Aneurysm of the heart in children. What you need to know about an atrial septal aneurysm Signs of a small atrial septal aneurysm

Atrial septal aneurysm (ASA) is a curvature of the wall between the left and right atrium and belongs to the group.

The essence of this anomaly lies in the fact that the atrial wall is bent, protruding to the side. At the moment, doctors have identified three forms of MPP anomalies:

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

Reasons for the appearance

Mankind has known about such a disease as an aneurysm of the interatrial septum for a very long time, but despite this, in the entire history of medicine, no serious studies of this disease have been conducted. Today, experts in the medical field 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 MPP is associated with a violation in the formation of connective tissues inside the heart during the development of the fetus in the womb.

A 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, aneurysm of the IAS is the result of a previous myocardial infarction. All theories are supported by proven arguments, which means that the appearance of an MPP anomaly can be triggered by one of the three listed factors.

Types and symptoms

The symptomatology of the curvature of the MPP can be very different. Often, the symptoms of such a disease are similar to those of a myocardial infarction or heart failure. According to the speed of the course of the disease after a heart attack, doctors divide the MPP aneurysm into three types.

1. Chronic aneurysm of the MPP. Appears at the sixth week after myocardial infarction and the symptoms of this type are similar to those of heart failure.
2. Sharp form. Appears within two weeks after a heart attack. Symptoms of the acute form include fever, heart rhythm failure, the appearance of heart failure and leukocytosis.
3. Subacute form. The period of appearance of a 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 are manifested by 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 in detail to the patient all the primary signs of an interventricular anomaly. At the second stage, a visual examination is carried out, namely, the detection of pulsations in the chest and epigastric region.

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

• electrocardiography;
• CT scan.

In some cases, such a disease is diagnosed with an ultrasound of the heart immediately at birth. After the birth of a child with a curvature of the interatrial septum, this pathology is very clearly visible.

The final diagnosis is established only on the basis of a differential study using dopplerometry of the open oval window.

Is an aneurysm dangerous?

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

The pressure in both atria does not have much force to break the wall, both in a child and in 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 defect is formed in a person that does not harm health and the patient can live with it all his life. Sometimes, in the presence of an acute form of aneurysm of the urinary tract, 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 in people with this disease there is a risk of blood clots in the anomaly, which, having come off, can cause a stroke. These clots are called emboli.

Embolic stroke, as confirmed by many years of research, is very common in patients with anomalies of the interventricular wall. However, an embolic stroke can be caused by other factors, and the MPP aneurysm has nothing to do with it. Embolus detachment 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 MPP can lead to disruption of the heart. In addition, because of the aneurysm, some adults are diagnosed with chronic heart failure.

With a rupture of the septum (applies only to the acute form of the anomaly), a detached blood clot can migrate not only to the brain, but also to one of the vital organs. In view of this, the patient has a renal infarction and.

Treatment

Only those who are diagnosed with chronic or slowly developing aneurysm of the urinary bladder are subjected to conservative treatment. In this case, patients are prescribed complex drugs that normalize the work of the heart, improve its rhythm, promote metabolic processes in the myocardium and significantly lower blood pressure.

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

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

During the operation of the curvature of the MPP, a heart-lung machine is used. The type of surgical intervention is selected depending on the size of the curvature of the septum, and during the operation, the enlarged area of ​​the MPP aneurysm is resected, it is strengthened using artificial materials, and corrugated sutures are applied.

The operation completely eliminates this pathology in a child and an adult and restores coronary circulation. It is impossible to refuse surgical treatment, as it will save a person from death, prolong life and improve heart function.

Preventive actions

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

For those who suffer from acute myocardial infarction, prevention of interventricular curvature consists of strict control and adherence to an increased motor regimen for two months.

Within 2 months, the patient develops a strong scar. Also, preventive measures include the earlier appointment of an angiotensin-converting enzyme inhibitor, namely enalapril or captopril.

According to studies by cardiologists around the world, every tenth person suffers from congenital and acquired malformations of the 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 for timely visits to doctors.

An 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 the unclear mortality, profile studies were carried out in a small number. Therefore, it is not known in what number of cases the deviation poses a threat to health. Experts from Europe and the USA achieved the greatest success in the matter of surveys.

It is extremely rare that the condition makes itself felt by any symptoms. Basically it is a silent phenomenon. It is diagnosed by chance, during echocardiography or tomography. Recovery as needed is carried out by 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 whole system is laid 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. What kind of defect will be formed in advance cannot be said.

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

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

Classification of an aneurysm of the intercardiac septum as such has not been developed.

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

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

The specified typification has no great clinical significance. This is a statement of fact: there are three types of anatomical defect.

They are approximately the same in terms of likely symptoms, consequences, and solutions. Difficulties in healing are also identical.

The reasons

Development factors are not well understood. Based on the known data, the following conclusions can be drawn.

congenital forms

They are represented mainly by genetic syndromes, less often spontaneous mutations occur as a result of exposure to the body of a future woman in labor of negative factors (chemical reagents, ionizing radiation, drugs).

• Down Syndrome. Trisomy. Contrary to the possible ideas of the average person, it is determined not only by severe mental retardation. Also, cardiac problems that 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 varieties of anatomical defects. All of them in the complex cause increased mortality. Many patients do not live up to 10 years.
• Pallister-Killian Syndrome. It is characterized by massive deviations from the cardiovascular system. An atrial septal aneurysm is a clinically common variant and is part of a typical complex.
• Cardiofacial syndrome. Relatively rare pathology. It is characterized by heart lesions, as well as cosmetic defects (recovery is carried out under the supervision of a jaw surgeon).
• Sickel syndrome.

Other pathological processes. There are dozens of possible deviations in development. All, one way or another, affect the state of the atrial septum.

Acquired Forms

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

We can name such states that precede 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 pains, problems with rhythm, also shortness of breath, a change in objective indicators from the blood and instrumental techniques. Treatment should begin from the very first days of the pathological process. Delays can have catastrophic consequences. MPA aneurysm is a clinical variant of an acquired defect that develops at an early stage. Outside of medical care, complete destruction of cardiac structures occurs.

• Heart attack. Acute death of the heart muscle. Depending on the localization of the process, there is a decrease in blood circulation of varying degrees of severity. 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, detected only in objective ways as part of the early diagnosis of cardiosclerosis and insufficiency after an emergency.
• Ischemic disease. Chronic circulatory disorders in the cardiac structures. By its nature, it 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 occurrence of an aneurysm of the interatrial septum is about 30%, possibly higher, there is not enough empirical material for far-reaching generalizations.

• Rheumatism. Autoimmune pathological process. It develops at any age, what is caused is not known for certain. It is assumed that a large role is played by viral agents that pass into the cardiac structures from distant sources, but do not provoke inflammation as such. Treatment is lifelong, with the use of immunosuppressants for an acute period. Aneurysm of the septum of the heart - a late acquired defect, is eliminated by surgical methods, if there are indications for this.
• Hypertensive process of any genesis. Increase in blood pressure. It creates a significant load on all cardiac structures. Malformations of cardiac formations, including septa, are possible. Stable GB with high tonometer readings is especially dangerous.
• Acquired malformations of the heart of a different origin. May cause aneurysm. In what percentage of cases this occurs - it is impossible to say for sure. However, there is a pattern. If or is detected, the pathology in question is diagnosed in almost 20% of cases. Which suggests a possible relationship.

• Atherosclerosis of large arteries. It arises against the background of other states, that is, it turns out to be secondary. Accompanied by a generalized violation of the processes of blood circulation in the body. Cardiac structures also suffer. The consequence is heart failure. Development takes more than one year, so there is enough time for prevention or high-quality detection.

• . An increase in pressure in the corresponding artery. It is characterized by an increase in the mass of a 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, the diagnosis does not give results. Then one speaks of the idiopathic variety.

How does the disease manifest itself?

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

An approximate list of symptoms in this case:

• Pain in the chest of varying degrees of intensity. From slight tingling to unbearable attacks resembling angina pectoris in character. 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 a normal rhythm. Moreover, the patient ceases to pay attention to manifestations, which complicates the diagnosis at the initial appointment. Everything is solved by routine methods.
• Discomfort in the chest. The symptom is directly related to the previous one. A sharp blow, fluttering of the heart, skipping iterations, unequal time intervals between contractions. Here are the options.
• Shortness of breath and other violations of normal gas exchange. 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. It is characterized by blueness of the area around the mouth. A visiting card of pathologies of the cardiovascular system in general. nonspecific sign.
• Skin blanching. The dermal layer becomes like marble. More often this is 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 required to differentiate the processes of cardiac origin with tuberculosis and lung cancer.
• Vertigo of unknown origin.
• Cephalgia.
• Nausea and vomiting. They are reflexive. Therefore, relief after episodes, as in case of poisoning, does not occur.

Signs are non-specific and may indicate a wide range of pathologies, which is defined by dozens of conditions.

Atrial septal aneurysm in adults is more pronounced, 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 stationary conditions, everything happens faster, in addition, it is possible to control the effectiveness of the prescribed treatment.

Approximate list of methods:

• Patient interview and history taking. A huge role is played by previously transferred diseases of the cardiological profile, as well as the presence in the past or present of autoimmune conditions, genetic syndromes. It is necessary to clarify whether there were problems in the prenatal period.
• Measurement of blood pressure and heart rate. An increase in both the one and the other indicator indicates violations of an organic nature. Subsequent diagnostic activities will allow you to learn more.
• Daily monitoring using an automatic programmable tonometer. It takes place over 24 hours. The rhythm is assessed, as well as the dynamics of blood pressure. Perhaps repeated repetition in doubtful cases.
• Electrocardiography, EFI as needed. Study of the functional viability of cardiac structures. Even slight deviations in rhythm and activity are detected.
• Echocardiography. The main diagnostic technique. Allows you to identify all defects and anatomical defects. This method is enough to state the fact.
• MRI. As part of verification, in controversial cases.

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

Treatment Methods

Therapy only as needed. In most cases, an atrial septal aneurysm does not make itself felt, it is discovered by chance, during preventive diagnostics or examinations for other diseases.

If there are no symptoms, organic pathologies are also not detected, dynamic monitoring is indicated under the supervision of a cardiologist. The frequency of screening events is once a year or more often.

When symptoms are detected, as well as concomitant pathological processes, complex treatment is carried out with the use of medications, and due to the ineffectiveness of the conservative path, with surgical intervention.

By itself, the aneurysm is not subject to curation with drugs. Basically, a supporting technique is prescribed with the use of potassium, magnesium.

A large role is given to proper nutrition, with a low 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 quitting smoking, alcohol, psychoactive substances, sleeping 8 hours a night, avoiding stressful situations, physical overstrain, negative climatic factors (sudden changes in pressure, humidity, air temperature).

Folk 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 arbitrarily, by express method).

With caution, herbal treatment is resorted to in the presence of allergic reactions, especially of a polyvalent nature.

Forecasts and possible consequences

The outcome is mostly favorable if the pathological defect is not complicated by concomitant processes. Mortality is minimal and is 3-8% in pure form.

If there is coronary, heart failure, previously suffered a heart attack, or other congenital or acquired defects, mortality varies widely: 10-50% over 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. 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.
• Recurrent or primary infarction.
• Fainting. Leads to a fall. Often trauma. Which is already dangerous.
• It is also possible to develop vascular dementia, heart failure with the prospect of other complications.

In general, survival is good. Treatment is associated with an even better prognosis.

Finally

Atrial aneurysm is an anatomical defect in which the septum separating the atria bulges to the right, rarely to the left, and rarely has an S-shaped deformity.

Symptoms are almost non-existent, making diagnosis difficult. Identification of the pathological process is possible only by objective methods.

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

The treatment is controversial, it includes dynamic monitoring, and, if necessary, surgery. Maintenance therapy with the use of vitamin-mineral complexes is permanent. The role is played by a change in diet and lifestyle in general.

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

Features of the disease

Aneurysms most commonly affect adult males. In fact, it proceeds the same way in all people, regardless of age or gender. However, studies have found that in children, the disease rarely causes negative symptoms, more often it proceeds without complications.

There are also differences in causes. So, congenital aneurysms are more common in children. With proper treatment, they practically do not have relapses.

The following video will tell you what an atrial septal aneurysm looks like:

Types and forms

In medical practice, there are 3 forms of MPP:

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

Also, aneurysm is divided according to the severity of the flow:

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

Diagram of an atrial septal aneurysm

Causes

The most common cause of UTI is a previous myocardial infarction. This disease affects the entire cardiovascular system, which greatly increases the risk of not only UTIs, but also 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 a 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 an atrial septal aneurysm include:

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

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

Let's talk about the symptoms of an atrial septal aneurysm.

Symptoms

MPP has no specific symptoms, so the disease is difficult to detect. For different age groups, the signs differ:

• Up to 3 years. Inhibited development, underweight, poor immunity, general malaise. Sometimes you can observe an increase in the volume of the right ventricle and an overload of the pulmonary circulation.
• Up to 7 years. Growth retardation, fatigue, weakness, amplification of the first tone when listening, rarely arrhythmia.
• Teenage years. Strengthening of the second tone when listening, pallor of the skin, enlargement of the pulmonary trunk and right atrium, protrusion in the heart zone, decrease in pulse and blood pressure.
• In adults, shortness of breath, heart failure, dizziness, and high fatigue are observed.

At any age, MPP is characterized by retrosternal pain. Pain can vary in strength and character, usually sharp and aching.

Diagnostics

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

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

You may also need additional counseling from other specialists, such as a therapist. Read more about how to cure an atrial septal aneurysm.

Treatment of aneurysm of the interatrial septum

Often, MPP does not require treatment, because it does not cause discomfort to the patient. If the aneurysm progresses, or the symptoms are acute, 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:

• Eating a diet low in salt and cholesterol.
• Low physical activity.
• Taking stabilizing drugs at the rate.

Also, patients are shown oxygen barotherapy. The technique consists in treatment through an air environment in which oxygen pressure is increased.

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

Medical

Medical treatment is indicated for medium-sized aneurysms. For this, appoint:

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 arrhythmias.

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

Surgical

Surgical treatment is required in the absence of a response to medication, a threat to the life of the patient. Most often, doctors reinforce the wall of the aneurysm with polymeric materials, which prevents its growth and rupture.

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

Folk

Small aneurysms can be treated with herbal preparations. 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 is to take the collection, which includes;

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

Ingredients in the proportion 1/1/1/1 must be crushed and pour 0.5 boiled hot water, let it brew for half an hour. China. dilute a spoonful of the resulting broth in 300 ml of water. The resulting infusion drink a glass of 3 r. a day before meals. For 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 throughout the year.

Disease prevention

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.
• Timely treat diseases of the cardiovascular system.

Patients with aneurysm should limit physical activity, try to avoid emotional overstrain. It is also necessary to constantly be observed 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, pallor of the skin, loss of consciousness. If medical care is not provided to the patient during the break, he will soon die.

Also, an aneurysm can lead to impaired blood supply, which affects the functioning of internal organs, especially the heart. Often MPP is accompanied.

Forecast

The prognosis for MPP is favorable, because, usually, it does not cause discomfort to a person. So say in their reviews patients with aneurysm of the interatrial septum. Aneurysm rupture occurs in about 10% of cases. The five-year survival after surgery is over 80%.

In more detail about the aneurysm of the interatrial septum, as well as its other types, the following video will tell:

One of the anomalies of the heart is the curvature of the wall between the right and left atrium. Such a violation is called an 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 intrauterine development, the embryo has an open hole here, which closes immediately after the birth of the child.

But in some cases, there is no equalization in thickness, so there remains a “thin spot” between the atria, where an atrial septal aneurysm occurs. Pathological change in the interatrial septum manifests itself 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.

The reasons

According to modern medical classification, aneurysm of the interatrial septum belongs to the group of heart diseases known in medicine as minor anomalies of the heart. This disease was discovered a long time ago, but serious studies of this cardiac anomaly have not yet been conducted.

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

• hereditary factor;
• Violation of the formation of the cardiac connective tissue of the embryo, due to any destabilizing factor, for example, intrauterine infection.

Also, according to 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 or ultrasound is taken. These surveys are now mandatory for newborns. If necessary, an 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. To see an accurate picture of changes in the heart in children, and, therefore, to make an accurate diagnosis, the following examination methods allow:

• Transesophageal echocardiography;
• cardiac catheterization;
• CT scan.

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

External symptoms of curvature of the septum between the atria in born children are practically absent. Only an experienced pediatrician can suspect the presence of a cardiac anomaly by bluish skin or, according to medical terminology, cyanosis.

But even if a child has been diagnosed with an atrial septal curvature, 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 in children at each age there are characteristic changes in the body, so the course of the disease may change.

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

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

For older children, signs of disease progression are usually associated with:

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

In 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 slight bulge in the heart zone;
• An increase in the size of the pulmonary trunk and right ventricle;
• Decreased blood pressure and heart rate.

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

This disease can occur after myocardial infarction. According to the speed of the course, the disease is classified into the following types:

• The chronic form is observed at 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 shows signs such as severe shortness of breath, fatigue and palpitations.

Treatment of anomalies of the interatrial septum

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

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

Methods of treatment

Treatment in a conservative way is prescribed to patients who, after examination, have a chronic or constantly developing form of the disease. In this case, as a rule, special complex means 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 curvature of the 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 the elimination of any other heart disease, for example, an aneurysm of the interventricular septum. The danger is related to the fact that complications after surgery can be very serious and pose a threat to life.

Often, cardiologists wait, leaving the patient under observation, and make a decision 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, the plastic of the septum between the atria is used or the place of the rupture is sutured. For this, special anti-allergenic synthetic materials are used.

Prevention of the disease includes measures aimed at preventing the development of myocardial infarction. For children, healing decoctions that strengthen the heart are very useful. With a positive attitude to life, a healthy lifestyle, as well as the exclusion of stressful situations, this heart anomaly is not dangerous and allows you to lead a full life without any restrictions.

Atrial aneurysm is a pathology characterized by protrusion of the interatrial septum at the site of its greatest thinning. This condition is included in the group of so-called minor anomalies of the heart.

Groups of small anomalies in the development of the heart constitute developmental deviations in the structure of the heart, which may disappear or decrease during the life of the child. Often the anomaly is combined with an atrial septal defect. In such a case, this condition is called congenital.

1 Mechanisms of aneurysm formation

In the prenatal period in the fetal body in the septum between the atria, there is an oval window. Through this window, blood is discharged from the left atrium to the right. Thus, the blood flow does not capture 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 foramen ovale closes (overgrows). If the window does not fully close, thin connective tissue forms in this place, or a message remains between the atria.

2 Complications and risks of the disease

In some cases, aneurysm of the interatrial septum can behave quite 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. Violation of the heart rhythm.
2. thromboembolic complications. This complication is often observed when an atrial septal aneurysm is associated with a communication between the atria. Conditions are created for the swirl of blood flow in the region of the hole. This leads to the formation of blood clots, which can enter the brain through the bloodstream. 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 accompanies high blood pressure. This is, of course, an unfortunate fact. As a result of various emotional and physical overloads, a rupture of the septum may occur against the background of hypertension.

   Given that the pressure in the atria is much lower than in the ventricles, the rupture does not lead to the death of the patient. However, this condition can significantly worsen the patient's condition. There are signs of heart failure that reduce the quality of life of the patient.

3 Prevalence and causes of the disease

The prevalence of the disease is 1% in the population and is equally common in both men and women. The causes leading to the development of aneurysm of the urinary tract can be divided into 2 large groups:

1) Congenital. Genetic (hereditary) disorder, which is manifested by a violation of the development of connective tissue even 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 vegetovascular dystonia. With the local nature of involvement, the process affects only the interatrial septum. The second option is much less common.

2) Acquired.

4 Classification of MP aneurysms

Aneurysm of the interatrial septum is divided into 3 types:

1. R-type. The septum protrudes 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. Presence of communication of the left and right atria. In this case, there is a discharge of blood into the right atrium.
2. No message.

5 Clinical manifestations in adults

Whether an atrial septal aneurysm appears or not depends on a number of factors:

• size of the aneurysm.
• Dimensions of the open oval window.
• Presence or absence of signs of heart failure.
• Patient's age. 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 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, slight fatigue may appear.

As a rule, a small SMP aneurysm does not manifest itself in any way without communication between the atria. If there is an open oval window of a large size, 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 exercise.
• Palpitation. A symptom that develops during exercise as a response of the heart to an increase in oxygen demand.
• Fast fatiguability. This condition also accompanies physical activity.

6 Diagnosis of the disease

As mentioned earlier, aneurysm of the urinary tract is a congenital anomaly. Therefore, it can be detected without difficulty even in childhood. Another situation is observed if it has been progressively stretched, then for the first time it can be seen at a more mature age.

The main methods for diagnosing an aneurysm are:

• echocardiographic study. Ultrasound of the heart reveals a protrusion of the interatrial septum.

When the aneurysm is complemented by the existence of an open foramen ovale, the following methods may be informative:

• ECG is the easiest method. An electrophysiological study of the heart helps to see the overload of the right heart. Heart rhythm disturbances are also detected. In this case, signs of atrial fibrillation can be detected.
• X-ray of the chest. An aneurysm with an open 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 an aneurysm without a message, this method is very important in the diagnosis of an open foramen ovale. Thanks to this method, you can see the swirl of blood flow in the region of the hole. Valvular abnormalities may also be seen.

Instrumental diagnostics can also be supplemented by the following methods:

• Transesophageal ultrasound.
• Transthoracic ultrasound.
• CT scan.
• Catheterization of the chambers of the heart.

7 Treatment of an aneurysm

Treatment of aneurysm in adults can be either medical or surgical.
1) Drug treatment is non-specific. It is used even in the case when surgical treatment is not indicated. The drugs that can be used belong to different groups.

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

However, this treatment is non-specific. As a rule, patients who do not need surgical treatment need constant monitoring by a cardiologist or internist. They should have an annual cardiac ultrasound to monitor the condition of the aneurysm.

Patients are recommended general strengthening measures. It is advisable to observe the regime of work and rest, to avoid emotional and physical overload. It is important to control 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 for an aneurysm larger than 10 mm and accompanied by impaired cardiac function. The main method of surgical intervention is to strengthen the aneurysm with synthetic material. If there is a hole in the septum, it can be closed in the following ways:

• Suturing. It is performed in the case of a small hole.
• Setting up a synthetic patch.
• Endoscopic way to close the window using special devices.