home Audience 1 Functioning foramen ovale in the heart of a newborn. Open oval window in children - basics of interaction

Functioning foramen ovale in the heart of a newborn. Open oval window in children - basics of interaction

When you hear from a doctor that a recently born baby is not doing well with his heart, you feel uneasy. Cardiac malformations are common, but not all of them are life-threatening or require surgical intervention. An example of this is open oval window in newborns. What is this window? When is there cause for concern? And is it possible to perform heart surgery without making a single cut? This is what our article is about.

The role of the oval window

The oval window acts as a door in the interatrial septum, through which blood is discharged from right to left in the area of the atria. This is necessary because the fetal lungs do not yet participate in the blood circulation properly. Therefore, thanks to the oval window (an opening with a valve), blood from the vena cava immediately enters big circle blood circulation

So at birth, all babies have the oval window open for completely physiological reasons. But over time it should become overgrown. When?

How does closure occur and when?

As soon as a newborn is born, the pulmonary circulation starts, the lungs begin to function fully, producing gas exchange, and there is no longer a need for open communication between the atria. In the left atrium, pressure dominates in relation to the right, due to which the valve closes and the oval window gradually closes.

The “window” in the cardiac septum is not yet born child simply necessary to maintain normal blood circulation in intrauterine life

Ideally, complete closure is observed at 3 months after birth. For some reasons, the overgrowth of the valve may last longer, up to 2 years of age, but doctors assure that there is no need to sound the alarm: this is also the norm.

If there is no closure

But what to do if the window has not closed, and by the age of 5-10 years the doctor announces: “the oval window is open”? In a child, the hole may not close tightly due to the structural features of the valve: genetically, it may be smaller than usual. This happens in premature babies and in those who have been diagnosed with intrauterine developmental pathologies.

A defect such as a patent foramen ovale in newborns does not refer to heart defects, but to minor anomalies of cardiac development (abbreviated MARS). This means that the existing damage does not pose a major threat. People live for years without even suspecting that something is wrong with their hearts.

Another problematic situation is a completely open foramen ovale, when the valve between the atria does not perform its functions at all. This pathology is called atrial septal defect.

If a diagnosis has been made, from the age of 3 the child is assigned health group II, and young men of military age are given fitness category “B”, which means limited suitability for military service.

Symptoms

Often the defect has no obvious clinical symptoms, and the person is accidentally surprised to learn about the problem during a routine examination. But sometimes the following symptoms may appear:

blue discoloration of the so-called nasolabial triangle, which appears during coughing, heavy bowel movements, or when the baby screams for a long time; in the normal state, the blue tones disappear;
the child often suffers from colds and respiratory diseases;
murmurs are heard during auscultation of the lungs and heart;
rapid heartbeat, shortness of breath;
the baby is not gaining weight well and does not have a good appetite;
in older children, the disease may manifest itself in rapid fatigue during physical training or additional stress; characteristic frequent dizziness up to loss of consciousness.

Diagnostics

A comprehensive examination is necessary when the above symptoms have been noticed and the diagnosis needs to be clarified. Ultrasound examination of the heart is considered the most informative.

During an ultrasound, the valve is visible in the left atrium, located in the area of the fossa ovale. The dimensions of the hole range from 2 to 5 mm, the walls of the interatrial septum are thinned (this is different from a septal defect, in which the valve is not visible and the walls are thicker than usual).

Ultrasound of the heart allows you not only to see the hole, but also to determine its size

Echocardiography allows you to assess how much blood is moving in the wrong direction, what is the additional load on the heart and whether there are additional pathologies (in many cases, in addition to the open foramen ovale, a number of concomitant cardiac anomalies are found, which complicates treatment).

In some cases, they may suggest echocardiography through the esophagus or with bubble contrast. In the latter case, shaken saline solution is injected through special catheters inserted into the cubital vein. If the bubbles immediately flow from the right atrium to the left, then the oval window is open.

Using X-ray chest assess the boundaries of the heart and the thickness of the great vessels.

Treatment: is surgery necessary?

We found out that the baby has OOO - absolutely normal phenomenon, and up to 2 years, it is enough to be observed by a cardiologist and have an echocardiogram done every year. In principle, a person can live with such a defect all his life. If no concomitant cardiac anomalies were found, there is no severity of symptoms of cyanosis, there are no chronic diseases lungs and venous system, and the size of the hole is small, nothing can be done.

To avoid complications, growing children with a similar diagnosis are prohibited from engaging in sports that involve stress on the cardiovascular and respiratory system: weightlifting, scuba diving, etc.

On the other hand, in adulthood, difficulties may arise in women during pregnancy, in persons prone to increased thrombus formation, as well as in the development pulmonary insufficiency in severe form.

The greatest risk to life is posed by paradoxical embolism - a condition when emboli penetrate through the LLC into the left atrium, and then into the systemic circulation. Traveling through the vessels towards the brain, they provoke the development of ischemic and cardioembolic stroke. Sadly, young people aged 30-40 years become victims of embolism, and the process itself begins suddenly.

For reference. An embolus is any foreign substance or particle found in solid, liquid or gaseous form in the bloodstream that can cause blockage of a vessel. It can be a detached blood clot or part of it, drops of fat or cholesterol, air bubbles, etc.

Due to the seriousness of complications, each case of unclosed open window should be examined individually by a good cardiologist, or preferably several, in order to determine whether surgery is necessary in a particular case or not.

And finally, there are situations when surgery is a direct indication: the large size of the oval window, the absence of a valve, which regards the anomaly as an atrial septal defect, or a person who has suffered a stroke. How is surgery performed?

Operation: what is the point?

All manipulations are performed using the endovascular method (also called transcatheter closure). A catheter is installed on the right thigh, through which an occluder - an umbrella-like device on both sides - is delivered to the heart through the vessels using special instruments. Once the occluder is opened, the hole is securely plugged and the problem disappears.

The introduction of an occluder into the heart cavity blocks the blood communication between the atria, as if “patching” the hole

The advantage of such interventions is obvious: there is no need to cut the chest, stop the heart, resort to artificial circulation, or use deep anesthesia.

For a child who has undergone surgery in the first 6 months, antibiotic therapy is prescribed to prevent bacterial endocarditis.

So, an open oval window found in newborns is not a cause for alarm at all. If the window has not closed after 2-5 years, it is necessary to observe and consult a cardiologist. Discussions about what is “normal” and what is “pathology” are still ongoing. Therefore, each case will be individual. However, most situations are not life-threatening and do not require treatment.

Congenital heart disease (CHD) is a developmental abnormality of the heart that develops between 2 and 8 weeks of pregnancy. According to statistics, heart disease in newborns occurs in 5-8 cases out of 1000.

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One of the most common cardiac defects is patent foramen ovale (PFO), a minor anomaly in which communication between the right and left atria is partially or completely preserved. As a matter of fact, such a hole in the heart is necessary for the full development of the fetus, therefore all newborns are born with it, and during the first year of life, sometimes several years, it closes up.

However, it happens that the hole does not close. Depending on its size, the degree of disruption of the circulatory process depends. If the opening is too large and there is no connecting valve between the atria, an atrial septal defect occurs.

In addition to this vice, there are many others, including:

open ductus arteriosus(AOP) in newborns, in which oxygenated blood enters the lungs;
defect of the aortopulmonary trunk - incomplete fusion of the septum between the aorta and the pulmonary trunk;
defect interventricular septum(VSD) - the opening that separates the right and left ventricles;
coarctation (narrowing) of the aorta;
stenosis (narrowing) of the pulmonary or aortic valves.

The cause of the disease is improper development of the organ inside the womb.

It is important to note that in many cases, heart defects do not appear individually, but together. For example, the most common reason cyanosis in a newborn – tetralogy of Fallot, combining VSD, aortic displacement and ventricular hypertrophy.

Causes of cardiac abnormalities

The nature of the disease remains unclear today, however, doctors highlight following reasons UPS:

genetic predisposition, i.e., a history of congenital defects in the baby’s relatives;
chromosomal disorders;
gene mutations;
infectious and viral diseases suffered by a woman in the first trimester of pregnancy;
unhealthy lifestyle (drug addiction, smoking, alcoholism);
taking certain medications during pregnancy ( anticonvulsants, amphetamines, antibiotics);
external factors (exposure to radiation).

The father's health is of no small importance. Risk factors also include:

late pregnancy;
endocrine diseases in parents;
severe pregnancy and threat of miscarriage in the first trimester;
history of stillbirths.

According to latest research, children of women suffering from obesity have an increased risk of being born with congenital heart disease and other pathologies of the heart and blood vessels.

Pathology is congenital or acquired changes in the structures of the heart

Clinical manifestations and diagnostic methods

Congenital heart disease in newborns has different signs. They depend on the type of pathology and how it affects the health of the newborn.

A patent foramen ovale may for a long time not to express oneself in any way without causing any concern to the parents. If the hole is not closed and the size of the hole is significant, difficulties with breathing, pale skin or cyanosis appear, and there is a delay physical development.

With more severe defects, parents immediately notice that something is wrong with the child. The most common symptoms of heart defects are.

Cyanosis is a bluish discoloration of the skin that develops due to a lack of oxygen in the blood. Depending on the type of congenital heart disease, it may only turn blue nasolabial triangle, as well as limbs and even the whole body.
Dyspnea. It is observed not only during activity, but also when the child is inactive.
Heart rhythm disturbances. The most common symptom of heart defects is rapid heartbeat, tachycardia. But with some defects, a decreased pulse and bradycardia also occur.
Other symptoms include a general weak condition of the child, lack of appetite, drowsiness, and crying out in sleep. In severe pathologies, lack of air and loss of consciousness are possible.

A cardiac surgeon diagnoses defects. If there is a suspicious heart murmur in a newborn, he will certainly undergo an ultrasound examination. Ultrasound of the heart (echocardiography) allows you to examine the condition of the valves and muscles of the heart.

As additional methods diagnostics are used:

X-ray examination, including using contrast agent(ventriculography);
electrocardiogram (ECG), as well as its varieties (treadmill test, bicycle ergometry).

Dr. Komarovsky recommends undergoing a thorough examination if suspicious heart murmurs do not go away within 3-4 days after the birth of the child, and bluish skin, pale and cold extremities are also observed.

Why is LLC dangerous?

Under normal conditions, the oval window usually closes between 2 and 12 months after the baby is born.

For a long time, this defect was considered by doctors to be quite safe, with which people could live full life and even actively engage in sports. Today, doctors' opinions are divided. We can definitely say that children with foramen ovale and heart murmurs need careful medical supervision.

One of the most dangerous complications, which can occur with patent oval window, is a paradoxical embolism, accompanied increased risk blood clots, stroke or bacterial diseases.

It is important to note that often a patent foramen ovale is combined with another defect - cardiac aneurysm in newborns, and this is fraught with the risk of developing cardioembolic complications.

Thus, children with congenital heart disease require special attention and careful care. They are contraindicated in certain sports:

scuba diving;
weightlifting;
diving to great depths;
other exercises that involve holding your breath or straining.

Treatment of heart disease

The treatment method for congenital heart disease depends on its severity. If the child, in addition to the LLC, has no other anomalies, the hole does not exceed 5 mm, there is no significant circulatory disorder, his state of health does not cause concern.

A pediatric cardiologist will help in treating the disease

Mostly over time, the size of the oval ring decreases. To reduce the risk of blood clots, you may be prescribed anticoagulants - blood thinning drugs.

At large size Foramen ovale (7-10 mm) should be considered an atrial septal defect. Such holes are called “gaping”; in this case, the issue of carrying out surgical removal anomalies.

Modern surgery OOO involves inserting a special tube (catheter) into the artery, at the end of which there is a valve that completely occludes the oval window. Find out what causes blood clots after childbirth

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Attention!

The information published on the website is for informational purposes only and is intended for informational purposes only. Site visitors should not use them as medical recommendations! The site editors do not recommend self-medication. Determining the diagnosis and choosing a treatment method remains the exclusive prerogative of your attending physician! Remember that only full diagnostics and therapy under the supervision of a doctor will help you completely get rid of the disease!

All questions regarding the structure of the baby’s heart raise many questions and fears among parents, because the heart is the basis of life, along with the brain, and if there is a defect in it, even a small one, this greatly frightens parents. Often, after an ultrasound examination of the heart in conclusion, the doctor writes a diagnosis of “patent foramen ovale or oval”, and parents believe that the child has a heart defect, panic and begin to frantically run to doctors and search through the groans of information. Today, on average, up to 70% of babies receive such a conclusion in the first month of life, but what is this window and why is it open?

Fetal circulation
During gestation, the cardiovascular system develops early, the heart is formed already at three weeks, and at five or six it is clearly visible on ultrasound due to its rhythmic contractions. Of course, it is still developing and forming, but it already copes with its main function, driving blood through the vessels. In the prenatal period, the blood circulation of the fetus is special, since the lungs are turned off because they do not breathe. In addition, the blood circulation of the fetus is closely connected with the vessels of the placenta and mother, although they do not mix and each has its own blood. To provide oxygen to the growing brain and body, but to carry out blood circulation without the participation of the lungs (while their function is performed by the placenta), you need special structure hearts.

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Therefore, the blood in the heart passes through bypass routes, bypassing the pulmonary circulation, and therefore there are several additional openings in it - the ductus ductus and the oval window. Blood flows from the heart through the duct, bypassing pulmonary vessels into the aorta, and through the oval window it is discharged from the right atrium to the left, again due to the fact that the lungs are turned off from breathing. If this hole did not exist, the right parts of the heart would be overloaded and the child would not be able to survive in the womb. Blood from the right parts of the heart nourishes the brain and head area, giving them the opportunity to grow and develop, while the left parts “feed” the rest of the body.

At the birth of a baby, the child’s blood circulation fundamentally and dramatically changes, the ductus ductus and the open oval window lose their relevance, therefore, they must become obliterated (in other words, close) and the blood circulation will be rebuilt to a new, already “adult” type. This occurs due to the expansion of the lungs, breathing, the first cry and the activation of the system of pulmonary veins and pulmonary arteries. Do you remember that in the lungs everything is the other way around - through the veins blood comes from the lungs, and it is arterial, and the pulmonary artery collects from the whole body venous blood and enriches it with oxygen in the lungs. Due to changes in pressure in the left atrium, the oval window is closed with a special valve like a door and the edges of the valve adhere tightly to the hole.

Usually this happens in the first day of life, functional closure occurs - that is, the door closes, but its complete overgrowth and the formation of a full-fledged interatrial septum occurs in different time– from two months to a year. Sometimes this happens longer, up to two to five years. This is quite normal. However, not all children have a window that closes completely on the first day of birth. It may turn out to be slightly larger than the valve, it may not fit tightly, which is why this peculiar defect is formed - an open oval window.

Reasons for the formation of LLC.
Underdevelopment of the valve and an open oval window occurs most often in premature babies, but it can also occur in full-term babies. Reasons this phenomenon consider disturbances during pregnancy - threats of miscarriage, toxicosis, fetal hypoxia. In addition, the risk of getting OOO is higher in women who smoke and took alcohol before pregnancy. In addition, the development of an open window is also facilitated by unfavorable ecology, stress during pregnancy, and the influence of heredity.

As a result, the normal development of the valve in the area of the oval window is disrupted; it does not have time to grow to the size of the oval window, and as a result, at the moment the baby takes his first breath and his pulmonary circulation begins to function, he is simply unable to cover the hole completely. However, an open oval window also occurs with more serious problems rather than just a functional defect. Sometimes, with diseases that overload the right chambers of the heart, the window will not close to alleviate the condition - it acts as a relief hole, due to which part of the blood is removed and reduces the pressure in the chamber. This occurs with the development of primary (as a heart defect) or secondary (as a result of disease) pulmonary hypertension, with stenosis pulmonary artery(this is a heart defect), with anomalous structure pulmonary veins or heart valve defects. These are all cardiac supports in which a patent foramen ovale occurs.

How does this condition manifest itself?
For small size defects, this is quite ordinary child and no vice this state is not considered, therefore it will not have any manifestations. OOO is detected during routine ultrasound examinations, which are provided to all children under one year of age as part of the birth certificate. However, with sufficiently large defects, there are some small symptoms that give the doctor the right to suspect this defect. These include:

Cyanosis of the nasolabial triangle or lips with strong crying, screaming, physical exertion or activity. When alone, it disappears and the child behaves as usual.
- frequent colds, frequent pneumonia or bronchitis.
- some slowdown in the rate of mental or physical development compared to peers.
- listening to a heart murmur
- systematic attacks of loss of consciousness, manifestation of symptoms of cerebrovascular accident
- inability to exercise, fatigue, development of a feeling of shortness of breath.
The last three signs occur when the defects are quite large. If the doctor suspects that the child has an unclosed oval window, he will send him for a consultation with a cardiologist and an ultrasound.

What do we have to do?
When making a diagnosis of “patent foramen ovale”, it is necessary to resolve the issue of further actions parents, pediatrician and possibly a cardiologist. First of all, defects up to 4-5 mm in size should not cause any concern, since they generally close quickly and easily in the first months of life. They only require observation by a cardiologist and periodic ultrasound examinations. Parents will simply observe the well-being and condition of the baby and the pace of its development; usually all this goes well and does not require intervention at all.

With larger window sizes, approximately once every six months to a year you will undergo a heart ultrasound to determine the size of the defect. If it tends to decrease, the doctor will also suggest that you wait and do nothing; the likelihood of spontaneous healing of the defect is very high. In addition, the pressure in the area of the left atrium is always higher than in the right and blood through the open oval window simply will not flow into the area more high pressure, and the valve will be pressed tightly, plus due to muscle contractions of the walls, the defect will decrease. Therefore, for defects of five to seven millimeters, only active monitoring of the defect is necessary.

At the same time, in newborns and children, the defect will appear only when straining, anxiety, when blood pressure in the right side of the heart increases. In older children this may occur when severe cough, exercises with straining and holding your breath, diving. Therefore, most likely the doctor will not allow such a child to swim, engage in weightlifting, or choose professions related to extreme sports - diver, pilot, miner.

If the size of the defect is more than 7-10 mm, disorders typical of a heart defect may appear - ASD - atrial septal defect. Such an open oval window is called gaping. Then the child must be consulted with a cardiac surgeon and decide on surgery to correct the septum. A catheter with a special plate, an occluder, is inserted through the femoral vein; it closes and welds the hole.

Most great danger oval window is the possibility of developing a paradoxical embolism in it - through the defect, the embolus penetrates into an unusual area - the vessels of the head. Fortunately this rarely happens.

So, conclusions.
The diagnosis of “ooo” is not a heart defect, its size is up to 7 mm and it does not require heart surgery. It does not disrupt the child’s life and does not affect his health, provided normal image life without extreme sports such as climbing Everest or scuba diving for six months.
The defect is permissible up to two years; in 90% it closes in the first months of life. However, in some children it can persist for up to five years, without affecting growth and development in any way. Children at OOO lead a normal child’s life, there is no need to fuss over them and blow off specks of dust from them, but you shouldn’t give them to three sections at once either - it is necessary to dose the loads and not overload the baby.

Ooo demands regular checkups and ultrasound, but it is enough to conduct them once every six months; it is not advisable to do an ultrasound more often - this is extra stress for the child and the results are not indicative.

Nowadays, quite often, during the first examination, parents may be informed that an open foramen ovale has been detected in the child’s heart. Initially, the fetus has such a hole between the atria in the womb in order to ensure normal blood supply.

Usually, before it is born, it should be completely overgrown, since it is simply no longer needed. Let's figure it out: an open oval window in children is a really serious pathology or just one of the structural features of the body.

heart diagram with LLC

The interatrial septum in humans performs important function– it prevents blood from mixing with each other. But in newborn children, this septum is not always a complete structure. Initially, this is necessary for better oxygen enrichment of the brain, but in in good condition in a newborn, the hole should already be completely closed. At the moment of the first cry, the pressure in the lungs increases and the valve completely closes the window.

Up to 5 years it completely fuses with the walls, but in some cases it may be too small in size to completely close the hole. But do not confuse LLC with a septal defect - these are completely different things. A septal defect is a much more complex pathology, which is a heart defect. In this case, then it is worth saying that the valve completely fails to cope with its functions.

At the same time, it is worth understanding that closing the “window” in a child’s heart is individual for each baby and therefore it is impossible to clearly determine the standard period when exactly the valve should grow to the walls.

For some babies this happens at one, two, three, five years - it all depends on individual characteristics body. Ideally, closure of the oval window in the heart of a newborn occurs in the first 3 months after the birth of the baby.

Hole dimensions

Further prognosis, as well as the need for surgery, directly depends on the size of the opening of the open oval window in children:

2-3mm - with such a deviation from the norm, no serious consequences cannot be and therefore there is no need for any treatment;
small size – 5-7mm. In this situation, everything depends on the accompanying provoking factors;
more than 7mm ( maximum size– 19mm) – gaping hole. Requires surgery;

Statistics show that in adults, large openings of the oval window in the heart are very rare. This indicates that there is no reason to panic.

Causes

In medicine, it is customary to identify a number of main provoking factors that can cause the problem of an open oval window in an infant.

These include:

genetic predisposition. This is the most common cause of this problem. Maternal predisposition is especially common;
frequent stress during pregnancy;
birth of a baby prematurely;
exposure to negative environmental factors on the pregnant woman’s body;
taking alcohol, drugs, illegal drugs, smoking.

Symptoms of the disease

Often, a patent foramen ovale in newborns can be detected during a routine examination. But sometimes a number of basic symptoms may indicate pathology:

blueness around the mouth (cyanosis of the nasolabial triangle). Blue discoloration often appears when coughing, crying, screaming and disappears during periods of rest;
fatigue, lethargy. This symptomatology is especially acute during intense physical activity;
dizziness, loss of consciousness;
poor body resistance to viral infections. Frequent colds;
rapid heartbeat, shortness of breath;
disturbed heartbeat, heart murmurs;
poor weight gain.

Diagnosis of the disease

Usually, a doctor can make a preliminary diagnosis after examining the baby and listening to the heart. Next, to accurately establish the pathology, an ultrasound of the heart is necessary (an ultrasound will show that the walls of the septum between the atria are thinned). If additional heart defects can be diagnosed by ultrasound, then it is necessary to additionally conduct transesophageal echocardiography (the exact volume of blood that is moving in the wrong direction is established), as well as an angiographic study.

These studies are carried out only in a specialized cardiology hospital. Such examinations make it possible not only to confirm the diagnosis of an open oval window in a newborn, but also to establish the degree of risk for the baby and find out how much serious illness in this case. X-rays may also be needed to determine the boundaries of the heart and the thickness of the blood vessels.

Treatment method

Treatment of an open oval window in children directly depends on the size of the hole. If the hole does not exceed 3 mm, then usually no therapy is prescribed in this case. In a newborn, everything heals itself within a few months. The child is prescribed the usual restorative therapy (walks on fresh air, moderate physical activity, proper nutrition).

You should take your baby’s daily routine seriously, without overloading him not only physically, but also psychologically. The baby's diet should first of all include vegetables and fruits, as well as protein food. If any infections are detected, it is necessary to begin treatment as quickly as possible, since any advanced disease puts a lot of stress on the heart.

If the dimensions of the open oval window are more than 3 mm, then in this case you will need to do an ultrasound every six months to monitor the dynamics. Can also be assigned additional medications to improve the functioning of the heart muscle (panangin, analogues of L-carnitine (elcar)), vitamins. If there is a risk of blood clots, the doctor may additionally prescribe medications to thin the blood (anticoagulants).

The operation is indicated only in cases where the size of the open oval window in the child’s heart exceeds 7 mm, because of this the blood is thrown into the left side heart disease, which causes serious manifestations similar in severity to heart defects. In this case, only surgery is indicated to close the hole. In any case, it will not be possible to eliminate the problem with medication.

The surgical intervention involves inserting a special catheter through the artery. At the end of this catheter is special device, allowing you to close the hole.

It is possible to determine exactly whether an operation is needed or not only by considering each specific case separately. To do this, it is important for the cardiologist to assess the size of the window, the characteristics of the patient’s heart, as well as the presence of additional diseases. Only after this can a final decision be made about the need for surgery.

Now a type of operation developed by London scientists is also beginning to be practiced, in which a kind of plaster is applied to the hole, which dissolves within a month, but at the same time completely eliminates the pathology.

Features of the operation

IN given time surgical intervention is performed exclusively by the endovascular method.

Injected through the artery on the right thigh special catheter, at the end of which there is an occluder - a device in the form of an umbrella, which opens in the right place and reliably plugs the hole, thereby eliminating the pathology.

The advantage of this operation is that there is no need to open the chest, stop the heart and use deep anesthesia. After surgery, antibiotics may be prescribed to prevent bacterial endocarditis.

Additional reasons when surgical intervention is required in any case:

septal defect;
heart defects;
large hole size;
valve is missing.

These are those cases when surgery most likely cannot be avoided.

According to statistics, an LLC that continues after the age of five is likely to accompany a person throughout his life. Often the window in a child’s heart does not have any special symptoms and doesn't interfere at all normal life person. Therefore, if a child does not want to engage in intense sports in the future, then a window will not interfere with him in everyday life.

But in the future after 50 years, if available concomitant diseases, this can complicate the course of diseases such as hypertension, heart failure, and also worsen the prognosis for recovery after heart attacks and strokes.

If the oval window does not close in a timely manner, then this is still not considered a defect, but only a feature of the development of the heart. At the same time, people with this pathology are advised to limit physical activity. It is also necessary to visit a cardiologist every six months and do a routine ultrasound.

There is no cause for concern if the baby has no additional diseases(other heart defects, diseases of the pulmonary system, circulatory disorders).

This is due to the fact that an unclosed area of the septum can only bother you if there are other provoking factors.

Also, if you have this pathology, it is prohibited:

do weightlifting;
scuba diving;
dive on greater depth from the springboard.

Girls may also experience problems with their heart function during pregnancy in the future.

Possible complications

Rare complications of this pathology may also include embolism. Emboli are small particles of fatty tissue, blood clots or gas bubbles. Under normal conditions, they are absent from the bloodstream, but in the event of chest injuries, fractures, or other problems, they can enter the bloodstream.

If there is an LLC, then they can enter the brain vessels through the left atrium through the veins and, clogging them, lead to the development of strokes and cerebral infarctions.

Although this is a fairly rare problem, it still requires a long course of treatment in case of injury or planned operations It is necessary to warn the attending physician about this feature of the body.

Results and conclusions

To summarize, it is worth noting once again that prognosis and treatment methods directly depend on the presence of other provoking factors. Each case is individual and should be considered separately by a cardiologist.

But there is no particular cause for concern if there are no additional heart defects.

In most cases, this feature of the body is not a pathology and therefore does not require special treatment. Over time, the hole closes up on its own.

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With its appearance in medicine ultrasound diagnostics, young parents increasingly began to learn from doctors that the baby’s oval window remained open. Having heard such a diagnosis, you should not panic, because the baby reacts sharply to the mother’s emotions. All parents should be aware of what a patent foramen ovale in a child’s heart means, what symptoms the pathology causes, why it is dangerous and what are the ways to eliminate it.

The foramen ovale in some babies' hearts does not close with a valve after birth.

What is the 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 cry for the first time, the lungs open, the flow of blood to them increases, and the pressure in the left atrium becomes greater, and the oval window in the newborn’s heart is covered with a valve. Over time, it becomes firmly fused with interatrial septum. However important point is that each person’s body is individual and not everyone experiences this at the time of birth.

Many parents are scared similar phenomenon and they ask doctors when the oval window in the child’s heart will close. In reality, it prevents the blood circulation from functioning properly, so it must gradually close. This occurs through the growth of the valve to the edges of the interatrial septum.

Patent foramen ovale is an anomaly of the heart, 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 some after five years. This is absolutely normal, and if there are no other diseases associated with cardiovascular system, then there is no need to worry.

Sometimes it happens that the valve size is not enough to completely cover the gap. Under such circumstances, an open foramen ovale in the heart of an adult or 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, upon reaching 3 years of age, receive a second disability group.

The video explains what the oval window is in the heart of the fetus and newborn:

Why does the oval window not close?

An open foramen ovale in newborns is an absolutely natural phenomenon, since when a child develops in the mother’s womb, it is vitally necessary for him. However, if the functioning oval window has not closed 5 years after the birth of the child, it is worth thinking about. Let's consider why this pathology can occur:

most often this problem is hereditary, which is transmitted mainly from first-degree relatives;
if, while carrying a baby, a pregnant woman allowed herself to regularly drink alcohol or smoke frequently;
the problem can be caused by the poor environment in which a woman expecting a baby lives;
If, future mom ate incorrectly;

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

with regular stress and depressive states, in which a woman stayed while carrying a baby;
if there were toxic poisoning during pregnancy;
when a child is born ahead of schedule.

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

How does the deviation manifest itself?

Whatever disease a person faces, they all manifest themselves differently and cause certain symptoms; an open foramen ovale in the heart in children or adults is no exception. However, the severity of the symptoms depends on the size of the hole:

if the open oval window in the child’s heart 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 manifests itself as follows:

when a child cries, tenses or coughs, the nasolabial triangle, tip of the nose or fingertips may turn blue;
the skin of such children is paler than that of others who do not have pathologies;
Infants also experience increased heart rate.

Symptoms of the pathology depend on the size of the hole

In adults who have had this 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 severe physical activity;
in the presence of diseases associated with the lungs;
if there are any other heart pathologies.

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

systematic loss of consciousness occurs;
turns blue skin covering even in the absence of strong physical activity;
worries general weakness all over the body, dizzy;
the child may be very developmentally behind his peers.

The skin of babies with heart abnormalities is pale in color.

Diagnostic methods

During a standard examination, a cardiologist is not able to diagnose a patent foramen ovale in a child, because there is no heart murmur when listening. To diagnose pathology, the following procedures exist:

Echocardiography (ultrasound of the heart). Thanks to this study, the doctor is able to understand in which direction blood circulation occurs, how much blood flows between the right and left atria, and also determine the presence of other serious pathologies. These points are very important during diagnosis; with their help, the specialist understands what stage the disease is at and prescribes effective therapy.
Contrast echocardiography. This procedure shows whether there is a patent foramen ovale in the heart of a child or an adult. To identify the pathology, the patient is given intravenous 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 the other.

Ultrasound of the heart allows you to identify in detail abnormalities 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. The procedure also determines whether there are any complications such as inflammatory processes in the heart valves, blood clots or enlargement 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 is stagnant in the lungs.

How dangerous is the pathology?

An open foramen ovale in the heart of a newborn is diagnosed very often, and this is normal, but if it does not close after some time, 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 activities or life expectancy.

Heart abnormality caused by the formation of a patent window requires observation by a cardiologist

However, it should be remembered that a foramen ovale in the heart 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 parts of the brain, which can lead to a stroke.
Impaired functioning of the heart causes areas of muscle tissue to die, which can lead to myocardial infarction.
Due to impaired blood circulation, kidney cells may die - an organ infarction will occur.
If there are circulatory disorders in the brain, a person may have deformed speech, memory loss, numbness in the upper and lower lower limbs. Symptoms last for 24 hours, after which they disappear on their own.

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

If a child has complaints, he is prescribed medication.

Treatment methods

If a patent foramen ovale is diagnosed in the heart of an infant, then before the child turns 5 years old, no therapeutic therapy is not required, this is due to the fact that during this time it can close on its own. If this does not happen, and the pathology does not make itself felt in any way and does not interfere with the child’s normal development, then there is no need to treat the problem.

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

The condition is alleviated by anticoagulants. One of the most effective medicines in this group of drugs is Warfarin. If the patient takes 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.

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

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

Patients after surgery due to a large oval hole in the heart are forever freed from pathology

Prognosis for an open foramen ovale in the heart

A small functioning foramen ovale in newborns does not interfere with either social or work activities throughout their lives. However, people with this diagnosis need to avoid extreme sports, intense physical activity and professions that are associated with it.

Non-closure of the oval window large sizes requires surgical intervention. For six months after completion of the operation, in order to avoid bacterial endocarditis, patients are recommended to take antibiotics and regularly visit a cardiologist. However, after recovery period a person can continue to live without limiting himself in anything.