
- During epidemics, do not visit crowded places,
- Undergo genetic counseling in preparation for pregnancy.
A child with a congenital malformation and undergoing treatment needs careful special care.
Prevention measures are aimed at preventing a heart attack or coronary artery disease. They consist in a regular examination by a doctor, observing a healthy lifestyle. It is necessary to eat only healthy food (excluding smoked meats, fried foods, spices from the diet), to get rid of bad habits.
Patients who suffer from acute myocardial infarction need to constantly increase their motor regime, as a result of which a strong scar must form. Patients are prescribed inhibitors (for example, “Captopril” or “Enalapril”). Aneurysm of an innate nature does not exclude sports. Military service (army) also will not bring harm to man. Acquired prohibits intense physical activity and exempts from military conscription.
One of the abnormalities of the heart is the curvature of the wall between the right and left atria. This violation is called atrial septal aneurysm. Usually this anomaly occurs in children in a place where the septum between the atria is the thinnest. The fact is that during fetal development, the embryo has an open hole here, which closes immediately after the birth of the baby.
But in some cases there is no alignment in thickness, so there remains a “thin spot” between the atria, where the atrial septal aneurysm occurs. A pathological change in the atrial septum is manifested in three forms:
- Curvature from left to right, which is the most typical case;
- Protrusion to the left side of the right atrium;
- S-shaped curvature when the upper and lower parts of the partitions bend in different directions.
When you find out what an atrial septal aneurysm is, how difficult the diagnosis and treatment will be, it’s worth considering preventive measures. They will reduce the risk of developing pathology, as well as facilitate the course of the disease if an aneurysm has already formed. The following measures must be observed:
- Take infectious diseases seriously – any cold or flu needs to be treated urgently, as they can accelerate the growth of the neoplasm. To go or not to see a doctor is your right, but it is better to carry out such treatment under the supervision of a specialist;
- Treat a cough immediately – even such a harmless disease can lead to rupture of the walls, it will be better to do an examination during this period;
- Completely give up bad habits, which will positively affect not only the work of the heart, but also the whole organism;
- Eat fully and balanced. Unhealthy fatty foods will have to be removed from the diet, since it contributes to the formation of blood clots and plaques in the vessels, and since the blood flow is already impaired, an additional deviation is unacceptable;
- Monitor the development of atherosclerosis, pressure and weight. If necessary, use drugs as directed by your doctor.
In addition, moderate physical activity, lack of stress and an accurate daily routine with sufficient time for sleep and rest will help reduce the risk of illness or the appearance of complications.
MPP aneurysm is a pathology that can form in a person of any age, proceeding without symptoms. But the absence of signs does not mean that the disease is not dangerous, there is always a risk of rupture or complications. So the patient should undergo regular examinations to identify aneurysm and other defects in the heart or circulatory system.
Factors affecting the development of heart aneurysm
The reasons for the development of the disease were discussed above.
Factors that may adversely affect the work of the heart in the fetus in the womb are as follows:
- Weakness of connective tissue, which developed before the birth of the baby.
- Connective tissue can develop poorly due to certain diseases, such as Marfan syndrome.
- Decreased vascular tone. This happens due to the development of diseases such as syphilis or atherosclerosis.
- A sudden increase in blood pressure.
- Damage to blood vessels.
- The development of thrombosis.
- Error in nutrition, passion for fatty and fried foods.
- Infectious diseases.
One of the methods for examining and evaluating a person’s heart and its contractile activity is cardiac echocardiography (EchoCG), also called ultrasound of the heart. This definition includes 3 components: “echo” (echo), “cardio” (heart), “grapho” (depict). Based on the main component, we can conclude that cardiologists conduct echocardiography.
It is she who makes it possible to obtain a visual image of the heart and blood vessels. This method relates to ultrasound, i.e., the study occurs by applying high-frequency sound waves that are not audible to the human ear. To do an echocardiography means to evaluate it in the present tense mode:
- The work of the heart muscle;
- The condition of 4 chambers and valves;
- The size of the heart cavities and pressure in them;
- The thickness of the walls of the heart;
- The rate of intracardiac blood flow (blood movement).
This method allows you to identify intracavitary thrombi, heart defects (congenital or acquired), areas of asynergy (impaired ability to carry out a cycle of certain movements), valve changes.
This ultrasound method is used both to assess the heart in a normal condition, and if any heart disease is detected. Echocardiography is also used to measure pulmonary artery pressure.
Benefits of Echocardiography
The echocardiography procedure during the detection of cardiovascular diseases, including heart defects, is key because of its basic characteristics, which include:
- High information content.
Echocardiography does not have any harmful effects on the body, is not traumatic, does not carry radiation, pain, side effects. The procedure can take from several to 45 minutes – it all depends on the symptoms and purpose of the exercise.
It is with the help of this examination that heart contractions, which are its main function, are evaluated. This is done by obtaining quantitative indicators, which are analyzed later, and on the basis of which doctors make a conclusion. Specialists can recognize a decrease in this function even at the initial stage, after which the required treatment is prescribed. Repeated echo examination allows you to see the dynamics of the course of the disease, as well as the result of treatment
For help, doctors who mandatory prescribe the passage of an ultrasound of the heart should be consulted in cases of the appearance of such symptoms:
- Heart sounds detected during listening and rhythm disturbances;
- Pain in the area of the heart and chest;
- Signs of heart failure (e.g., enlarged liver, swelling of the legs);
- Both chronic and acute (myocardial infarction) ischemia;
- Fatigue, shortness of breath, lack of air, frequent white skin tone, cyanosis of the skin around the lips, ears, upper and lower extremities.
Ultrasound examination is carried out after suffering chest injuries, heart surgery. It is necessary to identify a group of patients who should undergo echocardiography. These are those who complain of persistent headaches that have turned into chronic ones. The need for such a study is explained by the fact that microemboli – particles of blood clots that move from the right heart to the left due to a defect in the septum, could become a possible cause of pain.
For the diagnosis of heart defects, often congenital, as well as in the presence of prosthetic valves, echocardiography is also necessary. Echocardiography is performed by patients with hypertension, atherosclerosis, with the appointment of a course of treatment with antibiotics in oncology. If a young child has poor weight gain, Echocardiography can also be prescribed.
Hidden cardiac abnormalities can be detected by echocardiography in people who are actively involved in sports requiring various loads on the heart: weightlifting, diving, parachuting, long-distance running, etc. Diagnosis will help to prescribe treatment in a timely manner and to prevent serious complications of heart disease.
Preparation for echocardiography does not cause any particular difficulty. You need to undress to the waist and lie down on the couch on your left side. A similar position helps bring the left side of the chest and the top of the heart closer together. This, in turn, gives a better picture of the heart from a four-chamber position.
Next, the area of the chest where the sensors are attached is smeared with gel. Their various positions make it possible to visually see all departments of the heart and take measurements with fixing performance indicators and sizes. Sensors connected to the echocardiograph do not cause pain or discomfort. Ultrasonic vibrations from the sensors are transmitted to the human body.
Acoustic waves move in the tissues and mutate, and then return to the sensor. Here they are converted into electrical signals, which are processed by the echocardiograph. Changing waves is associated with changes in the state of internal organs. This is precisely the difference between the Echo of the CG and the ECG (electrocardiogram), which shows a graphical record of the activity of the heart, and not its structure.
The results are displayed on the screen in the form of a clear picture. The described examination method is the most common and is called “transthoracic echocardiography” (from lat. “Thorax” – chest), indicating access to the heart through the surface of the patient’s body. The doctor examining the human heart, in this position of the patient sits to the left or right of him, controls the settings of the device depending on the image displayed on the display.
If chronic heart diseases have been identified, then echocardiography is recommended at least 1 time per year.
When ultrasound is performed for pregnant women at the 11-13th week of the term, it is possible to determine the main indicators of the fetal heart, the presence of chambers and the determination of the rhythm.
There are cases in which certain factors interfere with transthoracic echocardiography. For example, subcutaneous fat, ribs, muscles, lungs, and also prosthetic valves, which are acoustic barriers to ultrasonic waves. In such cases, transesophageal echocardiography is used, the second name of which is “transesophageal” (from lat.
“Oesophagus” – the esophagus). It, like Echocardiography through the chest, can be three-dimensional. In such a study, the sensor is inserted through the esophagus, which is adjacent directly to the left atrium, which makes it possible to better see the small structures of the heart. A similar study is contraindicated in the presence of diseases of the patient’s esophagus (varicose veins of the esophagus, bleeding, inflammatory processes, etc.).
Unlike transthoracic, a mandatory preparatory step for conducting transesophageal echocardiography is starvation by the patient for 4-6 hours before the procedure. The sensor placed in the esophagus is treated with ultrasound gel and is often located in the location zone for no more than 12 minutes.
In order to study the work of the human heart with physical activity during echocardiography according to indications, they carry out:
- Similar load in certain doses;
- With the help of pharmacological drugs, they cause enhanced heart function.
In this case, the changes that occur with the heart muscle during stress tests are examined. The absence of ischemia often means a small percentage of the risk of various cardiovascular complications.
Since such a procedure may have the characteristics of a biased assessment, echo programs are used that simultaneously display images on a monitor recorded during various stages of the examination. This visual demonstration of the heart in a calm state and at maximum load allows you to compare these indicators.
A similar method of research is stress echocardiography, which allows you to detect hidden abnormalities in the heart, invisible at rest. Usually the whole procedure takes about 45 minutes, the load level is selected for each patient separately, depending on the age category and state of health. In preparation for stress echocardiography, the following patient actions:
- Clothing should be free, not restraining movement;
- 3 hours before stress echo, any physical activity and food intake in large quantities should be stopped;
- 2 hours before the examination, it is recommended to drink water and a little snack.
Types of Research
In addition to differences in the method of conducting, echocardiography can be of three types:
- One-dimensional in M-mode.
When echocardiography in M-mode (from the English. Motion), the sensor delivers waves along one selected axis. As a result, a picture with a heart image, obtained as a top view in real time, is displayed on the screen. By changing the direction of ultrasound, it is possible to check the ventricles, aorta (a vessel leaving the left ventricle and supplying oxygenated blood to all human organs) and the atrium.
Using two-dimensional echocardiography, doctors obtain an image in two planes. During its implementation, an ultrasonic wave with a frequency of 30 times in 1 sec. guided in an arc of 90 °, i.e. the scanning plane is perpendicular to the four-chamber position. By changing the position of the sensor, it is possible to analyze the movement of cardiac structures due to the displayed high-quality picture.
Atrial septal defect classification
Aneurysm of the septum is 3 types:
- R – protrusion occurs on the right side.
- RL – protrusion is formed on the right side, over time, gradually moving to the left side.
- LR – displacement of the cardiac septum to the left.
By the presence or absence of an opening of the intercardiac septum, an MPP aneurysm is with or without a message. If an opening between the left and right atria is present, a blood discharge occurs in the right atrium.
Types of MPP Aneurysm
Atrial septal aneurysm is divided into 3 types:
- R-type. The septum bulges towards the right atrium.
- RL type. The swelling of the septum goes first to the right, and then to the left.
- LR type. The partition moves to the left, and then to the right.
Depending on the presence of a hole in the partition:
- The presence of a message of the left and right atria. In this case, there is a discharge of blood into the right atrium.
- Missing message.
Atrial septal defects vary in the number, size, and location of the openings.
Taking into account the degree and nature of the underdevelopment of the primary and secondary atrial septa, primary, secondary defects, as well as the complete absence of the interatrial septum, which determines the general, single atrium (three-chamber heart), respectively, are distinguished.
Primary ASDs include cases of underdevelopment of the primary atrial septum with the preservation of the primary atrial communication. In most cases, they are combined with the splitting of the valves of the two- and tricuspid valves, an open atrioventricular canal. The primary atrial septal defect, as a rule, is characterized by a large size (3-5 cm) and is localized in the lower part of the septum above the atrioventricular valves and does not have a lower edge.
Secondary ASDs are formed by the underdevelopment of the secondary septum. Usually they are small (1-2 cm) and are located in the center of the interatrial septum or in the area of the mouth of the vena cava. Secondary atrial septal defects are often combined with abnormal flow of pulmonary veins into the right atrium. With this type of defect, the atrial septum is preserved in its lower part.
There are combined defects of the atrial septum (primary and secondary, ASD in combination with a defect in the venous sinus). Also, an atrial septal defect can be part of the structure of complex CHD (Fallot triads and pentads) or combined with severe heart defects – Ebstein’s anomaly, hypoplasia of the heart chambers, transposition of the great vessels.
The formation of a common (single) atrium is associated with the underdevelopment or complete absence of the primary and secondary septa and the presence of a large defect, which occupies the area of the entire interatrial septum. The structure of the walls and both atrial ears are preserved. A three-chamber heart can be combined with abnormalities of atrioventricular valves, as well as with asplenia.
One of the options for interatrial communication is an open oval window due to the underdevelopment of the oval foramen own valve or its defect. However, due to the fact that the open oval hole is not a true septal defect associated with insufficiency of its tissue, this anomaly cannot be attributed to defects of the interatrial septum.
Atresia of the right atrioventricular foramen
Atresia of the right atrioventricular opening is a congenital heart disease, the main anatomical characteristic of which is the absence of communication between the right atrium and the right ventricle, the presence of interatrial communication, hypoplasia or the absence of the right ventricle. A frequent, but not permanent, element of the defect is a ventricular septal defect.
The variety of anatomical variants of APAVO and the accompanying anomalies causes a difference in hemodynamic disturbances and clinical manifestations of the disease. Hemodynamics with all anatomical defects has common features. Venous blood from the right atrium, bypassing the right ventricle, enters through the atrial communication into the left atrium, where it mixes with the oxygenated blood of the latter.
In newborns and young children, the clinical picture of the disease depends mainly on the size of the atrial communication and the state of blood flow in the pulmonary circulation. Most children with APAVO die during the first year of life, as the fusion of the oval window or open ductus arteriosus makes them unviable. An ECG study determines the deviation of the electrical axis of the heart to the left, hypertrophy of the left ventricle and right atrium.
An X-ray examination reveals a degree of enlargement of the heart due to left ventricular hypertrophy and right atrium. An echocardiographic study allows a correct diagnosis to be made with a high degree of certainty: the absence of an echo signal from the tricuspid valve, the location of a small cavity of the right ventricle, an interruption of the echo signal in the atrial septum, and the presence of an enlarged cavity of the left ventricle.
The program of x-ray surgical research includes: 1. Catheterization of the right atrium.
2 Catheterization of the left atrium and left ventricle (via atrial communication).
3. Right atriography.
4. Left ventriculography. One of the pathognomonic signs of cardiac catheterization in this pathology is the impossibility of a catheter from the right atrium to the right ventricle. The catheter easily passes through the atrial communication into the left atrium and further into the left ventricle. When recording pressure curves, an increase in the maximum and average values of pressure in the right atrium is determined, the presence of an average pressure gradient between the right and left atria, the magnitude of which depends on the size of the interatrial communication.
An analysis of the gas composition of the blood reveals a decrease in blood oxygen saturation in the left atrium and severe arterial hypoxemia. Left ventriculography is important for the choice of surgical treatment. It allows you to evaluate the size of the ventricular septal defect, the degree of hypoplasia of the right ventricle, the size of the open ductus arteriosus, the state of collateral circulation and the nature of the lesion of the pulmonary artery system. Right atriography allows you to assess the nature of the interatrial communication.
In this study, the dimensions of this message are determined in the lateral projection or in the projection of “4 cameras” along the width of the jet of contrast medium coming from the right atrium to the left. It is important to note that with right atriography, a pathognomonic sign of malformation in the anteroposterior projection is revealed: an uncontrastable portion of a triangular shape located on the site of the inflow of the right ventricle between the contrasted right atrium and the left ventricle. Indications for palliative surgery are determined by the size of the interatrial communication, the state of pulmonary blood flow.
Angiocardiogram of a patient with atresia of the right atrioventricular opening. Right atriogram in anteroposterior projection. Contrasted blood, bypassing the right ventricle, enters the left atrium, then into the left ventricle and aorta. An uncontrasted triangle is defined in the projection of a hypoplastic right ventricle
In newborns and young children with APAVO and inadequate atrial communication, which are in critical condition, urgent decompression of the right atrium is shown to avoid systemic venous insufficiency, which is successfully achieved by expanding the atrial communication using closed atrioseptostomy.
After the successful completion of this procedure, depending on the state of pulmonary blood flow, one of the options for hemodynamic surgery is performed. With increased pulmonary blood flow, the pulmonary trunk is narrowed. In patients with a deficiency of pulmonary blood flow, one of the types of systemic-pulmonary anastomosis is performed.
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.