Atrial septal defect

August 12, 2017 17:51 | Genetic Diseases

Atrial septal defect - a communication between the atria.It is a fairly common congenital heart defect.The frequency of atrial septal defect in children during the first three years of life is 2.5%, over three years -11%.

Atrial septal defect can be isolated congenital heart disease or be a part of such vices as transposition of the great vessels, total anomalous pulmonary venous disease Ebstein et al. The defect size is from 2-4 to 15-17 mm.

With a small atrial septal defect due to higher pressure in the left atrium has a discharge of blood to the right.This oxygen-rich blood is discharged into the venous bed, which leads to an overflow of the pulmonary circulation and the expansion of the right ventricular cavity.For large atrial septal defect size and direction of the blood discharge are determined not so much by the pressure difference in the atria as a relative elongation of both ventricles during diastole (rest period), a pressure ratio in their cavities during this period.The children of the fir

st months of life the ability to stretch both ventricles determined by the thickness of their walls, which is the same or nearly the same, resulting in a discharge of blood is small, and vice proceeds without any visible signs.After 1-2 months after birth pulmonary vascular resistance decreases, which leads to a reduction of myocardial (muscle layer) of the right ventricle.At the same time there is an increase in vascular resistance systemic circulation.Since the expulsion of the blood vessels in the great circle of blood circulation

left ventricle to overcome the resistance arose, it thickens the wall, and the ability to relax during diastole decreases.These changes lead to an increase in the blood level of dumping on the left side to the right atria.Because of the reset basic load increased blood volume during this vice falls on the right side of the heart.

Most children with atrial septal defect lead a normal life, some play sports, but closer inspection reveals a great fatigue, shortness of breath on exertion.cyanotic skin they do not happen.If there is cyanosis, it is likely a combination of atrial septal defect with anomalous pulmonary venous drainage, Ebstein's disease or flowing into the superior vena cava into the left atrium.The exceptions are infants with atrial septal defect who cry when sometimes there is slight bluish coloration of the skin, indicating that shunt from right to left (ie. E. "Waste" blood flows through the systemic circulation).

When the feeling trembling of the heart are rarely defined.Borders of the heart, which are determined by a physician, normal or slightly increased at the expense of the right to increase the right departments.Over the years, formed a heart hump.When auscultation of the heart doctor determines the characteristic of this vice noise.Additional research methods are an electrocardiogram, phonocardiogram (PCG), chest X-ray, ultrasound of the heart, cardiac catheterization cavities.

In heart failure in young children with atrial septal defect prescribe cardiac glycosides and diuretics.As a rule, a good effect on the treatment and allows to postpone surgery.In such cases, as described in "Ventricular septal defect" age child general condition improves.Duration of assignment of cardiac glycosides (in particular, drug digoxin) is determined individually by the attending physician, and as a rule, the need for it is stored for 10-12 months.If this treatment is not effective, then held surgical defect correction, regardless of the age of the child.

defect can be closed independently.If to 5-6 years of age does not occur spontaneous closure of the defect, there comes the need to consult a heart surgeon that determines timing of surgical intervention.The operation is suturing (with small defects) or plastic defect.surgical results are good.