Patent foramen ovale in the heart - Causes, Symptoms and Treatment .MF .
Nowadays, many parents are often heard from the doctor that the baby in their patent foramen ovale in the heart.In this article we will try to find out what it is - a serious diagnosis or an innate feature of the structure of the heart.
newborn baby's heart is very different from adult human heart.The heart consists of four chambers (atrium and ventricle), and in adults there is a partition between the atria, which does not allow to mix the arterial and venous blood in the right and left heart halves, respectively.In newborn infants, the interatrial septum is not always a holistic education in connection with the following features of fetal circulation: when the baby is still developing in the womb of a woman, the lungs do not take part in spontaneous breathing, so the blood to them to flow less (only 12% of the total fetal blood flow).This is necessary so that more blood, oxygen enriched, prepared actively functioning organs of the fetus -. The brain, liver, etc. The proper dis
From the left ventricle window covered with a small valve that is fully ripe for the birth.At the time of the first cry of a newborn, when revealed his lungs, the blood supply to it increases, increases the pressure in the left atrium, and the valve closes the window, and then firmly fused with the wall of the atrial septum (in most cases during the first year of life, at least - tofive years). Sometimes this valve size is too small to cover the opening, and then say that the newborn patent foramen ovale in the heart.
patent foramen ovale - a hole between the atria in the human heart through which blood can flow from one atrium to the other (usually from the left to the right, as physiologically pressure in the cavity of the left atrium above).Do not confuse patent foramen ovale with atrial septal defect as a defect - this is a more serious diagnosis related to congenital heart disease, while the patent foramen ovale is classified as one of the small anomalies of heart development, and is, rather, individual structural featureschild's heart.
patent foramen ovale
reasons cleft oval window in the heart
the first place in the structure of the causes of disease is a genetic predisposition, especially on the maternal side.Also, as the reasons may be noted factors that have a negative impact on the fetus during gestation - adverse environmental conditions, poor nutrition pregnancy, stress, the use of toxic substances (alcohol, drugs, nicotine, drugs, prohibited for use by pregnant).
Typically, the clinical manifestations of isolated patent foramen ovale in children (without the presence of congenital heart disease) rather meager.To suspect this anomaly structure of a newborn child can be based on the following complaints: heart palpitations, shortness of breath and cyanosis (gray or blue color) nasolabial triangle when crying and feeding.The child may have a poor appetite and poorly gaining weight.Older children may experience decreased tolerance (tolerance) exercise.
In the period of intensive growth, as well as hormonal changes the body (adolescence, pregnancy) increases the load on the cardiovascular system as a whole, which can cause the appearance of fatigue, weakness, feeling disruptions of the heart, especially during exercise or sports.
In cases where the oval window does not grow after the age of five, most likely, it will accompany a person throughout life, which, however, does not affect the consumer and his career.But at a later age (after forty - fifty years), when a person can develop diseases such as hypertension and coronary heart disease, the oval window is able to complicate the course of the recovery period after myocardial infarction and for chronic heart failure.
diagnosis is based on the basis of auscultation (listening to) the chest when viewed from the child (systolic murmurs are heard), as well as on the basis of instrumental methods.
main method for detecting PFO - imaging by echocardiography (ultrasound of the heart).Ultrasound of the heart should be carried out for all children aged 1 month according to new therapeutic and diagnostic standards in pediatrics.
If the oval window is accompanied by congenital heart disease, then, if necessary, the doctor prescribes a transesophageal echocardiography, angiography (an introduction to the heart cavity through the vessels of radiopaque substance), held in the profile cardiac surgery hospital.
treatment of patent foramen ovale
In the absence of clinical symptoms and hemodynamic disturbances (pronounced changes in heart operation), which most often occurs in practice, pediatrician or medical therapy or hospitalization are not shown.Appointed restorative treatments - hardening, walking outdoors, observance of a balanced regime of work and rest, proper nutrition, exercise therapy.
When the minor complaints of the cardiovascular system may be justified by the appointment of vitamins and medicines, providing additional power of the heart muscle - Magne B6, Pananginum analogues L- carnitine (Elkar), coenzyme Q (ubiquinone).
In cases of combination with malformations of the heart and surveillance tactics of treatment is determined by the cardiology and cardiac surgery with the choice of the optimal method of surgical correction of defects.In recent years, scientists have developed London operation in which the cavity of the right atrium via the femoral vein injected with plaster probe, which is superimposed on the window, and within 30 - days resorbed.This similarity creates a patch "patch" and additionally stimulates the formation of connective tissue in the own atrial septum, which leads to the oval window imperforate.Surgical treatment in uncomplicated cases is not applicable.
Complications cleft oval window in the heart
Among the extremely rare, almost isolated cases of complications related "paradoxical" embolism - a dangerous, life-threatening condition.Emboli - is the smallest particles that carry the gas bubbles, blood clots or pieces of adipose tissue.These substances normally found in the bloodstream should not be, they get into the blood stream in various pathological conditions, so that the gas bubbles when air embolism, sometimes accompanied by complex trauma of the chest with the damage of the lung tissue;blood clots - if thrombophlebitis (vein disease with the formation of parietal thrombus);adipose tissue - with open fractures.These dangerous emboli that open when the oval window may slide from the right to the left atrium, and then into the left ventricle, then through the vessels reach the brain where occlude the vessel lumen, cause the development of cerebral infarction or stroke.This complication can be fatal.Manifested it suddenly developed symptoms of brain at the time of or immediately after the injury, or during prolonged immobilization, when a patient after major surgery, injury, serious illness forced to comply with bed rest for a long time.The prevention of thromboembolic complications in general is adequate therapy aimed at improving blood clotting prevention of acute cardio - vascular system, injuries, surgical interventions, etc.
As already mentioned, the complication is quite rare, but nevertheless, a patient with a patent foramen ovale should always warn your doctor about the presence of his heart this particular structure.
forecast in the open oval window
Forecast for life, social and working life as a whole is favorable, however, for patients with the presence of patent foramen ovale are contraindicated extreme sports, as well as professions related to increased load on the circulatory system and respiratory - pilotsastronauts, divers.
Summarizing all the above written, it should be noted that in modern medicine doctors usually referred patent foramen ovale is more to the peculiarities of the structure of the heart, rather than serious malformations, as in most cases, the functional load on the heart is still within the normal.Still, because of this disease localization in the heart of a vital organ, to downplay the significance of it is not worth it.In any case, the patient management tactics cardiologist determines individually in the internal survey.
therapists Sazykina OJ