The gap in the heart. Open oval window in the heart: causes, symptoms, treatment and projections

Date: 01.04.2019

With the advent of ultrasound diagnostics in medicine, young parents increasingly began to learn from doctors that the baby had an oval window that was left unclosed. Having heard such a diagnosis, one should not panic, because the baby is acutely sensitive to mother's emotions. All parents should be aware of what the open oval window in the child’s heart means, what kind of symptoms pathology causes, how dangerous it is, and what are the ways to eliminate it.

Oval window in the heart of some babies does not close the valve after birth

What is a disease

In the zone of the left ventricle, the window is covered due to the small valve that is finally forming by the time the baby is born. When a newborn starts screaming for the first time, the lungs open, blood rises to them, and the pressure in the left atrium becomes greater, and the oval window in the heart of the newborn is covered with a valve. Over time, its strong fusion with interatrial septum occurs. However, the important point is that the body of each person is individual and not all of this happens at the moment of birth.

Many parents are frightened by a similar phenomenon and they are interested in doctors when the oval window in the child’s heart closes. In fact, it interferes with the proper functioning of the blood circulation, therefore it must be gradually closed. This happens through valve growth to the edges of the interatrial septum.

Open oval window refers to the number of anomalies of the heart, not its vices

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

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

Children with such a diagnosis, reaching 3 years of age, receive a second disability group.

The fact that such an oval window in the heart of the fetus and newborn is described in the video:

Why the oval window does not close

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

most often this problem is hereditary, which is transmitted mainly from first-line relatives;
if a pregnant woman allowed herself to regularly drink alcohol or smoke frequently while carrying a baby;
the problem can be provoked by a bad environment in which a woman awaits the baby;
if the expectant mother did not eat properly;

In most cases, the problem is due to genetic factors and is inherited from parents.

with regular stressful and depressive states, in which a woman remained when carrying a baby;
if there were toxic poisoning during pregnancy;
when the child is born early.

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

How does the deviation

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

if a child has an open oval window in the heart 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 trigger the development of an abnormal heart in the baby

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

In newborns, an abnormality in the development of the heart manifests itself as follows:

when a child cries, strains, or coughs, a nasolabial triangle, nose tip, or fingertips may turn blue;
the skin of such children is paler than that of others who have no pathologies;
babies also have heart palpitations.

Symptoms of pathology depends on the size of the hole

In adults with such a pathology, the lips may also turn blue in some circumstances:

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

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

there is a systematic loss of consciousness;
blue skin, even in the absence of strong physical exertion;
worried about general weakness in the whole body, dizzy;
a child can be far behind in development from their peers.

The skin of babies with abnormalities of the heart is distinguished by a pale shade.

Diagnostic methods

With a standard examination, the cardiologist is unable to diagnose a child’s open oval window, because there is no murmur in the heart when listening. To diagnose pathology, there are the following procedures:

Echocardiography (ultrasound of the heart). Thanks to this research, the doctor has the ability to understand in which direction blood circulation occurs, how much blood flows between the right and left atria, as well as to determine the presence of other serious pathologies. These moments are very important in the course of diagnosis, with the help of them the specialist understands at what stage the disease stays and prescribes an effective therapy.
Contrast echocardiography. This procedure shows whether there is an open oval window in the heart of a child or an adult. To identify the pathology, the patient is intravenously injected with saline. If a slit is present, the reaction will occur immediately, and the doctor will see air bubbles penetrating from one atrium into another through this opening.

Ultrasound of the heart allows you to identify violations in the structure of the body

Extraesophageal echocardiography. This study is conducted if it is necessary to find out exactly where the gap is located and what size it is. It is also determined by the procedure whether there are any complications in the form of inflammatory processes in the heart valves, blood clots or expansion of the heart.
Chest X-ray. It shows what size the patient has the heart, the diameter of the heart vessels, and also determines whether the blood in the lungs is stagnant.

What is dangerous pathology

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

There is no need to panic with this diagnosis, since such an anomaly almost never affects a person's activity or the duration of his life.

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

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

The disease can provoke the death of some parts of the brain, which is fraught with a stroke.
Impaired functioning of the heart causes the death of muscle tissue, which can cause myocardial infarction.
Because of the impaired blood circulation, kidney cells may die - an organ infarction will occur.
With circulatory disorders in the brain in humans, speech can be deformed, memory lapses are noted, upper and lower extremities become numb. Symptomatology lasts for a day, after which it disappears on its own.

It is important to understand that, whatever 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 an open oval window in the heart of a baby is diagnosed, then before the child is 5 years old, no medical treatment is required, this is due to the fact that during a given time it can close on its own. If this does not happen, and the pathology does not make itself felt, and does not prevent the child from developing normally, 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 surgery is not indicated. However, the patient is prescribed medical therapy:

Lightened condition anticoagulants. One of the most effective medicines in this group of drugs is warfarin. If the patient is taking this drug, then there is a need for frequent blood tests, so that doctors can monitor the state of the hemostatic system, in order to avoid education.

By 5 years the majority of small patients oval hole closes

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

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

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

Forecast with an open oval window in the heart

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

Filling a large oval window requires surgery. For six months after the operation is completed, in order to avoid bacterial endocarditis, patients are advised to take antibiotics, as well as systematically visit a cardiologist. However, after the recovery period, a person can continue to live without restricting himself in anything.

The open oval window is a temporary opening with a valve in the middle part of the interatrial septum, which divides the atria between them, being their wall. In its center is a recess - an oval hole, at the bottom of which is an oval hole (oval window), fitted with a valve.

Fetal open oval window in the heart is necessary for a number of physiological reasons: through the oval window there is a message between the atria, which allows blood from the hollow veins, bypassing the inoperative lungs in the prenatal period, to flow into the systemic circulation. Premature closure of the oval window during fetal development of the child contributes to the development of right ventricular failure, fetal death, and the death of the child immediately after birth. Therefore, absolutely all children are born with an open oval window in the heart.

After birth, the baby’s lungs are straightened with the first inhalation, and the baby begins to breathe on its own: the pulmonary circulation starts to work fully, oxygen enters the body from the lungs, and there is no need for communication between the atria. After birth, the oval window closes, as the pressure in the left atrium increases (becomes slightly higher than the pressure in the right atrium).

When the load in newborns and infants (crying, crying, anxiety, feeding), which contributes to an increase in pressure in the right heart, the oval window begins to function temporarily. This is accompanied by the discharge of venous blood through the oval opening and appears blue in the nasolabial triangle. Then, for most children, the valve grows, and the oval hole disappears completely.

When should the oval window in the child's heart close?

The open oval window should gradually close, as it interferes with normal blood circulation through the pulmonary system. The closing of the oval window occurs gradually by increasing the valve to the edges of the oval fossa and can last for each child individually - at someone at once, at someone in a year, two, or in five. This is the norm and, in the absence of other heart diseases, should not cause concern to parents. In 20-30% of cases, the opening between the atria is tightly closed, and the oval window can remain open throughout life.

In rare cases, the oval hole remains completely open - this defect on the ultrasound is seen more clearly, and is called atrial septal defect (DMPP). The difference between the oval window and the interatrial septal defect is that the oval window has a working valve, and there is no valve for an interatrial septal defect.

An open oval window in the heart of a child is not a defect, but belongs to small anomalies of heart development (MARS), such children from the age of three belong to the second group of health. For draftees, an open oval window without a drop of blood provides for a B category, that is, fit for military service with minor restrictions.

How to recognize an open oval window?

In most cases, the presence of an open oval window is recognized by chance, when examined as part of a follow-up examination, or if a small defect is suspected with the following symptoms:

in newborns and infants - blue around the mouth (cyanosis of the lips or nasolabial triangle) when coughing, screaming, crying, when emptying the intestines. At rest, the blue disappears;
in older children - low endurance to physical exertion, rapid fatigability, unexplained episodes of dizziness and loss of consciousness;
predisposition to frequent colds and inflammatory diseases of the respiratory system.
hear the noise in the heart of a child.

If a child is suspected of having an open oval window, the pediatrician sends him for a consultation with a cardiologist and an echocardiography (ultrasound of the heart, echoCG). Ultrasound of the heart will allow you to see and recognize the hole in the interatrial septum, as well as the opening flap of an open oval hole. In addition, by ultrasound, you can determine how much blood passes through a defect in the interatrial septum, in which direction the blood moves through the heart and which there are still anomalies in it.

The following signs are characteristic of an open oval window by ultrasound: small size (from 2 to 5 mm, 4.5 mm on average), valve visualization in the left atrium cavity, location in the middle part of the interatrial septum (in the area of the oval fossa), inconsistent visualization, thinning of the walls of the interatrial septum in the area of the oval window (with a defect in the septum, the edges are thickened).

Open oval window treatment

Most often, no complaints about the presence of an open oval window does not cause complications are extremely rare, treatment is not required. The risk of complications for children and adults with an open oval window presents some specific loads. In older children, the discharge of blood can occur during paroxysmal coughing, diving, exercises, accompanied by straining and holding the breath. Therefore, such children are contraindicated for scuba diving, deep-sea diving, weightlifting.

At older age, in conditions that increase the right-atrial pressure, an oval window can be opened, in particular, during pregnancy, severe pulmonary insufficiency and pulmonary embolism (blockage of the pulmonary artery with blood clots).

If a child or an adult has no other abnormalities in the functioning of the heart other than an open oval window, if he does not suffer from chronic diseases of the veins and lungs, and this opening does not greatly interfere with blood circulation, then there is no reason for concern. In this case, doctors advise only to avoid unnecessary physical exertion and be observed by a cardiologist, periodically repeating ultrasound of the heart (to monitor the size of the hole).

At high risk of blood clots (the formation of blood clots) prescribed medications that prevent the formation of blood clots (anticoagulants).

However, if the orifice reaches a significant size, blood is being dumped from one atrium to another — surgical intervention may be required. To do this, a catheter (tube) is inserted into the artery, at the tip of which there is a special device that, when inserted into the oval window, completely clogs it.

The news of an open oval window in the heart is alarming and troubling many parents of children of different ages. As a rule, they learn about this diagnosis quite by accident: during a routine examination or an ECG. In some cases, such an anomaly of the heart does not manifest itself at all, and people live for many years without experiencing any inconvenience until they appear serious.

In recent years, such a feature in the structure of the heart began to emerge much more often, and in our article we will tell you about the open oval window in the heart and the dangers that this diagnosis may carry in the future.

What is an open oval window in the heart?

During the first cry of a newborn, an oval window in the heart closes.

The oval window is an open gap in the wall between the right and left atrium, which normally functions in the embryonic period and completely overgrown after 12 months of life. On the side of the left atrium, the orifice is covered with a small valve that fully matures by the time of birth.

During the first cry of a newborn and the moment of lung opening, there is a significant increase in pressure in the left atrium and under its influence the valve completely closes the oval window. Subsequently, the valve tightly adheres to the wall of the interatrial septum and the gap between the right and left atrium closes.

In most cases, in 40-50% of children, such an “accretion” of the valve occurs in the first year of life, less often by five years. With an insufficient valve size, the slit cannot close completely and the right and left atria are not isolated from each other. In such cases, the child may be diagnosed - an open oval window in the heart (or MARS syndrome). This condition is classified by cardiologists as a small abnormality of heart development, and, in the absence of severe symptoms affecting the quality of life, can be perceived as an individual feature of the structure of the heart.

An open oval window into the heart is a through hole between the atria, through which blood can be thrown from one atrium during contraction of the heart muscle to another.

In adult patients, this anomaly is detected in approximately 30% of cases. It is a canal, or shunt between the atria, and can cause malfunction of the cardiovascular system or lungs due to blood pressure fluctuations.

The reasons

The most common cause of cleft of the gap between the atria is a genetic predisposition. In most cases, this anomaly is betrayed on the maternal line, but it can be caused by a number of other reasons:

prematurity of the child;
connective tissue dysplasia;
congenital heart defects;
drug addiction or mother;
smoking during pregnancy;
toxic poisoning with certain medications during pregnancy;
stress;
insufficient nutrition of the pregnant woman;
unfavorable ecology.

An open oval window is often detected with other malformations of the heart: with open and congenital malformations of the tricuspid and valves.

Various risk factors may contribute to the opening of the oval window:

excessive exercise (weightlifting and gymnastics, strength sports, diving);
pulmonary thromboembolism episodes in patients with small pelvis or.

Symptoms

Often, an open oval window in the heart does not manifest itself in any way, or it makes itself felt only through scanty and nonspecific symptomatology.

In young children with this anomaly can be observed:

blue or sharp pallor of the periubical region or nasolabial triangle during straining, crying, crying, coughing or bathing;
propensity to and bronchopulmonary diseases;
slow weight gain.

Older children may experience poor exercise tolerance, which manifests itself by increased heart rate and.

During puberty or during pregnancy, when a total hormonal alteration occurs in the body, provoking an increase in the load on the cardiovascular system, an open oval window may manifest itself as frequent episodes and rapid fatigue and feelings of disruption of the heart. These manifestations are especially pronounced after intense exercise. In some cases, this abnormal development of the heart can lead to sudden and unmotivated fainting.

Non-dilation of an oval window to the age of five indicates that this anomaly is most likely to accompany a person throughout his life. At a young age and in the absence of cardiovascular lesions, it has almost no effect on his health and work, but after 40-50 years and the development of heart disease or vascular disease, the oval window can aggravate the course of these ailments and complicate their treatment.

Diagnostics

During auscultation of heart tones, the doctor may suspect a non-occlusion of the oval window, since this anomaly is accompanied by systolic sounds of varying intensity. To confirm this diagnosis, the patient is recommended more accurate instrumental examination techniques:

Echo-KG (usual and doppler, transesophageal, contrast);
radiography.

Invasive and more aggressive diagnosis of an open oval window is resorted to when necessary for surgery. In such cases, patients are assigned to sounding of the cavities of the heart.

Treatment

If there are no signs of a decrease in heart function, a child with an open oval window is cared for as healthy, without the use of medications.

The amount of treatment is determined by the severity of symptoms of an open oval window. In the absence of pronounced irregularities in the work of the heart, the patient is given. Reception of drugs with asymptomatic course of such an abnormality of the heart structure is not prescribed, and the patient is recommended general strengthening procedures (exercise therapy, hardening and sanatorium-resort treatment).

If a patient has minor complaints about the work of the cardiovascular system, it may be recommended to take vitamin preparations and drugs that provide an additional tonic effect on the heart muscle (Panangin, Magne B6, Elkar, Ubiquinone, etc.). In such cases, the patient must adhere to large restrictions in physical activity and pay attention to restorative procedures.

With a more pronounced manifestation of symptoms, a high risk of thrombosis and a significant discharge of blood from one of the atria to another, observation by a cardiologist and a cardiac surgeon is recommended, and the following measures can be prescribed:

taking antiplatelet agents and anticoagulants (to exclude blood clots);
endovascular treatment (through a catheter that is inserted into the femoral artery and advances into the right atrium, a patch is applied to the oval window, it stimulates the clogging of the opening with connective tissue and after a month it resolves itself).

In the postoperative period, the patient is prescribed antibiotics for prophylaxis. Endovascular treatment of such an abnormal development of the heart wall allows patients to return to a completely fulfilling life without any restrictions.

Possible complications

Complications of the non-opening of an oval window are rarely developed. Such an abnormal structure of the heart wall lead to such diseases:

kidney infarction;
transient violation of cerebral circulation.

The cause of their development is paradoxical embolism. Despite the fact that this complication is quite rare, the patient should always inform his attending physician about the presence of an open oval window.

Forecasts

In the overwhelming majority of cases, projections for patients with an open oval window are favorable and rarely result in complications.

constant supervision by a cardiologist and Echo-KG control;
rejection of extreme and accompanied by significant physical activity sports;
restrictions on the choice of professions associated with significant respiratory and cardiac loads (divers, firefighters, astronauts, pilots, etc.).

Surgical treatment for such an abnormal development of the heart is prescribed only for marked disorders in the functioning of the cardiovascular system and lungs.

Congenital heart disease (CHD) is an abnormality of heart development that develops at 2-8 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 heart defects is the oval open window (LLC) - a small anomaly in which the 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, so all newborns are born with it, and during the first year of life, sometimes, for several years, it becomes overgrown.

However, it happens that the hole does not overgrow. Depending on its size depends on the degree of violation of blood circulation. If the opening is too large and the connecting valve between the atria is absent, atrial septal defect occurs.

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

open arterial duct (AOP) in newborns, in which the blood enriched with oxygen enters the lungs;
aortic pulmonary defect - incomplete accretion of the septum between the aorta and the pulmonary trunk;
ventricular septal defect (VSD) - a hole separating the right and left ventricles;
coarctation (narrowing) of the aorta;
stenosis (narrowing) of the pulmonary or aortic valves.

The cause of the disease is an abnormal organ development inside the womb

It is important to note that in many cases, heart defects do not appear separately, but together. For example, the most common cause of cyanosis in a newborn is Fallot's tetrad, which combines VSD, aortic dislocation and ventricular hypertrophy.

Causes of heart abnormalities

The nature of the disease today remains unclear, however, doctors identify the following causes of CHD:

genetic predisposition, i.e., the presence in the history of the relatives of the infant congenital malformations;
chromosomal abnormalities;
gene mutations;
infectious and viral diseases that a woman suffered 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).

Equally important is the health of the father. Also risk factors include:

late pregnancy;
endocrine diseases of parents;
severe pregnancy and the threat of termination in the first trimester;
stillborn in the anamnesis.

According to recent studies, children of obese women have an increased risk of being born with CHD and other heart and vascular pathologies.

Pathology is a 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.

An open oval window can not manifest itself for a long time without causing any concerns to parents. At not clearing and the considerable size of an opening there are difficulties with breath, pallor of integuments or cyanosis, the delay of physical development is available.

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

Cyanosis - blue skin that develops due to lack of oxygen in the blood. Depending on the type of CHD, only the nasolabial triangle, as well as the limbs and even the whole body, may turn blue.
Dyspnea. It is observed not only during the activity, but also when the child is inactive.
Heart rhythm disorders. The most common symptom of heart defects is rapid heartbeat, tachycardia. But with some defects there is also a reduced pulse, bradycardia.
Other symptoms, among which - the general weak condition of the child, lack of appetite, drowsiness, crying out in a dream. In severe pathologies, there may be a lack of air, loss of consciousness.

The diagnosis of defects is performed by a cardiac surgeon. In the presence of suspicious murmurs in the heart of a newborn, he will certainly be prescribed an ultrasound. Ultrasound of the heart (echocardiography) allows you to explore the state of the valves and the muscles of the heart.

As additional diagnostic methods are used:

x-ray examination, including with the use of a contrast agent (ventriculography);
electrocardiogram (ECG), as well as its varieties (treadmill test, bicycle ergometry).

Dr. Komarovsky recommends that you carefully undergo a thorough examination if suspicious heart murmurs do not pass within 3-4 days after the birth of the child, while blue skin, pale and cold extremities are also observed.

What is dangerous LLC?

Under normal conditions, the oval window usually closes between 2 and 12 months after the birth of a baby.

For a long time, this defect was considered by doctors to be fairly safe, with which people could live a full life and even actively engage in sports. Today, the opinions of doctors are divided. Definitely it can be said that children with an oval window and heart murmurs need careful medical monitoring.

One of the most dangerous complications that can occur when an oval window does not open is paradoxical embolism, accompanied by an increased risk of thrombus formation, stroke or bacterial diseases.

It is important to note that often the open oval window is combined with another defect - aneurysm of the heart in newborns, and this is fraught with the risk of developing cardioembolic complications.

Thus, children with CHD require special attention and careful care. They are contraindicated in some sports:

scuba diving;
weightlifting;
deep dive;
other exercises, accompanied by breath-holding or straining.

Heart Disease Treatment

The method of treatment of CHD depends on its severity. If the child, in addition to the LLC, does not detect any other abnormalities, the opening does not exceed 5 mm, there is no significant circulatory disturbance, his health condition does not cause concern.

The pediatrician cardiologist will help in the treatment of the disease.

Mostly over time, the size of the oval ring decreases. To reduce the risk of blood clots, they may prescribe anticoagulants - blood thinners.

With a large size of the oval opening (7-10 mm), it is necessary to speak of an atrial septal defect. Such holes are called “gaping”, in which case the question of performing surgical removal of the anomaly is resolved.

Modern surgical treatment of LLC involves the introduction into the artery of a special tube (catheter), at the end of which is a valve that completely clogs the oval window. Find out what causes blood clots after childbirth

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Attention!

Information published on the site is for informational purposes only and is intended for reference only. Visitors to the site should not use them as medical recommendations! Editing the site does not recommend self-medicating. The determination of the diagnosis and the choice of treatment methods remains the exclusive prerogative of your doctor! Remember that only complete diagnosis and therapy under the supervision of a physician will help to completely get rid of the disease!

The disease with the beautiful name "open oval window" in newborns and children under the age of 5 years has recently become common. This “window” - an oval opening, with a diameter of up to 3 mm, is located in the median zone of the septal space between the two atria. The partition divides the two atria in half, representing a natural defense, in its center - a small depression in the shape of an oval fossa. Such a “window” is on the bottom of the recess, supplemented with a valve and can normally close after a certain period. But this is not always the case, so we will take a closer look at the open oval window and the method of its treatment.

An open oval window in the heart of a child is a normal physiological symptom when self-retarding for 2-5 years. This window is required to the fetus, because through it the atria are able to work and connect with each other. With the help of the deepening, the blood from the hollow veins instantly passes into the great circle of blood circulation, since the lungs of the fetus are not yet fully operational during pregnancy. With this pathology, all children are born, and it is always present in infants.

Heart diagram with two pathologies

Sometimes a dimple closes itself in a child who has not yet had time to be born, which causes a failure of the right ventricle and the sudden death of the fetus in the womb or after birth. After birth, the baby breathes fully, begins to work the circle of blood circulation in the lungs. Since oxygen enters the lungs from the atria, they no longer need to connect through the opening, and the window closes after a certain amount of time.

Important! Since the babies experience heavy loads, and taking into account their unprepared body, the oval groove still works: during feeding, if the baby cries or screams, the pressure in the right heart zone becomes higher.

When venous blood is ejected through a depression in an infant, the triangular area under the nose turns blue, this symptom ensures a functioning oval window. It should close completely by five years, the duration of the process depends on the characteristics of the organism and is manifested differently in each child. Usually, the oval does not close immediately, ideally the valve grows gradually to the edges of the recess. In certain cases, it closes after a short period of time, while for others it can take several years. .

Symptoms of pathology

An oval window in a newborn is considered normal and most often does not become a cause for concern. But in about 20-30% of people, such a hole in the zone of the atria does not fully grow together and is able to remain half open during the whole life. In rare cases, it remains open: the deviation is recognized by ultrasound of the heart and is a defect of the septum between the atria (DMPP). What is dangerous defect, will the child have further health problems?

Important! A person with an unopened oval window should be referred to a cardiologist more often, he will be able to quickly identify all abnormalities and prescribe treatment that prevents the occurrence of complications.

In case of problems with a septum, the working valve, typical for an open oval window, is completely absent. But the presence of the hole is not considered a dangerous deviation, it is referred to as small type anomalies (MARS). If it is not closed in a child under three years old, it is ranked as the second group of health. Young people in military age with this defect are suitable for military service, but with additional restrictions. Such a deepening does not cause problems in life, as it can function when coughing or during physical exertion. Difficulties arise:

when blood passes through the atria, if the oval window in the heart in adults is not completely covered;
in the presence of diseases of the lungs or veins in the legs;
in case of mixed heart disease;
during childbirth and childbirth.

Main factors

The reasons that an open oval window of 2 mm or larger is present in the heart are different, they are influenced by the physiological characteristics of the organism of each individual person. At the moment there are no proven scientific theories or assumptions that could fully substantiate and confirm the specific causes of pathology. When the valve does not grow together with the edges of the oval window, various factors become the cause. Recorded echocardiography or ultrasound of the heart can detect the presence of LLC .

Partition in pathology

Sometimes the valve is not able to close the groove completely because of too small dimensions, which provokes a non-closing of the natural oval window. Underdevelopment of the valve provokes poor ecology and stressful states, smoking or drinking alcohol by the mother during pregnancy, or constant contact with toxic components. An open oval window in the heart in an adult remains if developmental, slow growth or prematurity are found in childhood.

Important! In the presence of thrombophlebitis of the legs or the pelvic zone, some people experience pressure in the area of the right heart regions, which further becomes the reason for the appearance of an open small oval window in adults.

Hereditary causes, dysplasia of the connective tissue, defects of the heart or valves of an innate nature can lead to the opening of windows in older children in the development process. If a child goes in for sports, he is at risk of having such a defect, since playing sports seriously affects health. As physical loads in gymnastics, athletics or other sports activities are serious, this provokes the appearance of a window.

Signs depending on age

Standard signs in newborns or adolescents are not fixed when an open oval window appears in the interatrial septum, and often the presence of a defect is discovered by chance, for example: during echocardiography and other diagnostic procedures. Pathology does not threaten serious complications, except for other complex diseases that may affect it. For example: if your baby or adult has problems with hemodynamics in detecting heart defects, including a mitral or tricuspid valve or an arterial duct.

Pathology diagnosis

Symptoms of such a defect, such as an open oval window, are manifested in both an infant and adolescents. , in specific cases vary with age. When it comes to a child of 4-7 years old, the diagnosis is in most cases made in the course of a standard examination by a pediatrician or pediatric cardiologist. Only ultrasound or echocardiography can confirm the presence of a window. It is possible to learn about the presence of a defect in babies of infancy by the main feature - blue nasolabial triangular area and lips area under loads. The remaining deviations include:

frequent diseases of the lungs and bronchi;
noticeable lag in growth and development;
shortness of breath and excessive fatigue during exercise;
persistent and causeless fainting and dizziness;
when listening to an appointment with a cardiologist.

In some adults, pathologists are accompanied by characteristic symptoms and are temporary and permanent. Sometimes the functional window opens after overgrowth in the presence of specific pathologies, if the pressure in the area of the right atrium gradually increases. An open oval window appears in a pregnant woman, with pulmonary insufficiency in a complex shape, or when a lung artery is blocked. Despite the almost complete absence of difficulties, the deviation can be a problem and provoke:

hypertension of the lungs and congestion of the right heart region;
difficulties with conductivity in the area of the right bundle of His;
migraine;
gradual development of infarction or stroke;
shortness of breath.

Diagnostic methods

Before you assign a complex therapy and confirm the pathology, a specialist usually prescribes a diagnosis, as a result of which you can know for sure about the presence of an oval hole. The standard method is the method of listening, or auscultation, of the sternum during the examination of the baby: in case of pathology, the doctor records systolic sounds. There are more reliable methods, including ECG and ultrasound.

Ultrasound open oval window

If parts of the channel do not cover the edges of the hole completely, it is recommended that you contact a specialist as soon as possible and undergo a full examination. Visualization through echocardiography represents the main method, it is prescribed to each child who has reached one month of age, as evidenced by the new standards in the field of pediatrics. If a patient has heart defects, he is sometimes recommended to have an ecocardiography through the esophagus and undergo an angiographic type examination in a specialized hospital.

Therapeutic measures

The method of treatment of a child or an adult depends on the age, the presence of additional pathologies and whether the patient has signs of a pathology or not. If there are no symptoms, and the defect does not accompany additional problems, the patient's condition does not deteriorate, you just need to be examined by a pediatrician, a general practitioner and a cardiologist. Doctors will be able to assess the state of the oval groove and take appropriate measures in time to prescribe treatment. If the window does not close in a natural way up to five years, then corrective drugs are prescribed.

Important! When it comes to an oval-type window, the dimensions of which do not exceed 5 mm in norm, surgical correction is not required. If there is a large dimple, specialists can prescribe the operation in conjunction with corrective therapy.

The risk group consists of patients who do not have pronounced signs, but ischemia, heart attack, stroke, leg veins or other diseases are likely to occur. In some cases, surgery may be required when the oval window is too large in diameter, and blood enters the area of the left atrium. Among the techniques, endovascular type surgery is particularly notable: during the operation, a catheter is inserted into the patient's vein of the thigh, which is then carried out to the area of the right atrium.

The path of the catheter is monitored using an x-ray machine and an ultrasound probe that are laid through the esophagus. Then occluders are placed through such catheters, which cover the hole well. This technique also has disadvantages, since occluders can provoke inflammatory processes in the heart tissues. There is an additional way to solve the problem, which is a special patch that is inserted through the catheter, which is then opened in the atrium. It regenerates tissues well and self-absorbs for thirty days.

Prevention of complications

The occurrence of complications can cause dangerous conditions, including the risk of thromboembolism, such patients need to more often study the condition of the veins in the lower extremities. Adults with an open oval groove usually do prophylaxis for thromboembolism if surgery is necessary. Such measures include the use of anticoagulants or bandaging the legs, a number of additional methods. Often, with this problem, symptoms of cardiac conduction problems and blood pressure disorders can be observed.