Open oval window in the heart: causes, symptoms, treatment. Open oval window in the heart in an adult: norm and pathology What does an open window in the heart mean

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what is the name of the disease "hole in the heart"?

what is the name of the disease "hole in the heart"? how dangerous is it for life and how does it radiate? Answers:

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Answer:
"A hole in the heart" is probably a literal translation. In Russian, such a diagnosis sounds like "heart disease". Defects are congenital and acquired and are characterized by holes (perforations) of the heart valves, interventricular or presciatic septa, large coronary blood vessels and the ascending aortic arch. Many heart defects in the recent past led to disability and death of patients. At present, the high cardiosurgical technique on the open heart, combined with the developed successful methods of implantation of vessels, tissues and stem cells, makes it possible to overcome the most severe heart defects.

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Answer:
This is most likely mitral valve prolapse. It can be of an indeterminate cause, or it can be acquired - as an accompaniment of some other disease.

Most often, we are talking about hemodynamically insignificant mitral valve prolapse, which is not dangerous, but it is best to check with your doctor.

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If a child has this, then there is a lack of some substances in the diet. This is successfully solved by dietary supplements - high quality biologically active supplements.
The highest quality in the world is from my American manufacturer company. One boy, my client, 5 years old, had this hole closed after 3 weeks. He ate a children's supplement with vitamins and minerals.
Doctors will offer you an operation. Everyone wants to earn money. What is better for you is up to you. Only you first look on the Internet how heart surgery is done.
If then the child continues to eat dietary supplements for prevention, he will live 120 years and will not get sick. It will be best to study at school and fully realize his genetic potential.
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With the advent of ultrasound diagnostics in medicine, young parents increasingly began to learn from doctors that the baby's oval window was not closed. Hearing such a diagnosis, one should not panic, because the baby reacts sharply to mother's emotions. All parents should be aware of what an open oval window in the child’s heart means, what symptoms the pathology causes, how dangerous it is and what are the ways to eliminate it.

The foramen ovale in the heart of some babies does not close with a valve after birth

What is a disease

In the area of the left ventricle, the window is closed thanks to a small valve, which is finally formed by the time the baby is born. When a newborn begins to scream for the first time, the lungs open, blood flow to them increases, and the pressure in the left atrium becomes greater, and the oval window in the heart of the newborn is covered with a valve. Over time, its strong fusion with the interatrial septum occurs. However, the important point is that the body of each person is individual and not all of them happen at the time of birth.

Many parents are frightened by this phenomenon and they are interested in the doctors when the oval window in the child's heart closes. In fact, it interferes with the proper functioning of the blood circulation, so it must gradually close. This happens with the help of valve growth to the edges of the interatrial septum.

An open foramen ovale is a heart anomaly, not a heart defect.

The duration of this process is different for all children - for some, the hole closes immediately, for others - after a year or two, and for someone - after five years. This is absolutely normal, and if other diseases associated with the cardiovascular system are not observed, then you should not worry.

Sometimes it happens that the size of the valve is not enough to completely cover the gap. Under such circumstances, an open oval window in the heart of an adult or a child is diagnosed, since this pathology remains for life. This phenomenon is not considered a disease, but an anomaly in the maturation of the heart.

Children with this diagnosis, reaching the age of 3, receive the second group of disability.

What is an oval window in the heart of the fetus and newborn is described in the video:

Why won't the oval window close?

An open oval window in newborns is an absolutely natural phenomenon, since when a child develops in the mother's womb, it is vital for him. However, if the functioning oval window has not closed 5 years after the birth of the child, it is worth considering. Consider why this pathology can occur:

most often this problem is hereditary, which is transmitted mainly from relatives of the first line;
if, when carrying a baby, a pregnant woman allowed herself to regularly drink alcohol or smoke often;
the problem can be provoked by the bad ecology in which a woman is expecting a baby;
if, the expectant mother ate improperly;

In most cases, the problem is caused by a genetic factor and is inherited from parents.

with regular stressful and depressive conditions in which a woman was while carrying a baby;
if there were toxic poisoning during pregnancy;
when a child is born before the due date.

If the oval window in the child’s heart has not closed, then it must be registered and constantly monitored by a specialist.

How deviation manifests itself

Whatever disease a person encounters, they all manifest themselves in different ways and cause certain symptoms, an open oval window in the heart in children or adults is no exception. However, the severity of the signs depends on the size of the hole:

if the open oval window in the heart of a child is from 2 mm to 7 mm, such a deviation is considered insignificant and makes itself felt only during strong physical exertion;

Bad habits of the mother during pregnancy can provoke the development of heart abnormalities in the baby

it happens that the gap between the atria is from 7 to 10 mm, under such circumstances the signs are more pronounced and practically do not differ from the symptoms of an atrial septal defect.

In newborns, an anomaly in the development of the heart is manifested as follows:

when a child cries, strains, or coughs, his nasolabial triangle, tip of his nose, or fingertips may turn blue;
the skin of such children is paler than that of others who do not have pathologies;
infants also have a rapid heartbeat.

Symptoms of pathology depend on the size of the hole

In adults who have had such a pathology, lips may also turn blue under certain circumstances:

when a person holds his breath for a long time, swims or dives, this is explained by the fact that during such procedures the pressure in the pulmonary vessels increases;
due to heavy physical exertion;
in the presence of diseases associated with the lungs;
if there are any other pathologies of the heart.

If the window size is more than 7 mm, then the symptoms of the pathology are as follows:

there is a systematic loss of consciousness;
the skin turns blue even in the absence of strong physical exertion;
worries about general weakness throughout the body, dizziness;
the child may lag far behind in development from their peers.

The skin integuments in babies with an anomaly of the heart are pale in color.

Diagnostic methods

On a routine examination, the cardiologist is unable to diagnose a patent foramen ovale in a child because there is no heart murmur on auscultation. To diagnose pathology, there are the following procedures:

Echocardiography (ultrasound of the heart). Thanks to this study, the doctor has the opportunity to understand in which direction blood circulation occurs, how much blood flows between the right and left atria, and also to determine the presence of other serious pathologies. These points are very important in the course of diagnosis, with the help of them the specialist understands at what stage the disease is and prescribes effective therapy.
Contrast echocardiography. This procedure shows if there is an open foramen ovale in the heart of a child or an adult. To identify the pathology, the patient is injected intravenously with saline. If a gap is present, then the reaction will occur immediately, and the doctor will see how air bubbles penetrate through this hole from one atrium to another.

Ultrasound of the heart allows to reveal in detail violations in the structure of the organ

Transesophageal echocardiography. This study is carried out if it is necessary to find out exactly where the gap is located and what size it is. Also, with the help of the procedure, it turns out whether there are any complications in the form of inflammatory processes in the heart valves, blood clots, or expansion of the heart.
Chest x-ray. It shows the size of the patient's heart, the diameter of the heart vessels, and also determines whether blood has stagnated in the lungs.

What is dangerous pathology

An open oval window in the heart of a newborn is diagnosed very often, and this is normal, but if it does not close after some time has passed, then there is a reason to contact a cardiologist.

There is no need to panic with this diagnosis, since such an anomaly almost never affects a person’s activity or life expectancy.

An anomaly of the heart caused by the formation of an open window requires observation by a cardiologist

However, it should be remembered that the oval heart window in adults increases the possibility of blood clots, which is why there is a possibility of the following complications:

The disease can cause the death of some areas of the brain, which is fraught with a stroke.
Impaired functioning of the heart causes the death of sections of muscle tissue, which can cause a myocardial infarction.
Due to impaired blood circulation, kidney cells can die - an organ infarction will occur.
In case of circulatory disorders in the brain, a person’s speech can be deformed, memory lapses are noted, the upper and lower limbs go numb. Symptoms last for a day, after which they disappear on their own.

It is important to understand that no matter what medical therapy is prescribed to the patient, the risk of these complications will not decrease.

When a child complains, he is prescribed medication

Methods of treatment

If an open oval window in the heart of an infant is diagnosed, then before the child is 5 years old, no medical therapy is required, this is due to the fact that during this time it can close on its own. If this did not happen, and the pathology does not make itself felt in any way, and does not prevent the child from developing normally, then there is no need to treat the problem.

If there are mild symptoms, and complications with the emergence of new diseases are not observed, then surgery is not prescribed. However, the patient is prescribed drug therapy:

The condition is relieved by anticoagulants. One of the most effective drugs in this group of drugs is Warfarin. If the patient is taking this drug, then there is a need for frequent blood tests so that doctors can monitor the state of the hemostasis system in order to avoid formation.

By the age of 5, in most young patients, the foramen ovale closes.

Also, a person is prescribed treatment with antiplatelet agents or antiplatelet drugs. One of the most common and effective means of this category is aspirin, which must be taken daily at 3–5 mg per 1 kg of body weight. If you adhere to this method of treatment, it is possible to prevent venous insufficiency, the formation of blood clots, as well as ischemic stroke.

If the foramen ovale in the heart of the newborn has not closed, and the symptoms are severe, X-ray endovascular occlusion of the open hole is required. Throughout the operation, the doctor monitors the patient's condition with the help of special X-ray and echocardiological devices.

Patients after surgery due to a large oval hole in the heart permanently get rid of the pathology

Prognosis for an open foramen ovale in the heart

A small functioning oval window in newborns throughout life does not interfere with either social or work life. However, people with such a diagnosis should avoid extreme sports, strong physical exertion and professions that are associated with it.

Non-closure of a large foramen ovale requires surgical intervention. For six months after the completion of the operation, in order to avoid bacterial endocarditis, patients are advised to take antibiotics, as well as systematically visit a cardiologist. However, after the recovery period, a person can continue to live without limiting himself in anything.

An open oval window is a pathology of the heart, namely the presence of a gap in the septum between the left and right atrium, which is necessary for the intrauterine life of the baby. After birth, this window should close completely with a valve and close up.

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This pathology is in 1/2 of the population who live a normal lifestyle and are unaware of its presence.

Classification of cardiac pathology

Pathology is classified by size, which is measured in millimeters:

With sizes ranging from 5 to 7 mm, the diagnosis may sound like hemodynamically insignificant. An open window can manifest itself in this case only with strong physical exertion.
If the dimensions are from 7 to 10 millimeters, then the diagnosis may sound like a "gaping oval window" and symptomatically differ little from congenital heart disease (atrial septal defect).

Reasons for the window not closing

There are a number of reasons that can lead to the development of this pathology:

hereditary factor, more often observed along the first line of family ties;
bad habits of the mother during pregnancy (alcohol and smoking);
the presence of a bad environmental factor during pregnancy;
lack of healthy nutrition of the mother during pregnancy;
stay of a woman expecting a child in constant stress and depression;
the presence of toxic poisoning during pregnancy (and drugs);
also the presence of early delivery, in most cases it is premature babies who suffer from this pathology.

How should it close?

According to all medical indications, the closing of the oval window with a special valve during the normal development of the baby occurs in the first seconds of his independent life, at the first breath.

With increasing pressure in the blood vessels of the lungs, the functionality of this hole becomes unclaimed.

The valve should fully adhere to the septum by the end of the baby's first year of life. But there are also known cases of completion of this process by the 5th year of a child's life.

Video

Adult problems

For an adult, whose age does not exceed 40 years, in the absence of diseases from the cardiovascular system, the presence of an open oval hole in the region of the heart does not interfere with leading a full-fledged lifestyle.

If a doctor suspects this pathology of the heart, the patient should be referred for diagnosis using an ECG, radiography and Echo-KG.

The presence of a violation in athletes

The life of an athlete is closely connected with physical activity of increased severity.

When performing tasks, this pathology can manifest itself with the following symptoms:

the appearance of shortness of breath;
be expressed in the low activity of the athlete, which is facilitated by his rapid fatigue;
the appearance of fainting;
the presence of severe headaches, migraines;
manifestation of signs of suffocation (lack of air).

In cases of detection of these symptoms, an urgent visit to the doctor is necessary to undergo a full examination and prescribe medication.

One of the ways is the method of surgical intervention. The ability to remain in big-time sports should be decided only by a doctor, based on the results of the diagnosis.

Since the presence of this pathology can lead to the formation of blood clots in the region of the heart, this is fraught with the development of the following series of diseases, which, due to untimely medical care, can lead to death:

myocardial infarction;
stroke;
kidney infarction.

Signs and manifestations of pathology

Any disease is accompanied by the presence of its symptoms.

Signs of an open window in childhood are as follows:

The baby's weight gain is very slow.
In cases where the child cries, strains, screams, coughs, there is a sharp blue or severe pallor of the skin around the lips.
The child often suffers from bronchopulmonary and catarrhal diseases.

At an older age, children may experience shortness of breath and increased heart rate during exercise.

In adolescence, this pathology is reflected in the following signs:

rapid fatigue of the body;
frequent headaches;
the presence of dizziness, leading to fainting;
the presence of interruptions in the work of the cardiac system.

The presence of frequent colds and respiratory diseases.
Lack of regularity of the pulse.
The presence of weakness and high fatigue of the body.
The appearance of shortness of breath.
The presence of loss of consciousness.

Functioning heart problem

Preservation of the function of the oval window in cases of a measured life rhythm associated with the absence of frequent physical exertion, poses no danger.

But there are cases in which the preservation of the functionality of the window contributes to the development of a number of unpleasant consequences:

Age-related growth of organs and tissues, when the heart muscle grows, and the valve remains the same size. Blood, due to the increase in the window connector, can freely penetrate from one atrium to another, which leads to an increase in the load on them.
Diseases that increase pressure in the right atrium. This factor contributes to the opening of the valve towards the left atrium.
In cases of the presence of the first degree of pulmonary hypertension, the preserved functionality of the interatrial opening can have a positive effect on the body. Part of the blood from the pulmonary circulation is discharged into the left atrium, resulting in a decrease in pressure.

The presence of constant control of the doctor is typical for these situations, so that the moment of transition to the decompensated state of the patient is not missed.

Of course, you can live a full life with this pathology. But the diagnosis of its presence must be carried out by everyone.

Methods of treatment

It should be said that this is such a pathology in which there is a gap between the right and left atrium. It can present with prominent symptoms, such as pale skin, blue lips, hands, and feet, frequent dizziness, loss of consciousness, and a predisposition to frequent colds.

Most of all, this pathology appears in newborns. But there is no reason to worry, since it can pass by two years, and if it does not pass, then special operations are currently being carried out using the latest methods.

However, it can occur without any symptoms, then treatment is not needed.

If there is a small discharge of blood, there is no previous disease and consequences after it, the operation is not performed.

Then, in such patients, if a transient ischemic attack or a history of stroke occurs, general therapy with the following drugs is prescribed to prevent thromboembolic complications:

Anticoagulants. The most popular anticoagulant is Warfarin (Coumadin). However, when using such drugs, it is often necessary to take blood tests to monitor the state of the hemostasis system in order to protect the patient from thrombosis.
Disaggregants or antiplatelet drugs. The most common representatives of this group of drugs is Aspirin, used at 3-5 mg / kg every day. Aspirin, when it enters the body, acts on the platelet cell, which after that remains inactive for some time to aggregation, in other words, to the process of gluing during the formation of blood clots. If every day to use Aspirin in small doses, it provides reliable prevention of venous insufficiency, as well as venous thrombosis and ischemic stroke.

But with a strong pathological discharge of blood, a low-traumatic X-ray endovascular occlusion of an unclosed window is performed from the atrium from the right side to the left. This whole procedure is controlled by special X-ray and echocardiological devices using an occluder, which, during opening, closes all the holes.

The operation and the use of the described drugs are used to treat both adults and children.

Help of folk remedies

Unfortunately, folk remedies for this pathology have not yet been identified.

If a person does not have obvious disorders in the work of the cardiovascular system, then doctors give him advice on how to lead a lifestyle, and they can also prescribe some vitamins and proper nutrition that help support the work of the heart. It is also recommended to limit physical activity. But drugs in the absence of symptoms are not prescribed to the patient, they can only prescribe measures to strengthen the body, for example, hardening, exercise therapy, spa treatment.

But with small complaints of the patient about the heart, the doctor sometimes prescribes special fortified medicines that strengthen the cardiovascular system, such as Panangin, Magne B6, Elkar, Ubiquinone, and so on. And with severe disorders in the work of the cardiovascular system, general therapy with the described drugs is used or an operation is performed.

Nutrition rules

In addition to medication, you need to follow proper nutrition. All people with such a difficult disease must adhere to a strict diet.

Namely, do not eat fried, smoked and salty. Include plenty of fresh vegetables and fruits in your diet, as well as legumes, cereals, pasta, greens, low-fat dairy products, fish, lean meats, and foods rich in potassium, such as grapes, kiwi, citrus fruits, baked potatoes . Exclude strong tea and coffee from the diet, it is better to replace them with freshly squeezed juices and dried fruit compotes. Food should be taken in small quantities and often.

Below is a sample menu for 5 meals a day:

Breakfast - pumpkin porridge, wholemeal bread, a glass of kefir, 1 apple, 1 orange.
Second breakfast - 1 banana, 1 apple.
Lunch - pea soup, a piece of boiled low-fat fish, a piece of bread from second-class flour, dried fruit compote.
Snack - fat-free cottage cheese, kefir.
Dinner - boiled potatoes with boiled chicken breast, second-class bread, dried fruit compote, 1 orange.

In no case should you take alcoholic beverages and smoke. Sleep time should be between 8 and 12 hours. Do light exercise. It is also very useful for such a problem to eat more nuts, because they contribute to the normal functioning of the heart.

Possible complications and prognosis

In many cases, there are almost no complications with such a pathology.

From such an unusual structure of the heart, the following problems sometimes occur:

myocardial infarction;
stroke;
kidney infarction;
transient change in cerebral circulation.

All these complications occur due to paradoxical embolism. Although this is extremely rare, it is always the patient's responsibility to tell their healthcare provider that they have a patent foramen ovale.

Almost always, the prognosis for people with this diagnosis is not very scary, and ends completely without complications.

People with this pathology should always follow the following recommendations:

every year to be examined by a cardiologist;
pass an Echo-KG test;
do not engage in heavy sports;
exclude work associated with large respiratory, cardiological loads, for example, divers, firefighters, astronauts, pilots, etc.

Surgery is performed only in the most urgent situations, during marked changes in the performance of the cardiovascular and respiratory systems.

And in conclusion, we can add that an unclosed oval window is a pathology that does not bring much harm to health, unless there is a risk of heart disease or some other heart disease. It depends on numerous factors.

Article publication date: 02/10/2017

Article last updated: 12/18/2018

From this article you will learn: in which cases an open oval window in the heart of a child is a variant of the norm, and in which cases it is a heart defect. What happens with this condition, can it be in an adult. Methods of treatment and prognosis.

The foramen ovale is a canal (hole, passage) in the region of the interatrial septum of the heart, providing unilateral communication between the cavity of the right atrium and the left. It is a vital intrauterine structure for the fetus, but after birth it must be closed (overgrown), as it becomes unnecessary.

If overgrowth does not occur, this condition is called an open oval window. As a result, oxygen-poor venous blood continues to be discharged from the right atrium into the cavity of the left. It does not enter the lungs, where it must be thrown out from the right half of the heart to saturate it with oxygen, but immediately, having got into the left parts of the heart, it spreads throughout the body. This leads to oxygen starvation - hypoxia.

Staying open after birth is the only violation of the oval window. But not in all cases this is regarded as a pathology (disease):

Normally, in all newborns, the window is open and can function periodically.
Overgrowth occurs gradually, but individually for each child. Normally, in children older than a year, this channel should be closed.
The presence of a small open area of the oval window in children aged 1–2 years is 50%. If at the same time there are no manifestations of the disease, this is a variant of the norm.
If a child has symptoms in the first year of life, and if the oval window functions in children older than 2 years, this is a pathology - a small anomaly in the development of the heart.
For adults and children over 2 years of age, the window must be closed. But under certain circumstances, at any age, it can open, even if overgrown in the first year of life - this is always a pathology.

This problem is curable. The treatment is carried out by cardiologists and cardiac surgeons.

What is an open oval window for?

The heart of a fetus in the womb beats regularly and provides blood circulation to all organs except the lungs. Oxygenated blood flows to the fetus from the placenta through the umbilical cord. The lungs do not function, and the underdeveloped vascular system in them does not correspond to the formed heart. Therefore, the circulation of blood in the fetus occurs bypassing the lungs.

For this, the oval window is intended, which dumps blood from the cavity of the right atrium into the cavity of the left, which ensures its circulation without entering the pulmonary arteries. Its peculiarity is that the hole in the septum between the atria is covered by a valve from the side of the left atrium. Therefore, the oval window is able to provide only one-way connection between them - only the right with the left.

Intrauterine circulation in the fetus occurs according to the following scheme:

Oxygenated blood flows through the umbilical vessels into the venous system of the fetus.
Through the venous vessels, blood enters the cavity of the right atrium, which has two exits: through the tricuspid valve into the right ventricle and through the foramen ovale (hole in the septum between the atria) into the left atrium. The vessels of the lungs are closed.
The increase in pressure during contraction pushes back the valve of the oval window, and part of the blood is dumped into the left atrium.
From it, blood enters the left ventricle, which ensures its advancement into the aorta and all arteries.
Through the veins connected to the umbilical cord, blood enters the placenta, where it mixes with the mother.

The oval window is an important structure that provides blood circulation to the fetus in the prenatal period. But after the birth of a child, it should not function and gradually overgrow.

Possible development of pathology

By the time of birth, the lungs of the fetus are well developed. As soon as a newborn baby takes the first breath and they are filled with oxygen, the pulmonary vessels open and blood circulation starts. From that moment on, the baby's blood is saturated with oxygen in the lungs. Consequently, the oval window becomes an unnecessary formation, which means it must overgrow (close).

When this happens - the process of overgrowing

The process of closing the oval window proceeds gradually. In every newborn, it can periodically or constantly function. But due to the fact that after birth the pressure in the left cavities of the heart is much higher than in the right ones, the window valve closes the entrance to it, and all the blood remains in the right atrium.

Children of the first year of life

The smaller the child, the more often the oval window is open - about 50% of children under one year old. This is an acceptable phenomenon and is associated with the initial degree of development of the lungs and their vessels at the time of birth. As the child grows, they expand, which helps to reduce pressure in the right atrium. The lower it is compared to the left one, the tighter the valve will be pressed, which should firmly fix (grow with the walls of the window) in this position for life.

Children of the second year of life

It happens that the oval window only partially closes (1-3 mm remains) by 12 months (15-20%). If such children develop normally and have no complaints, this is not considered abnormal, but requires observation, and by two years it should completely close. Otherwise, it is regarded as a pathology.

adults

Normally, in children older than two years and in adults, the foramen ovale should be closed. But in 20% it either never overgrows, or re-opens throughout life (and then it is from 4 to 15 mm.

Six reasons for the problem

Six main reasons why the foramen ovale does not close or open:

Harmful effects on the fetus (radiation, toxic substances, medications, intrauterine hypoxia and other complicated variants of the course of pregnancy).
Genetic predisposition (heredity).
Prematurity.
Underdevelopment (dysplasia) of connective tissue and heart defects.
Severe broncho-pulmonary diseases and pulmonary embolism.
Constant physical exertion (for example, crying or coughing for young children, strenuous exercise and sports for adults).

Pathological signs and symptoms

The discharge of oxygen-poor blood through the open oval window in the heart leads to oxygen starvation in all organs and tissues - to hypoxia. The larger the diameter of the defect, the greater the reset and the stronger the hypoxia. This can cause the following symptoms and manifestations:

About 70% of people with an open channel have no complaints. This is due to the small size of the defect (less than 3–4 mm).

How the problem is diagnosed

Diagnosis of pathology - ultrasound of the heart (echocardiography). It is better to perform it in two modes: standard and Doppler mapping. The method allows to determine the size of the defect and the nature of circulatory disorders.

Image of a large open foramen ovale during an ultrasound of the heart. Click on photo to enlarge

Treatment

In deciding whether treatment is necessary and choosing the optimal method, two factors are taken into account:

Are there any symptoms or complications?

if yes, an operation is indicated, regardless of the size of the defect;
if not, treatment is not required in both children and adults.

What are the dimensions of the defect and the magnitude of the discharge of blood according to echocardiography: if they are pronounced (more than 4 mm in a child) or there are signs of cerebral blood flow disorders in adults, an operation is indicated.

The oval window is easily closed with the help, which is performed without a single incision through the puncture of one of the large arteries.

Endovascular surgery to close the foramen ovale in the heart

Forecast

The asymptomatic course of an open oval window in adults and children does not pose any threats and restrictions in 90–95%. In 5–10% of cases, when unfavorable circumstances are added to this anomaly (diseases of the lungs, heart, hard work), a gradual increase in the defect is possible, resulting in clinical manifestations and complications. Operated patients recover in 99%. All adults and children with an open foramen ovale should visit a cardiologist once a year and undergo an ultrasound of the heart.

Why does it appear?

At the birth of a child, the lungs expand, pulmonary blood flow increases, pressure in the left atrium increases and contributes to the closure of the foramen ovale. Physiological closure does not occur with prematurity, alcoholic embryopathy, connective tissue dysplasia.

According to some assumptions, the reasons for abnormal development may be the use of alcohol by a woman during pregnancy, as well as smoking, ecology, drug use, heredity, fetal malformations.

An open oval window in the heart is diagnosed in adults and children by the results of an ECG, X-ray, contrast echocardiography, or by listening to rhythms with a phonendoscope.

Signs and symptoms

There are practically no specific manifestations in adults. The doctor can only suspect that the patient has this disease. An adult may complain of severe headaches, but not everyone has them. Most often, the disease is detected incidentally during other examinations or when complications occur.

But there are symptoms of an open oval window, according to which a preliminary diagnosis is established:

Blueness with coughing, physical exertion of the nasolabial triangle or lips (cyanosis);
Predisposition to acute respiratory infections and respiratory diseases (frequent bronchitis, pneumonia, asthma);
Unexplained fainting, thrombophlebitis, varicose veins, cerebrovascular accident;
physical intolerance. stress, respiratory failure, discomfort;
palpitations, shortness of breath, headaches (migraines);
The mobility of body parts is impaired, periodic numbness of the limbs;
The ECG shows changes in the right atrium;
Increased blood volume in the lungs.

What is dangerous?

Usually, an open foramen ovale in the heart in adults does not affect their activity or life expectancy. But it is dangerous during pregnancy, as well as for people with varicose veins, pulmonary diseases, thrombophlebitis.

Due to PFO, the risk of blood clots in the heart increases and the likelihood of some complications increases:

Stroke. With this severe disease, parts of the brain die;
Myocardial infarction. With such a violation of the work of the heart, a section of muscle tissue dies;
Kidney infarction. Due to a violation of the blood supply, a part of the kidney dies;
Violation of the blood supply to the brain. A person’s speech and memory are disturbed, hands and feet go numb, mobility and other symptoms are disturbed, which last no more than a day, then disappear without a trace.

Any treatment for an open foramen ovale will not reduce the risk of these complications.

How to treat?

In most cases, treatment of an open foramen ovale is not required. According to statistics, 10-15% of people live with an LLC and do not experience any inconvenience. When symptoms of an open foramen ovale do not appear, then no treatment is prescribed.

If complications of the disease appear, then drugs are prescribed that prevent thrombosis in the heart or blood vessels.

In case of reaching a significant size of the hole, surgical intervention is possible. Usually, grafts are inserted to close it - permanent "patches". But they can cause tissue inflammation. Relatively recently, they began to use an absorbable patch. Although it is a temporary “patch”, which resolves in a month, it effectively stimulates tissue repair. Thus, the hole is completely overgrown.

Cardiology. oval window

The open foramen ovale in the heart is located between the atria. This small hole during embryonic development takes part in the blood circulation of the fetus. At its core, the oval window in the heart is an adaptive-physiological mechanism. Due to the inactivity of the lungs, there is no need for a large blood supply to them; oxygen-enriched blood penetrates to the fetus through the placenta.

An open hole between the atria allows you to bypass the small (pulmonary) circle. This process is called "shunting". In addition, blood circulation along this path contributes to the direct flow of enriched blood to the brain, which is actively developing in the embryonic period.

As a rule, the oval window closes after birth. This is due to increased pressure (arterial) in the left side of the heart.

It should be noted that all newborns are always born with an open foramen ovale. As practice shows, normally, the hole closes during the first months. However, about 15-20% of patients survive to the age of forty with an open foramen ovale. This indicator is associated with some features in the structure of the hole itself. The fact is that the oval window has a sash, which is covered in the process of contraction in the left atrium. Thus, the penetration of blood into the right atrium is prevented.

But in some situations associated with an increase in pressure in the chest against the background of physical stress (during the act of defecation, sneezing, coughing and other stress), the sash opens. Some structural defects of the septum, as well as the size of the oval window itself, also contribute to the preservation of the open hole.

As observations show, shunting from left to right of blood from the atrium of the left to the right is not accompanied by any signs indicating its presence, thus proceeding asymptomatically. Along with this, the ejection of blood in the opposite direction (from the right to the left atrium) can provoke permanent or transient symptoms of cyanosis. As a rule, this condition is caused by an increase in the vascular resistance of the pulmonary artery system against the background of an apnea attack, breath holding, screaming and other stresses. In connection with the pathological release of blood into the left atrium, throughout the newborn age, constant cyanosis (bluish coloration of skin and mucous membranes) may persist. The condition is eliminated after the start of a decrease in resistance in the artery of the lungs.

A foramen ovale that closes prematurely can cause various malformations. So, early closing of the hole may be accompanied by a disorder in the development of the left half of the heart, the occurrence of hypoplasia in these parts of it.

An enlarged foramen ovale can provoke the formation of a paradoxical embolism, accompanied by signs of a transient attack (ischemic) or stroke. According to studies, an open window increases the likelihood of ischemic stroke by about 40%.

Signs of an open window in the heart also include paroxysmal migraine headache. Today, the mechanism of development of such a state against the background of an unclosed hole has not yet been sufficiently studied. Most often, the occurrence of pain is explained by microembolization in the brain with blood clots (small blood clots), as well as the influence of substances that form in the vein system and penetrate directly into the vessels of the brain.

Rarely, in the presence of an open hole in the heart, orthodeoxia platypnea syndrome can develop. This condition is characterized by a decrease in saturation (saturation) of blood with oxygen in the vertical position of the body, accompanied by shortness of breath.

What parents of children with congenital heart disease and other diseases of the cardiovascular system need to know

What is the danger of an open Oval Window?

Open oval window is a normal element of the structure hearts which is a mandatory element fetal cardiovascular system(the fetus is a period of development of the future child from the formation of the placenta to birth, that is, this is the period when the child is in the womb). OOO necessary in order to reduce blood flow to the non-working lungs in the prenatal period and transfer part of the blood to blood vessels to other organs and tissues. In this article, we will try to find out why it is dangerous to have an open oval window after birth and, in general, Is LLC a heart defect?

After the baby is born and takes its first breath, the lungs expand and begin to work. pulmonary circulation. In this case open oval window will interfere with normal blood circulation through the pulmonary system. Therefore, nature provided for its cover with a special fold, which gradually grows, closing oval window tightly. If it is not tightly closed, its presence is recognized by the noise that is heard in heart. and on ultrasound, the doctor finds the window open. This situation can be considered as minor anomaly of heart development. it is important that after three months in healthy full-term mature children with normal development oval window closes and the noise disappears.

If open oval window is not accompanied by other signs of heart failure, then you should not worry about this. It is only necessary to periodically monitor the child's condition by a pediatrician and pediatric cardiologist and regular echocardiography. the multiplicity of which will be determined for each individual child by a specialist. But if a child develops shortness of breath and palpitations during feeding, a sharp pallor of the skin, or, conversely, cyanosis(bluish discoloration of the skin), the child does not eat well, does not gain enough weight - an urgent need to seek help from a pediatric cardiologist: in this case, an in-depth examination, clarification of the diagnosis and exclusion will be required congenital heart disease .

One of the serious complications that can occur in case of non-closure of the open oval window is the so-called paradoxical embolism. The essence of this phenomenon is that emboli(small foreign particles, blood clots, bacteria or gas bubbles) coming from the venous system or arising directly in the right atrium can penetrate the left heart, and then the systemic circulation. If in the future emboli get into the vessels that feed the brain, then a stroke or a bacterial complication may occur. That is why it is very important to conduct a thorough examination in a timely manner upon detection Open Oval Window .