Cardiac aneurysm in children. What you need to know about atrial septal aneurysm Signs of a small diameter atrial septal aneurysm

Aneurysm of the interatrial septum (ASA) is a curvature of the wall between the left and right atrium and belongs to the group.

The essence of this anomaly is that the atrial wall is curved and protrudes to the side. At the moment, doctors have identified three forms of MPP anomaly:

• curvature to the left;
• curvature to the right;
• S-shaped curvature.

Reasons for appearance

Mankind has known about such a disease as atrial septal aneurysm for a very long time, but despite this, no serious research into this disease has been carried out in the entire history of medicine. Today, medical experts have not found an exact explanation for the appearance of this curvature of the interatrial wall.

Some doctors believe that the cause of the development of this anomaly in a newborn child is heredity, and some say that the aneurysm of the bladder is associated with a disruption in the formation of connective tissues inside the heart during the development of the fetus in the womb.

Cardiac anomaly at the time of embryonic development occurs against the background of various destabilizing causes, mainly due to the presence of any infectious diseases in the mother.

In most cases, in adults, an aneurysm of the sac is the result of a myocardial infarction. All theories are supported by proven arguments, which is why we can say that the appearance of an MPP anomaly can be provoked by one of the three listed factors.

Types and symptoms

Symptoms of curvature of the bladder can be very different. Often the signs of this disease are similar to those of a myocardial infarction or heart failure. Based on the speed of the disease after a heart attack, doctors divide the aneurysm of the sacral aneurysm into three types.

1. Chronic aneurysm of the bladder. Appears in the sixth week after myocardial infarction and the symptoms of this type are similar to those of heart failure.
2. Acute form. Appears within two weeks after a heart attack. Symptoms of the acute form include fever, heart rhythm disturbances, the appearance of heart failure and leukocytosis.
3. Subacute form. The period of appearance of the subacute form is the third to sixth week after a heart attack. In this case, the curvature of the interventricular wall is formed due to a violation of the formation of scars at the site of the infarction. Symptoms of the subacute form include shortness of breath, palpitations, heart failure and fatigue.

Diagnostics

Diagnosis of the disease consists of several stages. At the first stage, it is necessary to consult a doctor who will explain to the patient in detail all the primary signs of interventricular anomaly. At the second stage, a visual examination is carried out, namely the detection of pulsation in the chest and epigastric region.

After identifying the primary symptoms of IVS curvature, the patient is sent for a number of studies, namely:

• electrocardiography;
• Computed tomography.

In some cases, this disease is diagnosed using an ultrasound examination of the heart immediately at birth. After the birth of a child with a deviated atrial septum, this pathology is very clearly visible.

The final diagnosis is established only on the basis of a differential study using Doppler ultrasound of the patent foramen ovale.

Is an aneurysm dangerous?

Most people who have an atrial septal aneurysm are afraid of it rupturing, but in reality this does not threaten them.

The pressure in both atria does not have much force to rupture the wall, either in a child or an adult. In the event that this does happen, there will be no fatal consequences.

In the event of a rupture of the interatrial septum, a person develops a defect that does not cause harm to health and the patient can live with it for the rest of his life. Sometimes, in the presence of an acute form of an aneurysm of the interventricular ventricle, a rupture of the interventricular wall can disrupt blood circulation in the brain and provoke a stroke.

According to medical statistics, it is clear that people with this disease are at risk of developing blood clots in the anomaly, which, if broken off, can cause a stroke. Such blood clots are called emboli.

Embolic stroke, as confirmed by long-term studies, is very common in patients with an abnormality of the interventricular wall. However, an embolic stroke can be caused by other factors, and an aneurysm of the cervical tract has nothing to do with it. Embolus rupture sometimes occurs in the presence of other defects that are quite similar to an aneurysm. In the case when the size of the curvature of the interatrial septum does not exceed 1 centimeter, the risk of embolic stroke is very small.

Complication of MPP anomaly

This interventricular pathology is recognized as very dangerous. First of all, the curvature of the IVS can lead to disruption of the heart. In addition, due to an aneurysm, some adults are diagnosed with chronic heart failure.

If the septum is ruptured (applies only to the acute form of the anomaly), the detached blood clot can migrate not only to the brain, but also to one of the vital organs. Because of this, the patient experiences a renal infarction and.

Treatment

Only those who have been diagnosed with a chronic or slowly developing MPP aneurysm are treated conservatively. In this case, patients are prescribed complex medications that normalize the functioning of the heart, adjust its rhythm, promote metabolic processes in the myocardium and significantly lower blood pressure.

Elimination of interventricular aneurysm in acute and subacute form requires promptness from a medical specialist, since in this case there is a risk of heart rupture.

Such treatment is extremely necessary at this stage of the disease, and thanks to modern technology, open-heart surgery is safe and quick.

In the process of surgery for curvature of the bladder, a cardiopulmonary bypass machine is used. The type of surgical intervention is selected depending on the size of the deviated septum and the operation involves resection of the enlarged portion of the septal aneurysm, its strengthening using artificial materials and the application of corrugated sutures.

The operation completely eliminates this pathology in children and adults and restores coronary circulation. Surgical treatment cannot be refused, as it will save a person from death, prolong life and improve heart function.

Preventive measures

Prevention of aneurysm of the interatrial wall completely coincides with complex measures aimed at protecting against coronary heart disease, atherosclerosis and myocardial infarction.

For those suffering from acute myocardial infarction, prevention of interventricular curvature consists of strict monitoring and adherence to increased physical activity for two months.

Within 2 months, the patient develops a durable scar. Preventive measures also include the earlier prescription of an angiotensin-converting enzyme inhibitor, namely enalapril or captopril.

According to research by cardiologists around the world, every tenth person suffers from congenital and acquired malformations of a muscular organ.

Apparently, this figure is even higher, given that many simply do not go to the hospital: there are no pronounced symptoms, and if there are, the medical culture of the majority of the population is insufficient to visit doctors in a timely manner.

Atrial septal aneurysm is a rare anatomical defect in which the cardiac septum bulges to the right or left, and uneven curvature is also possible.

Due to unclear mortality, few specialized studies have been conducted. Therefore, it is not known in what number of cases deviation poses a threat to health. The greatest success in this research has been achieved by specialists from Europe and the USA.

It is extremely rare that the condition makes itself known by any symptoms. It is mostly a silent phenomenon. It is diagnosed accidentally, during echocardiography or tomographic examination. Restoration, as needed, is carried out using radical methods.

Due to the lack of specialized studies, the exact ways of folding the anatomical defect are unknown. There are several theories of pathogenesis.

The most common is perinatal. The heart and the entire system are formed in the first trimester, approximately in the second week. Of course, full-fledged cardiac structures are formed somewhat later, but problems are possible already at this stage.

The reason lies in genetic defects and syndromes. It is impossible to say in advance what kind of defect will be formed.

Aneurysmal protrusion of the interatrial septum (abbreviated ASP) is diagnosed in children from the first days of life during echocardiography. In other cases, years may pass before the pathological process is identified.

Another option is the acquisition of a developmental defect as a result of previous heart disease. Myocarditis, inflammatory lesions of an autoimmune nature, abnormalities leading to atrophy of cardiac structures are all factors in the formation of the defect.

A classification of aneurysm of the intercardiac septum as such has not been developed.

A standard anatomical layout is used, which is represented by three types of deviations:

• Protrusion to the left side.
• Right-sided aneurysm (the most common variant).
• S-shaped curvature (occurs in 15-20% of the total number of cases).

This classification does not have great clinical significance. This is a statement of fact: there are three possible types of anatomical defect.

They are approximately the same in terms of probable symptoms, consequences, and solutions. The difficulties in healing are also identical.

Reasons

Development factors have not been sufficiently studied. Based on the known data, the following conclusions can be drawn.

Congenital forms

They are represented mainly by genetic syndromes; spontaneous mutations occur less frequently as a result of the impact of negative factors on the body of the expectant mother (chemical reagents, ionizing radiation, drugs).

• Down syndrome. Trisomy. Contrary to the possible beliefs of the average person, it is determined not only by severe mental retardation. Also cardiac problems, which are the cause of early death among patients in this group. Interatrial aneurysm is considered a relatively common type of process, but far from the only one. At the same moment, there are several types of anatomical defects. All of them together cause increased mortality. Many patients do not live to see 10 years of age.
• Pallister-Killian syndrome. Characterized by massive deviations from the cardiovascular system. Aneurysm of the interatrial septum is a clinically common variant that is part of a typical complex.
• Cardiofacial syndrome. A relatively rare pathology. Characterized by heart lesions, as well as cosmetic defects (recovery is carried out under the supervision of an oral surgeon).
• Sickel syndrome.

Other pathological processes. There are dozens of possible developmental disorders. All, one way or another, affect the condition of the atrial septum.

Acquired forms

Are determined more often. The ratio, according to a few studies, is 70% versus 30% (phenotypic and genetic pathologies, respectively).

We can name the following conditions preceding the defect in question:

• Inflammatory lesions of the heart and surrounding structures. Usually has an infectious nature, somewhat less often autoimmune. The classic form is myocarditis. The deviation is accompanied by a prolonged increase in body temperature, chest pain, rhythm problems, shortness of breath, changes in objective blood indicators and instrumental techniques. Treatment should begin from the very first days of the pathological process. Delay can have catastrophic consequences. STD aneurysm is a clinical variant of an acquired defect that develops at an early stage. Without medical care, complete destruction of cardiac structures occurs.

• Heart attack. Acute death of the heart muscle. Depending on the location of the process, a decrease in blood circulation of varying severity occurs. As the deviation develops, the elasticity of the septum decreases. There is a protrusion towards one or two atria at once. Such consequences are relatively rare and are detected only by objective means as part of the early diagnosis of cardiosclerosis and failure after an emergency.
• Ischemic disease. Chronic circulatory disorders in cardiac structures. Its character resembles a heart attack, but the decrease in hemodynamics does not reach a certain critical level. Without timely treatment, myocardial necrosis will occur, but somewhat later. When - depends on the degree of ischemia. Such patients should be examined every 3-6 months. Lifelong treatment. The probability of an atrial septal aneurysm is about 30%, possibly higher; there is not enough empirical material for far-reaching generalizations.

• Rheumatism. Autoimmune pathological process. It develops at any age and what causes it is not known for certain. It is assumed that viral agents play a major role, passing into cardiac structures from distant sources, but not provoking inflammation as such. Treatment is lifelong, with the use of immunosuppressants during the acute period. Aneurysm of the septum of the heart is a late acquired defect; it is eliminated by surgical methods, if there are indications for it.
• Hypertensive process of any origin. Increased blood pressure. Creates a significant load on all cardiac structures. Malformations of cardiac formations, including septum, are possible. Stable hypertension with high tonometer readings is especially dangerous.
• Acquired cardiac malformations of a different origin. May cause an aneurysm. It is impossible to say for sure in what percentage of cases this occurs. However, there is a pattern. When or is detected, the pathology in question is diagnosed in almost 20% of cases. Which suggests a possible connection.

• Atherosclerosis of large arteries. It occurs against the background of other conditions, that is, it turns out to be secondary. Accompanied by a generalized disturbance of circulatory processes in the body. Cardiac structures also suffer. The consequence is heart defects. It takes more than one year to develop, so there is enough time for prevention or high-quality detection.

• . An increase in pressure in the corresponding artery. Characterized by an increase in the mass of the muscular organ (the so-called cor pulmonale). Against the background of the current process, additional deviations in the development of cardiac structures are possible.

The exact reasons, however, are not known. In some cases, the process occurs spontaneously, and diagnostics do not yield results. Then they talk about the idiopathic variety.

How does the disease manifest itself?

In most cases, no way. Signs are detected when the phenomenon is advanced, when secondary deviations occur in the functioning of other anatomical structures of the heart.

An approximate list of symptoms in this case:

• Chest pain of varying degrees of intensity. From minor tingling to unbearable attacks, reminiscent of angina pectoris in nature. The duration of each episode is no more than 5-15 minutes. Passes without a trace. As the underlying disease progresses, relapses become more frequent.
• Arrhythmias of various types. From simple, when the heart rate reaches 150-200 beats per minute to others. The ventricular form is especially life-threatening. Other possible options are , . As the process moves forward, it becomes more and more difficult to restore the normal rhythm. Moreover, the patient stops paying attention to the manifestations, which complicates the diagnosis at the initial appointment. Everything is solved using routine methods.
• Discomfort in the chest. The symptom is directly related to the previous one. A sharp beat, heart flutters, skipping iterations, unequal time intervals between contractions. Here are the possible options.
• Shortness of breath and other disturbances 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. It is difficult to catch the process from the first moments, perhaps through load tests.
• Cyanosis of the nasolabial triangle. Indicates tissue ischemia. Characterized by a bluish discoloration of the area around the mouth. A calling card for pathologies of the cardiovascular system in general. Nonspecific sign.
• Pallor of the skin. The dermal layer becomes like marble. This is most often noticeable in patients with weak pigmentation.
• Increased sweating, especially at night.
• Advanced cardiac pathologies are characterized by hemoptysis. This is a relatively rare sign; it is necessary to differentiate processes of cardiac origin from tuberculosis and lung cancer.
• Dizziness of unknown origin.
• Cephalgia.
• Nausea and vomiting. They are reflexive in nature. Therefore, relief does not come after episodes as with poisoning.

Signs are nonspecific and can indicate a wide range of pathologies, which are determined by dozens of conditions.

Aneurysm of the interatrial septum in adults manifests itself more clearly, especially if it is caused by congenital defects.

What needs to be examined?

Diagnostic measures fall on the shoulders of the cardiologist. Duration ranges from several days to a week. In an inpatient setting, everything happens faster, and it is also possible to monitor the effectiveness of the prescribed treatment.

An approximate list of methods:

• Interviewing the patient and collecting anamnesis. A huge role is played by previous cardiac diseases, as well as the presence of autoimmune conditions and genetic syndromes in the past or present. It is necessary to clarify whether there were problems in the prenatal period.
• Measurement of blood pressure and heart rate. An increase in both indicators indicates organic disorders. Subsequent diagnostic measures will allow us to learn more.
• Daily monitoring using an automatic programmable tonometer. Conducted over 24 hours. The rhythm and dynamics of blood pressure are assessed. Possible repetition in doubtful cases.
• Electrocardiography, EPI as needed. Study of the functional viability of cardiac structures. Even minor deviations in rhythm and activity are detected.
• Echocardiography. Basic diagnostic technique. Allows you to identify all defects and anatomical defects. This method is sufficient to state the fact.
• MRI. As part of verification, in controversial cases.

It is also possible to prescribe a general blood test, biochemical test, coronography, stress tests (with caution).

Treatment methods

Therapy only as needed. In most cases, an aneurysm of the interatrial septum does not make itself felt; it is discovered by chance, during preventive diagnostics or examination for other diseases.

If there are no symptoms and no organic pathologies are detected, dynamic observation under the supervision of a cardiologist is indicated. The frequency of screening events is once a year or more often.

When symptoms and accompanying pathological processes are detected, complex treatment is carried out using medications, and if the conservative route is ineffective, surgical intervention is performed.

An aneurysm itself cannot be cured with drugs. Basically, a maintenance technique is prescribed using potassium and magnesium.

A big role is given to proper nutrition, with a reduced content of fats and quickly digestible compounds. Fried, smoked food, canned food and semi-finished products are completely excluded. More vitamins, minerals, protein. Salt no more than 7 grams per day.

Other recommendations include giving up smoking, alcohol, psychoactive substances, sleeping 8 hours a night, avoiding stressful situations, physical strain, and negative climatic factors (sudden changes in pressure, humidity, air temperature).

Traditional recipes are also applicable as part of prevention. A 10% tincture of propolis is used in the amount of 30 drops 2 times a day, horse chestnut (30 drops/day), decoctions of chamomile, St. John's wort, motherwort and peppermint in the system (prepared at random, using the express method).

Herbal treatment is used with caution in the presence of allergic reactions, especially of a polyvalent nature.

Forecasts and possible consequences

The outcome is generally favorable if the pathological defect is not complicated by accompanying processes. Mortality is minimal and amounts to 3-8% in its pure form.

If there is coronary or heart failure, a previous heart attack, or other congenital or acquired defects, mortality varies widely: 10-50% over a period of several years. You need to look at the fact, in detail. There are no generally accepted calculations.

Complications leading to fatal consequences are:

• Cardiac arrest or. No pulse, no breathing. Resuscitation measures are immediate. The probability of death is maximum.
• Cardiogenic shock.
• Hypertensive crisis and subsequent stroke of hemorrhagic or ischemic type.
• Repeated or primary infarction.
• Fainting. Resulting in a fall. Often injury. Which is already dangerous.
• It is also possible to develop vascular dementia, heart failure with the prospect of other complications.

Overall survival rate is good. Treatment is associated with an even better prognosis.

In conclusion

An aneurysm of the atrium is an anatomical defect in which the septum separating the atrium is bent to the right, less often to the left, and rarely has an S-shaped deformation.

There are virtually no symptoms, making diagnosis difficult. Detection of the pathological process is possible only by objective methods.

The finding itself is not so dangerous, especially if there are no organic lesions of the cardiac structures.

Treatment is controversial, includes dynamic observation, and, if necessary, surgery. Maintenance therapy using vitamin-mineral complexes is constant. A change in diet and lifestyle in general plays a role.

Our heart is the second most important organ after the brain. Normally, the right and left atria are separated by a septum, which allows them to function normally. For a variety of reasons, the septum can become thin and then bulge into a pouch-like shape. In this case, doctors talk about an aneurysm of the interatrial septum or IAS. The disease is dangerous because it does not have specific symptoms, which is why the patient may become concerned too late. Is it possible to live with an aneurysm, and how is it treated in our time? Read in the article.

Features of the disease

Aneurysms most often affect adult men. In fact, it occurs the same in all people, regardless of age or gender. However, studies have found that in children the disease less often causes negative symptoms and more often occurs without complications.

Differences are also observed in the reasons. Thus, congenital aneurysms are more common in children. With proper treatment, they practically have no relapses.

The following video will tell you what an aneurysm of the interatrial septum looks like:

Types and forms

In medical practice, there are 3 forms of MPP:

1. with curvature to the left side;
2. with a curvature to the right side;
3. with an S-shaped curvature;

Aneurysms are also divided according to the severity of their course:

• Chronic form. The symptoms are similar to heart failure.
• Acute form. Symptoms progress rapidly, ranging from fever to the formation of leukocytosis.
• Subacute form. Manifested by the appearance of shortness of breath, increased fatigue, and heart failure.

Scheme of aneurysm of the interatrial septum

Causes

The most common cause of MPP is a previous myocardial infarction. This disease affects the entire cardiovascular system, which greatly increases the risk of not only MPP, but aneurysms in other areas of the heart muscle, as well as other organs.

The appearance of an aneurysm of the interatrial septum in a newborn is associated with a predisposition to aneurysms in the family history and pathologies of the formation of connective tissues during fetal development. Such disorders can appear due to various factors; a common cause of aneurysm of the interatrial septum is an infectious disease during pregnancy.

Risk factors for atrial septal aneurysm include:

• Weak connective tissue. Usually a birth defect.
• Diseases associated with connective tissue. For example, Marfan syndrome, characterized by damage to such tissues.
• Diseases associated with decreased vascular tone, such as cystic medial necrosis, late stages of syphilis and others.
• . Due to pressure surges, increased stress is created on the vessels, which can lead to protrusion of weak walls.
• Abuse of bad habits. This is especially true for alcohol and alcohol, which seriously harm the cardiovascular system.
• Vascular injury.
• Infected blood clots.

Also, blood vessels are affected by obesity and abuse of fatty foods, as well as some infectious diseases.

We will talk about the symptoms of atrial septal aneurysm below.

Symptoms

MPP does not have specific symptoms, so the disease is difficult to detect. The signs differ for different age groups:

• Up to 3 years. Slow development, underweight, poor immunity, general malaise. Sometimes you can observe an increase in the volume of the right ventricle and overload of the pulmonary circulation.
• Up to 7 years old. Stunted growth, fatigue, weakness, increased first tone when listening, rarely arrhythmia.
• Adolescence. Strengthening of the second tone when listening, pallor of the skin, enlargement of the pulmonary trunk and right atrium, protrusion in the heart area, decreased pulse and blood pressure.
• In adults, shortness of breath, heart failure, dizziness, and fatigue are observed.

At any age, MPP is characterized by chest pain. The pain can vary in strength and nature, usually sharp and aching.

Diagnostics

MPP is diagnosed in several stages. First, the doctor analyzes symptoms, collects family history, and conducts a physical examination. Based on the collected data, the doctor prescribes studies:

• Ultrasound of the chest to clarify the size of the heart and the presence of an aneurysm.
• ECG to determine the localization of pathology.
• MRI and CT to check for thickening of blood vessels, size, location and condition of the aneurysm.
• Doppler testing in infants to clarify the diagnosis.

Additional counseling from other specialists, such as a physician, may also be required. Read on to learn how to treat an atrial septal aneurysm.

Treatment of atrial septal aneurysm

Often, MPP does not require treatment because it does not cause discomfort to the patient. If the aneurysm progresses, or the symptoms manifest themselves acutely, then the disease requires urgent medical or surgical treatment.

Therapeutic

The therapeutic technique is suitable for the treatment of small aneurysms. It includes general recommendations:

• Follow a diet low in salt and cholesterol.
• Low physical activity.
• Taking stabilizing drugs according to the course.

Oxygen barotherapy is also indicated for patients. The technique consists of treatment through an air environment in which oxygen pressure is increased.

Patients with MPP need to visit a doctor every 6 months. to monitor the condition of the aneurysm.

Medication

Drug treatment is indicated for medium-sized aneurysms. For this purpose they prescribe:

1. glycosides;
2. anticoagulants;

It is also possible to take beta-blockers and antiarrhythmic drugs. The former reduce the heart rate, which leads it to an economical mode of operation. The latter are necessary for the prevention of arrhythmia.

In the preoperative period, patients with cardiac aneurysm are prescribed cardiac glycosides and anticoagulants

Surgical

Surgical treatment is required if there is no response to medication and the patient’s life is in danger. Most often, doctors strengthen the wall of the aneurysm with polymer materials, which prevents its growth and rupture.

If the situation has reached a critical state, the patient may be prescribed Cooley septoplasty or resection of the aneurysm followed by wall reconstruction if necessary.

Folk

Small aneurysms can be treated with herbal remedies. It is strictly forbidden to treat large aneurysms in this way, since folk remedies can eliminate the symptoms, while the problem itself will remain and develop.

The most balanced recipe consists of taking a collection that includes;

1. rose hip;
2. hawthorn;
3. roots of calamus;
4. valerian;

The ingredients in a ratio of 1/1/1/1 must be crushed and pour in 0.5 boiled hot water, let it brew for half an hour. Chain. Dilute a spoonful of the resulting decoction into 300 ml of water. Drink the resulting infusion in a glass of 3 rubles. per day before meals. Over a month, the dosage can be increased from a teaspoon to 2 tablespoons per 300 ml of water. It is necessary to be treated with such a decoction for a year.

Prevention of disease

There is no specific prevention of atrial septal aneurysm. To reduce the risk, it is recommended:

• Follow a diet low in cholesterol and high in fiber.
• Give up bad habits, especially smoking.
• Engage in moderate exercise regularly. Particular attention should be paid to cardio exercises.
• Treat cardiovascular diseases in a timely manner.

Patients with an aneurysm should limit physical activity and try to avoid emotional stress. It is also necessary to be constantly monitored by a cardiac surgeon to monitor the condition of the aneurysm.

Complications

The most dangerous complication of an aneurysm is its rupture. Symptoms of rupture are severe pain, pale skin, and loss of consciousness. If you do not provide medical assistance to the patient during a rupture, he will soon die.

An aneurysm can also lead to disruption of blood supply, which affects the functioning of internal organs, especially the heart. MPP is often accompanied.

Forecast

The prognosis for MPP is favorable, since, usually, it does not cause discomfort to a person. This is what patients with aneurysm of the interatrial septum say in their reviews. An aneurysm ruptures in approximately 10% of cases. The five-year survival rate after surgery is more than 80%.

The following video will tell you more about atrial septal aneurysm, as well as its other types:

One of the heart abnormalities is the curvature of the wall between the right and left atrium. This disorder is called atrial septal aneurysm. Typically, this anomaly occurs in children in the place where the septum between the atria is thinnest. The fact is that during intrauterine development the embryo has an open hole here, which closes immediately after the birth of the child.

But in some cases, thickness equalization does not occur, so a “thin place” remains between the atria, where an aneurysm of the interatrial septum occurs. Pathological changes in the interatrial septum manifest themselves 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.

Reasons

According to the modern medical classification, atrial septal aneurysm belongs to a group of heart diseases known in medicine as minor cardiac anomalies. This disease was discovered a long time ago, but serious research into this cardiac anomaly has not yet been carried out.

Consequently, aneurysm of the interatrial septum, which most often is congenital, has not been sufficiently studied and the exact causes of this heart disease have not been established. Today, scientists defend two theories explaining the development of this cardiac anomaly in children:

• Hereditary factor;
• Disruption of the formation of cardiac connective tissue of the embryo, due to some destabilizing factor, for example, intrauterine infection.

Also, according to medical practitioners, it can develop in adults due to myocardial infarction.

Diagnostics

Today, this disease is diagnosed in a child at an early age, when the first electrocardiogram is taken or an ultrasound is performed. These examinations are now mandatory for newborns. If necessary, additional examination may be prescribed to clarify the diagnosis.

As a rule, this is necessary in cases where signs indicate other cardiac pathologies, for example, an aneurysm of the interventricular septum. The following examination methods allow you to see an accurate picture of changes in the heart in children, and, therefore, make an accurate diagnosis:

• Transesophageal echocardiography;
• Cardiac catheterization;
• Computed tomography.

Modern equipment allows you to accurately determine the type of anomaly and its size, as well as exclude the presence of other heart diseases, for example, an aneurysm of the interventricular septum, which is a very serious and dangerous disease.

Symptoms of the disease

There are practically no external symptoms of curvature of the septum between the atria in newborn children. Only an experienced pediatrician can suspect the presence of a cardiac anomaly by bluish skin or, in accordance with medical terminology, cyanosis.

But even if a child has been diagnosed with a deviated atrial septum, the symptoms of the disease, unlike an aneurysm of the interventricular septum, may not appear for a long time. Of course, it should be understood that children at each age undergo characteristic changes in the body, so the course of the disease may change.

So, at the age of 1-3 years, children may experience:

• Inhibition of physical and mental development;
• Susceptibility to seasonal viral infections.

For older children, signs of disease progression usually include:

• With a lag in weight and height;
• With problems in puberty;
• With physical weakness and fatigue;
• With chest pain.

At a dangerous stage of the development of the disease, its symptoms in children become pronounced and manifest themselves:

• Noticeable pallor of the skin;
• External defects in the chest area, namely, a small bulge in the heart area;
• An increase in the size of the pulmonary trunk and right ventricle;
• Decreased blood pressure and pulse.

Advice! A child diagnosed with a congenital anomaly of the atrial septum must be registered at the clinic and regularly examined to monitor the dynamics of the disease.

This disease can occur after myocardial infarction. Based on the speed of progression, the disease is classified into the following types:

• The chronic form is observed in the sixth week after the attack and is expressed by heart failure.
• The acute form persists for a couple of weeks after a heart attack, while against the background of heart failure, the body temperature rises and the heartbeat fails.
• The subacute form occurs between the third and sixth week after the attack and exhibits symptoms such as severe shortness of breath, fatigue and palpitations.

Treatment of atrial septal anomaly

At the beginning of the development of atrial septal aneurysm in children, no treatment is required. The disease becomes dangerous to health if the curvature increases in size, which threatens its rupture. For many children, the critical period for such changes is adolescence, during which major changes in the body occur.

If the symptoms of the disease do not worsen with growing up and no complications are detected during regular examinations, which are mandatory, then no medical or surgical treatment is required.

Treatment options

Conservative treatment is prescribed to patients who, after examination, have been diagnosed with a chronic or constantly developing form of the disease. In this case, as a rule, special complex agents are used that can improve heart function and lower blood pressure.

If the disease progresses, that is, there is an increase in the size of the deviated septum, then the cardiologist may decide to eliminate the anomaly surgically. It should be understood that this is a very dangerous event.

The complexity of the operation is the same as that of eliminating any other heart defect, for example, an aneurysm of the interventricular septum. The danger is that complications after surgery can be very serious and life-threatening.

Often, cardiologists wait, leaving the patient under observation, and decide on surgical intervention only if they see the risk of developing pulmonary hypertension, which can arise from a strong discharge of blood.

During the operation, plastic surgery of the septum between the atria is performed or the rupture site is sutured. For this purpose, special anti-allergenic synthetic materials are used.

Disease prevention includes measures aimed at preventing the development of myocardial infarction. Healing decoctions that strengthen the heart are very useful for children. With a positive attitude in life, a healthy lifestyle, and the elimination of stressful situations, this heart anomaly is not dangerous and allows you to lead a full life without any restrictions.

Aneurysm of the interatrial septum is a pathology characterized by protrusion of the interatrial septum in the place of its greatest thinning. This condition is included in the group of so-called minor cardiac anomalies.

Groups of minor cardiac developmental anomalies comprise developmental deviations in the structure of the heart, which may disappear or decrease during the child’s life. Often the anomaly is combined with an atrial septal defect. In this case, this condition is called congenital.

1 Mechanisms of aneurysm formation

During the prenatal period in the fetus, the oval window is located in the septum between the atria. Through this window, blood is discharged from the left atrium to the right. Thus, the blood flow does not involve the pulmonary circulation, since during this period there is no need for the lungs to work.

After birth, the baby's lungs begin to function and the oval window closes (overgrows). If the window does not close completely, thin connective tissue forms in this place, or a communication remains between the atria.

2 Complications and risks of the disease

In some cases, an aneurysm of the interatrial septum can behave completely calmly and not pose a threat to the body if its size is small. However, its existence in adults may be accompanied by the following factors:

1. Heart rhythm disturbances.
2. Thromboembolic complications. This complication is often observed when an aneurysm of the interatrial septum is combined with the presence of communication between the atria. Conditions are created for the blood flow to swirl in the area of ​​the hole. This leads to the formation of blood clots, which can travel through the bloodstream to the brain. As a result, a life-threatening condition can develop - blockage of cerebral vessels and, as a result, a stroke.
3. Aneurysm rupture. This complication can occur when the disease is accompanied by high blood pressure. This is, of course, an unfavorable fact. As a result of various emotional and physical overloads against the background of hypertension, a septal rupture can occur.

   Considering that the pressure in the atria is much lower than in the ventricles, a rupture does not lead to the death of the patient. However, this condition can significantly worsen the patient's condition. Signs of heart failure appear, which reduce the patient’s quality of life.

3 Prevalence and causes of the disease

The prevalence of the disease is 1% in the population and occurs equally in both men and women. The reasons leading to the development of an aneurysm of the sac can be divided into 2 large groups:

1) Congenital. A genetic (hereditary) disorder that manifests itself as a violation of the development of connective tissue in the prenatal period. It occurs in 80% of young people and can be both systemic and local (isolated) in nature.

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 vegetative-vascular dystonia. If the involvement is local, the process affects only the interatrial septum. The second option is much less common.

2) Purchased.

4 Classification of MPP aneurysm

Aneurysm of the interatrial septum is divided into 3 types:

1. R-type. The septum bulges towards the right atrium.
2. R-L-type. The bulging of the septum goes first to the right and then to the left.
3. L-R-type. The septum moves to the left and then to the right.

Depending on the presence of a hole in the partition:

1. The presence of communication between the left and right atria. In this case, blood is discharged into the right atrium.
2. No message.

5 Clinical manifestations in adults

Whether an atrial septal aneurysm will manifest itself or not depends on a number of factors:

• Dimensions of the aneurysm.
• Dimensions of the unclosed oval window.
• The presence or absence of signs of heart failure.
• Patient's age. As a rule, with age, the patient's condition worsens, as the body's adaptive mechanisms wear out.
• Concomitant diseases (especially diseases of the cardiovascular system).

For a long time, an aneurysm with a hole is asymptomatic in adults. This happens because the body can adapt to such a load for a long time. Functional heart disorders may not be present until adulthood. The only sign at this age may be a slight delay in physical development. In the third decade of life, mild fatigue may appear.

As a rule, a small sac aneurysm without communication between the atria does not manifest itself in any way. If there is a large open foramen ovale, blood is discharged 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 this disease. These include:

• Dyspnea. It is difficult for the patient to take a breath - it is difficult. This condition occurs during physical activity.
• Heartbeat. A symptom that develops during physical activity as a response of the heart to an increase in oxygen demand.
• Fatigue. This condition also accompanies physical activity.

6 Diagnosis of the disease

As mentioned earlier, STD aneurysm is a congenital developmental anomaly. Therefore, it can be detected without difficulty even in childhood. Another situation is observed if its progressive stretching has occurred, then for the first time it can be noticed at a more mature age.

The main methods for diagnosing an aneurysm are:

• Echocardiographic study. Ultrasound of the heart can reveal protrusion of the interatrial septum.

When an aneurysm is accompanied by the existence of a patent foramen ovale, the following methods may be informative:

• ECG is the simplest method. An electrophysiological study of the heart helps to see overload of the right side of the heart. Heart rhythm disturbances are also detected. In this case, signs of atrial fibrillation can be detected.
• X-ray of the chest organs. An aneurysm with a patent foramen ovale is characterized by the presence of a specific symptom on an x-ray - “pulsation of the roots of the lungs.”
• Echocardiographic study. As in the case of non-communicating aneurysm, this method is very important in diagnosing a patent foramen ovale. Thanks to this method, you can see the turbulence of the blood flow in the area of ​​the hole. Valvular abnormalities may also be detected.

Instrumental diagnostics can also be supplemented with the following methods:

• Transesophageal ultrasound.
• Transthoracic ultrasound.
• Computed tomography.
• Catheterization of the heart chambers.

7 Treatment of aneurysm

Treatment of aneurysm in adults can be either medicinal or surgical.
1) Drug treatment is nonspecific. It can also be used in cases where surgical treatment is not indicated. Drugs that can be used belong to different groups.

• Drugs that stimulate collagen formation.
• B vitamins.
• Microelements - Cu, Zn, Mg.
• Drugs that affect heart rhythm.
• Drugs that prevent the formation of blood clots.

However, such treatment is nonspecific. As a rule, patients who do not require surgical treatment require constant monitoring by a cardiologist or internist. They must undergo an annual cardiac ultrasound to monitor the condition of the aneurysm.

Patients are recommended to take general strengthening measures. It is advisable to maintain a work-rest schedule and avoid emotional and physical stress. It is important to monitor your blood pressure levels. An important point is also the prevention of infections that have a negative effect on the body.

2) Surgical treatment is indicated when the aneurysm size exceeds 10 mm and is accompanied by impaired cardiac function. The main method of surgical intervention is strengthening the aneurysm with synthetic material. If there is a hole in the septum, it can be closed in the following ways:

• Stitching. Performed in case of a small hole.
• Installation of a synthetic patch.
• An endoscopic method of closing a window using special devices.