The child's foramen ovale did not close. Cardiology open foramen ovale. Causes of an open oval window

Our article is devoted to this common pathology. In this material, the essence of the problem of a functioning oval window will be revealed to you.

In 1930, scientists examined about 1000 children's hearts, as a result, about 35% of the subjects had an open oval window(OOO). Nowadays, the frequency of this phenomenon reaches 40% in the child population.

Why do I need an oval window for the fetus?

In the mother's womb, the child does not breathe in the truest sense of the word, since the lungs cannot function, they resemble a deflated balloon. A patent foramen ovale in newborns is a small opening between the atria. Through the foramen ovale, blood from the veins flows into the only big circle fetal circulation.

After birth, the baby takes the first breath, the lungs begin their work. Under the influence of a pressure difference, the open oval window is closed by a valve. But such a valve may be too small to completely tighten the hole.

A functioning foramen ovale is an anomaly of the heart, and by no means a defect.

The exact cause of this pathology does not exist.

Allocate some of the most common factors.

1. In almost all premature and immature newborns, the window remains open.
2. Smoking, maternal substance abuse.
3. Intrauterine fetal hypoxia.
4. Prolonged labor, asphyxia of the baby in childbirth.
5. Unfavorable environmental factors.
6. Mother's stress.
7. genetic predisposition.
8. Congenital heart defects.
9. Occupational hazard with toxic substances at mother.

Open foramen ovale in children and its symptoms

In most cases, these children do not complain.

Therefore, it is very important for mothers to be attentive and monitor the slightest deviations in the behavior of babies.

What can be seen?

1. The appearance of blue around the mouth in a newborn. Such cyanosis appears after crying, screaming, while sucking, bathing.
2. In older children, tolerance (resistance) to physical activity decreases. The child is resting, sitting down after the usual outdoor games.
3. The appearance of shortness of breath. In general, normally, the child should easily climb the 4th floor without any signs of shortness of breath.
4. Frequent colds in infants, namely: bronchitis, pneumonia.
5. Doctors listen to a heart murmur.

PERSONAL EXPERIENCE. The child is 10 days old, while bathing, the mother notes a blue nasolabial triangle. The child was born full-term, with a weight of 3500. Mom confessed that she smoked during pregnancy. On examination, a murmur was noted at the apex of the heart. The baby was sent for an ultrasound. As a result, an open oval window in 3.6 mm. The child has been registered.

Ultrasound of the heart has the main clinical significance. The doctor clearly sees the hole large sizes in the projection of the left atrium, as well as the direction of blood flow.

When listening to a heart murmur, the pediatrician will definitely refer your baby to this species research.

According to the new standards, at 1 month, all newborns should undergo ultrasound screening, including the heart.

As a rule, on the ECG with LLC there is no pathological changes.

In 50% of children, the oval window functions for up to a year and then closes on its own, in 25% of children, infection occurs by the fifth year of life. In 8% of the adult population, the window remains open.

What to do if the window has not closed after 5 years? Basically, nothing. The open foramen ovale in a newborn is too small to provide atrial overload with the development of heart failure. Therefore, it is necessary to dynamically monitor the baby, annually undergo an ultrasound of the heart and look around at a pediatric cardiologist.

PERSONAL EXPERIENCE. There was a 13 year old boy at the reception. For 4 years, the child has been involved in active sports - rowing. Accidentally, during the prophylactic examination, an ultrasound of the heart was performed, where for the first time a 4 mm oval foramen was found. At the same time, the child did not show any complaints for all his 13 years and coped well with physical activity. Even won first place in competitions.

When a child complains, a drug therapy in the form of cardiotrophic drugs and nootropics - Magnelis, Kudesan, Piracetam.

These drugs improve myocardial nutrition and exercise tolerance.

AT recent times it became reliable that the drug levocarnitine (Elkar) contributes to the rapid closure of the oval window, if you drink it for 2 months at a rate of 3 times a year. True, it is not entirely clear what this is connected with. From personal practice, I can say that I did not see a clear connection between taking Elkar and closing the LLC.

But still, it also happens that the oval window can lead to circulatory disorders and heart failure. In pediatric practice, this is rare, in most cases it occurs by the age of 30-40. Then the issue of surgical intervention with the closure of this hole is decided. A small patch is applied endovascularly (i.e. with a catheter) through the femoral vein.

With regard to sports and a functioning oval window, in the absence of complaints and good performance Ultrasound of the heart can be practiced in any sport.

Complications

They are quite rare. Associated with embolism and impaired blood flow. These are heart attacks, strokes and kidney infarction.

These complications can already occur in adults. And such a patient should always warn the doctor that he has a functioning oval window.

Small anomalies of the heart, for the most part, do not harm the health of children. Some famous athletes have this pathology and become Olympic champions. Many doctors consider LLC to be normal. But it should be remembered that annual monitoring by a specialist is necessary.

Open oval window (hole) in the heart: causes, closure, prognosis

According to statistics, the prevalence of open foramen ovale (PFO) in the heart differs in different age categories. For example, in children under one year old, this is considered a variant of the norm, since according to ultrasound, the foramen ovale is found in 40% of infants. In adults, this anomaly occurs in 3.65% of the population. However, in people with multiple heart defects, a gaping foramen ovale is recorded in 8.9% of cases.

What is the "oval window" in the heart?

The foramen ovale is an opening with a valve flap located in the septum between the right and left atria. The most important difference of this anomaly from is that the oval window is equipped with a valve and is localized directly in the region of the oval fossa of the heart, while in case of ASD, part of the septum is missing.

location of the oval window in the heart

Fetal blood circulation and the role of the oval window

Blood circulation in the fetus occurs differently than in an adult. During the intrauterine period, the so-called “fetal” (fetal) structures in the heart function in the baby. vascular system. These include the foramen ovale, aortic and venous ducts. All these structures are needed for one simple reason: the fetus does not breathe air during pregnancy, which means that its lungs do not participate in the process of oxygen saturation of the blood.

circulatory and fetal heart arrangement

But first things first:

Immediately after birth, when the newborn takes its first breath, the pressure in the pulmonary vessels increases. As a result, the main role of the oval window to dump blood into the left half of the heart is leveled.

During the first year of life, as a rule, the valve fuses completely on its own with the walls of the hole. However, this does not mean at all that an unclosed foramen ovale after 1 year of a child's life is considered a pathology. It has been established that communication between the atria can close later. Often cases are recorded when this process is completed only by the age of 5 years.

Video: anatomy of the oval window in the heart of the fetus and newborn

The oval window does not close on its own, what are the reasons?

The main cause of this pathology is the genetic factor. It has been proven that non-closure of the valve flap persists in people with a predisposition to connective tissue dysplasia, which is inherited. It is for this reason that in this category of patients, other signs of a decrease in strength and collagen formation can be found. connective tissue(pathological joint mobility, decreased skin elasticity, prolapse ("sagging") of the heart valves).

However, other factors also influence the non-closure of the oval window:

1. Unfavorable ecology;
2. Taking certain medications during pregnancy. Most often, this pathology is caused by non-steroidal anti-inflammatory drugs (NSAIDs). It has been proven that these drugs cause a decrease in the level of prostaglandins in the blood, which are responsible for the closure of the oval window. At the same time, taking NSAIDs is dangerous in late dates gestation, which is the reason why the oval window did not close;
3. Alcohol intake, as well as smoking during pregnancy;
4. Premature birth (in premature babies, this pathology is more often diagnosed).

Types of the oval window according to the degree of non-closure

• If the size of the hole does not exceed 5-7 mm, then usually in such a situation, the detection of an oval window is a finding in echocardiography. Traditionally, the valvular valve is considered to protect against backflow of blood. That is why this variant is hemodynamically insignificant and manifests itself only with high physical activity.
• Sometimes there are cases when the oval window is so large (exceeds 7-10 mm) that the size of the valve is not enough to cover this hole. In such situations, it is customary to speak of a “gaping” oval window, which clinical signs may not be very different from ASD. Therefore, in these situations, the boundary is very conditional. However, when viewed from an anatomical point of view, there is no valvular valve in ASD.

How does the disease manifest itself?

With a small size of the oval window external manifestations may be missing. Therefore, the severity of non-closure can be judged by the attending physician.

For kids infancy with an open oval window is characteristic:

In adults with pathology, cyanosis of the lips may also appear with:

1. Physical activity, which is fraught with an increase in pressure in the pulmonary vessels ( long delay breathing, swimming, diving);
2. Severe physical labor(classes in weightlifting, acrobatic gymnastics);
3. In diseases of the lungs ( bronchial asthma, cystic fibrosis, emphysema, lung atelectasis, pneumonia, with a hacking cough);
4. If there are others.

With a pronounced oval hole (more than 7-10 mm), the external manifestations of the disease are as follows:

• Frequent fainting;
• The appearance of cyanosis of the skin even with moderate physical exertion;
• Weakness;
• dizziness;
• Child lagging behind physical development.

Diagnostic methods

It is the “gold” standard and the most informative method for diagnosing this pathology. The following signs are usually seen:

1. Unlike ASD, with an open oval window, not the absence of a part of the septum is revealed, but only its wedge-shaped thinning is visible.
2. Thanks to the color Doppler sonography, you can see the "twists" of the blood flow in the area of ​​the oval window, as well as a slight shunt of blood from the right atrium to the left.
3. With a small size foramen ovale there are no signs of enlargement of the atrial wall, as is typical for ASD.

The most informative is ultrasound procedure heart, conducted not through the chest, but the so-called transesophageal echocardiography. At this study The ultrasonic transducer is inserted into the esophagus, as a result of which all the structures of the heart are much better visible. This is due to the anatomical proximity of the esophagus and the heart muscle. The use of this method is especially important in patients with obesity, when visualization of anatomical structures is difficult.

transesophageal echocardiography is the most informative method LLC detection

In addition to ultrasound of the heart, other diagnostic methods can be used:

• On the electrocardiogram, signs of blockade of the legs of the bundle of His, as well as impaired conduction in the atria, can be detected.
• With a large oval hole, changes are possible on the x-ray of the organs chest(slight enlargement of the atria).

What is dangerous pathology?

1. People at risk should avoid heavy physical exertion, as well as the choice of professions such as a scuba diver, diver, diver. It has been proven that in the presence of this pathology the probability of development is 5 times higher than among the healthy population.
2. In addition, this category of persons may develop such a phenomenon as. This phenomenon is possible in people with a tendency to in the vessels lower extremities. A blood clot detached from the vessel wall can enter the systemic circulation through the foramen ovale. As a result, blockage of the vessels of the brain, heart, kidneys and other organs is possible. If the blood clot is large, it can cause death.
3. It is important to remember that people with an open oval window are more likely to develop a disease such as. This is due to the fact that microthrombi can form on the walls of the valve flap.

Methods of treatment and prevention of complications

At favorable course pathology and with a small size of the oval window according to ultrasound of the heart specific treatment not required. However, this category of people be registered with a cardiologist and undergo a heart examination once a year.

• Given the likelihood of developing thromboembolism, patients at risk should also examine the veins of the lower extremities (with an assessment of the patency of the veins, the presence or absence of blood clots in the lumen of the vessels).
• When carrying out any surgical interventions in patients with an open foramen ovale, thromboembolism prophylaxis should be carried out, namely: elastic bandaging of the lower extremities (wearing compression stockings), as well as taking anticoagulants a few hours before surgery. (About the presence of a defect, you need to know and warn the attending physician).
• It is important to observe the regime of work and rest, as well as to dose physical activity.
• Sanatorium-and-spa treatment (electrophoresis with magnesium sulfate has a positive effect).

In the presence of blood clots in the lower extremities, these patients need constant control blood coagulation system (particularly important are indicators such as international normalized ratio, activated partial thrombin time, prothrombin index). Also in such a situation, observation by a hematologist and phlebologist is mandatory.

Occasionally, patients with an open foramen ovale show signs of cardiac conduction disturbance on ECG, as well as unstable arterial pressure. In such situations, you can take drugs that improve metabolic processes in cardiac muscle tissue:

1. Medicines containing magnesium (“Magne-B6”, “Magnerot”);
2. Medications that improve conductivity nerve impulse(“Panangin”, “Carnitine”, vitamins of group B);
3. Drugs that activate bioenergetic processes in the heart (“Coenzyme”).

Surgery

Surgical intervention may be required with a large diameter of the oval window with blood flow into the left atrium.

AT this moment endovascular surgery has become widespread.

The essence of the intervention is that a thin catheter is installed through the femoral vein, which is passed through the vascular network to the right atrium. Control over the movement of the catheter is carried out using an X-ray machine, as well as an ultrasonic sensor installed through the esophagus. Upon reaching the area of ​​the oval window, the so-called occluders (or grafts) are passed through the catheter, which are a “patch” that closes the gaping hole. The only disadvantage of the method is that occluders can cause local inflammatory response in the tissue of the heart.

endovascular closure of the foramen ovale in the heart

In this regard, the BioStar absorbable patch has recently been used. It is passed through the catheter and opens like an "umbrella" in the atrial cavity. A feature of the patch is the ability to cause tissue regeneration. After attaching this patch in the region of the opening in the septum, it resolves within 30 days, and the foramen ovale is replaced by the body's own tissues. This technique highly effective and already widespread.

Disease prognosis

With an oval window less than 5 mm, the prognosis is usually favorable. However, as mentioned above, the large diameter of the foramen ovale is subject to surgical correction.

Pregnancy and childbirth in women with a defect

During pregnancy, the load on the heart increases significantly. This happens for several reasons:

• The volume of circulating blood increases, by the end of pregnancy it exceeds the initial level by 40%;
• The growing uterus begins to occupy most abdominal cavity and closer to childbirth strongly presses on the diaphragm. As a result, the woman develops shortness of breath.
• During the bearing of a child, the so-called “third circle of blood circulation” appears - the placental-uterine.

All these factors contribute to the fact that the heart begins to beat more often, and the pressure in the pulmonary artery. In this regard, in women with this anomaly in the heart, adverse complications. Therefore, pregnant women with this pathology are subject to the supervision of a cardiologist.

Are young people with an open oval window taken into the army?

Despite the fact that in most cases this anomaly of the heart proceeds without any clinical symptoms, young people with an open foramen ovale are classified as category B with limited fitness for military service. This is primarily due to the fact that with high physical exertion, the likelihood of developing complications is high.

conclusions

In connection with the development additional methods studies revealing such an anomaly as an open oval window has increased significantly.

In most cases, this pathology is detected as an accidental finding during the study. However, patients must be informed about the presence of an open oval window, they also need to be aware of certain restrictions in physical labor, as well as in choosing a profession.

The presence of a large oval hole deserves special attention, which in fact is an analogue of an atrial septal defect. In this situation, patients are recommended surgical correction.

A small hole between the left and right atria, which is formed during the period prenatal development fetus is known as an open oval window.

What is the peculiarity of his education and does it pose a danger to human life?

The essence of LLC

Such a problem is the norm for the fetus, but in adults it is anatomical feature structures of the heart.

The human heart consists of 4 cavities: two atria and two ventricles, which are closely interconnected through special channels. Between the right and left atria is the interatrial septum.

Its role is to regulate blood flow from the LA to the right. It is not uncommon for this septum to form incorrectly, forming a hole - an open oval window.

The process of blood circulation in children and adults has some difference: during the development of the fetus in the womb, its lungs do not participate in the respiratory process. In this regard, only 12% of the blood from its total flow passes through them.

It is a necessity for enrichment internal organs fetus (brain, liver, etc.) with oxygen, which is contained in the blood passing through them.

The direction of blood in the body of the fetus is regulated by special messages that are in its cardiovascular system, for example, arterial and venous blood flows. An open oval window is also one such message. Through it passes the pumping of blood enriched with oxygen from the right atrium to the left, thereby reducing the flow of blood to the lungs of the fetus.

From the inside of the cavity of the left ventricle, the hole is covered with a small valve. Before the onset of childbirth, this valve is already fully formed.

After a newborn baby makes its first cry, its lungs open and oxygen enters them, and blood also enters them. This causes the valve to close and increase the level of pressure in the left atrium.

After some time, the walls of the valve leaflets gradually adhere to the walls of the interatrial septum. This process is finally completed during the first year (in rare cases- by 5 years).

It is possible that the valve leaflets are too small, which cannot provide complete occlusion of the opening between the atria. It is in this case we are talking about the development of OO windows.

According to statistics, an open oval window in adults (in 30% of all cases) entails the development various diseases of cardio-vascular system or lung disease.

The main reason for this situation is increased rate intracardiac blood pressure. Since the development of this problem begins even in the prenatal period of fetal development, in adults, PFO is considered a heart disease.

The reasons

As a result of the fact that the open oval window remains not closed or slightly open, with strong cough, crying or as a result of tension in the abdominal cavity, blood is ejected from the right atrium to the left. This is a clear manifestation of the operation of the OO window.

To date, experts have not been able to fully determine exact reasons that lead to this pathology. Among well-known factors include:

• hereditary factor;
• prematurity;
• congenital defect of the mitral or tricuspid heart valves;
• connective tissue dysplasia;
• negative impact of the environment;
• smoking;
• use during pregnancy alcoholic beverages.

Specialists also include in the risk group people whose bodies are subjected to heavy physical exertion, including athletes. It is also not necessary to exclude from this group those whose profession is connected with immersion to great depths.

Patients who are diagnosed with thrombophlebitis of the legs or MT, accompanied by moments of PE, as a rule, suffer from high blood pressure the right side of the heart are also at risk for the development of a functioning PFO.

If a person is at risk or a pregnant woman has been exposed to the above factors, you should immediately contact a specialist to undergo comprehensive examination. This can detect the presence of pathology and prevent heart disease.

Symptoms, danger and treatment

As a rule, an open oval window is small and does not cause any discomfort to patients.

In the event that PFO was not diagnosed and eliminated in childhood, in an adult patient this anomaly can provoke manifestation of the following symptoms:

• fast fatiguability;
• weakness;
• exposure frequent infections respiratory nature: cough, tonsillitis, bronchitis, etc.;
• shortness of breath, which tends to manifest itself not only with great physical exertion, but also with moderate;
• dizziness;
• severe headaches;
• migraine;
• frequent fainting.

Unfortunately, it is far from always possible to identify the RO window during a routine medical examination. As a rule, pathology is detected only after the patient begins to show complications of this anomaly.

FROM The most common complications include:

• cerebrovascular accident transient type- characteristically short-term disturbances functioning of the human brain. The main reason for this is the failure of the blood supply process in the GM. In this case, a person has a loss of speech, memory, numbness of the upper or lower extremities, a violation of the activity of some parts of the body. Maximum duration the manifestation of these symptoms does not exceed a day;
• stroke is quite severe and dangerous complication LLC, which consists in the death of some sections of muscle tissue. In this case, the patient exhibits symptoms such as transient disorder blood supply to the brain. Distinctive feature this condition is that the duration of the manifestation of these symptoms is much more than 24 hours;
• kidney infarction - manifests itself in the form of the death of part of the kidney, which is accompanied by severe pain in the lumbar region, bleeding in the urine, a small amount of urine excreted, an increase in body temperature.

It is also worth noting that an open oval window is extremely dangerous for people who are diving. This is due to the fact that they have an increased risk of developing decompression sickness. In order to obtain permission to dive below 10 meters, such people need to close the LLC.

An open foramen ovale is dangerous possible development complicating processes. To reduce the risk, you should immediately contact a specialist for a comprehensive examination.

The choice of treatment for this pathology depends on the size of the foramen ovale, the presence of complications, and comorbidities.

Usage drug therapy will not completely close the window. For this, the method of surgical catheterization or surgery is used. In most cases, the pathology does not require treatment. Patients with this anomaly live a long and full life work and have children.

In order to avoid the development of complications, children diagnosed with an open oval window should be under the supervision of specialists. As for adult patients, they must also undergo periodic medical examinations.

During the intrauterine period, the unborn baby receives a set of necessary nutrients from mother. This also applies to oxygen supplied from placental circulation through an open foramen ovale in a child. It looks like a small hole between the heart atria. After birth, the need for it disappears, but not everyone closes it.

Description of the problem

The foramen ovale (FOA) is a small opening between the atria of the heart. Its main purpose is to deliver oxygen bypassing the pulmonary circulation, which does not function in the prenatal period. To do this, the window has a special valve that acts as a door, which opens only towards the left atrial region, allowing the flow of oxygen with blood into it.

After birth, the need for a window disappears as the first breath fires up the lungs. They "turn on" the pulmonary circulation, increasing the pressure in the left heart sections. As a result of this, the door in the form of a valve is no longer able to open, it is pressed tightly against interatrial septum and gradually grows.

Important! The window usually closes completely between 3 months and 2 years of age. But sometimes it happens at a later date. AT last years open window often began to be diagnosed at the age of 5 or 7 years.

It is worth talking about heart problems in cases where the child's heart is growing, and the growth of the valve in the window area does not keep up with it. This leads to the fact that the window does not close tightly and blood begins to circulate between the atria, which should not happen. There is a certain percentage of people who do not experience much discomfort from an uncovered oval window.

Sometimes the load on the heart increases, which provokes the release of blood flow between the atria. This can lead to pathology of the veins in the lower extremities, combined heart diseases and chronic illness lungs. Often, pathological blood flow provokes pregnancy and childbirth. It is very important to control the doctor and conduct complex treatment if necessary.

Normal dimensions of the oval window

According to statistics, an open oval window is diagnosed among 25% of all adults and is not a pathology. It does not pose a serious threat and is simply physiological feature organism. The dimensions of the window can vary from 3 mm to 19 mm and largely depend on the person's age and height. The smallest diameter can be observed in a one-month-old baby.

A hole of 5–7 mm does not pose a particular threat. This small size in young patients precludes shunting of blood between the atria. And only strong crying, coughing or physical overload can provoke the flow of blood from one atrium to another. At an older age, diving into water, doing gymnastics or weightlifting, working as a pilot, diver or miner can lead to this.

The need to eliminate the hole directly depends on the size of the cover valve and the degree of compensation. Choice suitable therapy is within the competence an experienced specialist, which takes into account a number of features and factors. When the window size exceeds 7–10 mm, the question of the need for surgical treatment is decided.

window closing process

When the need for the oval window disappears, the process of its gradual overgrowth takes place. At the same time, it can periodically function. Most often this happens in children of the first year of life, whose lungs and blood vessels are not yet sufficiently developed. Therefore, with prolonged crying or straining, the hole swings open, passing a small amount of blood from one atrium to another.

But as the cardiovascular system grows stronger, intracardiac pressure changes. As a result of this, the window door fits very tightly and gradually fuses with the walls of the heart. In most cases, this happens to two years of age. But sometimes it depends individual features body and occurs somewhat later, which is also a variant of the norm.

Provoking factors

In recent years, the number of people with uncovered foramen ovale has increased. This usually happens in babies who are born ahead of time or as a result of the genetic characteristics of the organism.

Other reasons can contribute to non-closure:

• harmful effects on the cardiovascular system in the prenatal period (use various medicines, hypoxia and radiation);
• underdevelopment of the connective tissue of the heart and;
• severe lung disease;
• constant physical activity and overvoltage;

Important! Specialists do not consider an open oval window as a heart defect. It is usually referred to. Most people live with it all their lives without experiencing much inconvenience. But only with regular monitoring by a cardiologist.

Leading symptomatology

The blood circulating between the atria through the foramen ovale is especially poor in oxygen. Its constant supply leads to oxygen starvation organism, which is accompanied by characteristic symptoms.

With small window sizes (from 3 to 4 mm), the listed symptoms are extremely rare.

Diagnostic measures

Often, the presence of an open window can be suspected by a routine physical examination by a specialist. It detects cyanosis skin and developmental delays. As additional features heart murmurs will appear during auscultation (listening with a phonendoscope) and the study of anamnesis (frequent SARS and fainting).

Install accurate diagnosis allows instrumental diagnostics:

• ECG: allows you to detect signs of overload of the right heart;
• chest x-ray: reveals an increase in the size of the heart;
• probing of the cavities of the heart: performed only before surgery;
• Echo KG (ultrasound of the heart): allows you to visually determine the presence of a defect and its size, as well as a graphical representation of the movement of its leaflet.

Doppler echocardiography can detect turbulent blood flow, its volume and speed. And transesophageal ultrasound cardiography (EchoCG) provides the most accurate information through significant imaging.

Medical tactics

An open window is a variant of the norm in the absence of severe symptoms, without requiring special therapy. In this case, it is enough to be regularly observed by a cardiologist and to properly dose physical activity. But at the first sign of a stroke or therapy is mandatory.

Most often, antiplatelet agents and anticoagulants (Aspirin, Warfarin) with regular monitoring of the international normalized ratio (INR) act as medicines. Its indicators should be in a certain range (from 2 to 3), which is determined using laboratory tests.

With a pronounced pathological blood ejection between the atria, the issue of performing an operation is decided. To stop the flow of blood, it is carried out under the control of an x-ray and an echocardiograph. A special occluder allows the hole to be completely closed, which the doctor inserts through a vein in the thigh using a catheter.

Probability of complications and prognosis

The presence of an oval window is always a risk factor for certain disorders or complications. An example is paradoxical embolism. it pathological condition, in which small blood clots and air bubbles can enter through the window into the atrium, and then into the ventricle on the left. They can eventually reach the brain and cause a stroke.

To exclude such a development of events will allow regular visits to the doctor and necessary research. Under constant medical supervision, the prognosis for this defect is quite favorable. And the implementation of endovascular occlusion makes it 100 percent favorable.

There are no specially developed measures for the prevention of an open oval window. But it is quite possible to reduce the risk of its development in the prenatal period. For this future mother should be healthy lifestyle life, eat right and eliminate all bad habits.

In addition, any contact with chemicals(paints, varnishes, dangerous medicines) and ionizing radiation. When carrying a baby, a woman should try to protect her health and not come into contact with sick people. Infectious diseases at times increase the risk of cardiac pathology in the fetus (especially rubella).

When a child has already been diagnosed with an oval window in the heart, the most important thing is not to panic. This is not a verdict. In this case, parents need to follow a number of useful recommendations:

• get registered with a cardiologist with a child;
• learn how to dose physical activity;
• properly organize the daily routine;
• together with the doctor to develop proper diet nutrition;
• try to go to the sea every year.

Important! You need to show your child your confidence and calmness. No need to scare him medical terms and show excessive health concerns. Instead, you need to take care of his mental and psychological comfort.

Modern diagnostic methods allow specialists to timely detect an open foramen ovale in newborns. And up to a certain age, this is not a pathology, because through certain time it should close on its own. But in some cases this does not happen, which requires professional help from specialists. And only from timely detection problems and its competent solution directly depends on the comfort and quality of life of a growing baby.

The foramen ovale is a small opening located in the septum directly between the right and left atria. Normally, they should not communicate with each other so that there is no mixing of arterial and venous blood, as well as pressure drops. This state is a pathological phenomenon in adults and children of a certain age and is very common. Sometimes the disease does not cause serious physical discomfort, but in some cases it can lead to various violations in the work of the cardiovascular system and requires treatment.

The presence of an oval-shaped recess is the norm, because during pregnancy, while the lungs of the fetus do not function and its body needs additional oxygen, blood is transferred to the left atrium through this hole. The absence of such a duct in the process of intrauterine development can lead to various anomalies and even death of the child before birth or immediately after it.

When an infant takes its first breath, the work starts respiratory system, and his lungs instantly expand. Increased pressure in the left side of the heart stops the flow of blood through the foramen ovale.

In a newborn baby, the foramen ovale should close within a few days or weeks. But very often during the next planned medical examination it is discovered that this did not happen, and the doctor informs the parents about pathological abnormalities in the development of the cardiovascular system of the baby. An uncovered foramen ovale in most cases requires some treatment, but known pediatrician E.O. Komarovsky advises parents not to panic and not resort to drastic measures. In his works, he emphasizes the fact that in almost half of all newborns there is no abrupt closure of the hole in the heart septum and it can remain for a long time open, up to the age of five.

Despite the fact that an open passage in the septum between the two atria can be considered a variant of the norm for some time, there are other factors in the occurrence of a physical defect. They can cause the development of various pathological changes in the work of the heart muscle. These factors include:

• smoking and drinking alcohol during pregnancy;
• various malformations of intrauterine development (including infection with infections);
• medication not agreed with the doctor;
• hereditary factor.

If a child was born prematurely, then this also increases the risk that the hole in the heart will not close up, and blood will be transferred through it with a weak pulsation. With various anomalies in the structure and development of the heart muscle, a sharp opening of the previously connected oval window may occur due to temporary stretching of the chambers of the left and right atria.

Symptoms

In some cases, the hole does not close up even after several years of life. If an unclosed window was found in a teenager, then this defect will definitely remain with him forever. Why is it dangerous? In fact, according to official statistics, this phenomenon accompanies at least 25% of the entire adult working population through life. At the same time, restrictions are imposed only on extreme sports and activities associated with constant physical exertion. Caution is necessary because the presence of an open foramen ovale in the heart in an adult can lead to sharp drops blood pressure.

Much less common are cases with pronounced clinical picture diseases when the following pathological conditions make themselves felt:

• diseases of the respiratory system;
• impaired blood circulation of the brain and a tendency to thrombosis;
• phlebeurysm;
• severe headaches of a chronic nature;

• excess normal level volume of blood in the lungs;
• intolerance to physical activity;
• arrhythmia and shortness of breath;
• numbness of the limbs;
• mobility impairment different parts body;
• pathological changes in the right atrium (usually clearly visible during ultrasound);
• systematic syncope of unknown etiology.

In most cases, the disease is latent and it is quite difficult to diagnose it, so it is detected by random medical examinations and checks. Absence specific features also complicates the search for the main cause of ailments in adults, because the above symptoms occur in various pathologies.

Possible Complications

An open window in the heart rarely poses a serious threat to human health and practically does not affect life expectancy, but worsens its quality. But this pathology together with others chronic diseases respiratory system, varicose veins and thrombophlebitis, can lead to serious complications, which include:

• myocardial infarction;
• kidney infarction;
• stroke.

In addition, it may happen temporary violation blood supply to the brain, which can lead to memory loss, CNS depression, body immobility, numbness of the limbs and speech defects. After a while, these symptoms may disappear without a trace.

Treatment of the disease

If during a physical examination an open recess in the heart was revealed, but it does not bring a person any physical discomfort, then special treatment not carried out. For minor complications, various drugs preventing the formation of deep vein thrombosis.

In some cases, the defect can be corrected by surgery.

Doctors often use special absorbable patches, which are temporary patches for the oval window.

During the period of their use, connective tissue grows, which subsequently closes the duct between the atria.

Forecast

This disease generally has a good prognosis, but in order to avoid various complications it is required to periodically conduct an ultrasound examination (especially for newborns) and visit a cardiologist. Physical overwork and increased stress should also be avoided.

The same rules apply for teenagers. Parents should not send their children to boxing or martial arts classes, and it is better to avoid school competitions if possible, providing a certificate of birth defect in advance.

If you exclude all kinds of risks and treat in time accompanying illnesses, then you can live almost your whole life without remembering this problem. Pathology is not an obstacle to pregnancy and natural childbirth, but a woman should notify her obstetrician-gynecologist in without fail. In old age, the disease sometimes causes heart failure, so from time to time you need to undergo routine examinations and carry out prevention with the help of medications or traditional medicine.