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Diagnosis foramen ovale in the heart. Symptoms, diagnosis and treatment of an open oval window in children

According to statistics, the prevalence of an 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 between this anomaly and an atrial septal defect (ASD) 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 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 cardiovascular system function in the baby. These include the foramen ovale, aortic and venous ducts. All these structures are necessary 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 the formation of collagen in the connective tissue (pathological joint mobility, decreased skin elasticity, prolapse ("sagging") of the heart valves) can be detected.

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

Unfavorable ecology;
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 gestation, which is the reason why the foramen ovale did not close;
Alcohol intake, as well as smoking during pregnancy;
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, according to clinical signs, may practically not differ 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 absent. Therefore, the severity of non-closure can be judged by the attending physician.

For infants with an open oval window, it is typical:

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

Physical activity, which is fraught with an increase in pressure in the pulmonary vessels (prolonged breath holding, swimming, diving);
Heavy physical labor (weightlifting, acrobatic gymnastics);
In diseases of the lungs ( bronchial asthma, cystic fibrosis, emphysema, lung atelectasis, pneumonia, with a hacking cough);
In the presence of other heart defects.

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;
The lag of the child in physical development.

Diagnostic methods

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

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.
Thanks to color Doppler sonography, one 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.
With a small size of the foramen ovale, there are no signs of enlargement of the atrial wall, as is typical for ASD.

The most informative is an ultrasound examination of the heart, which is carried out not through the chest, but the so-called transesophageal echocardiography. In this study, an ultrasound probe 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 for detecting PFO

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 foramen ovale, there may be changes on the chest x-ray (slight atrial enlargement).

What is dangerous pathology?

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 developing decompression sickness is 5 times higher than among the healthy population.
In addition, this category of persons may develop such a phenomenon as paradoxical embolism. This phenomenon is possible in people with a tendency to thrombosis in the vessels of the 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.
It is important to remember that people with an open foramen ovale are more likely to develop a disease such as septic endocarditis. This is due to the fact that microthrombi can form on the walls of the valve flap.

Methods of treatment and prevention of complications

With a favorable course of the pathology and with a small size of the oval window, according to ultrasound of the heart, specific treatment is 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 oval window, it is necessary to prevent thromboembolism, 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 exercise.
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 monitoring of the blood coagulation system (such indicators as international normalized ratio, activated partial thrombin time, prothrombin index are especially important). 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 the tissue of the heart muscle:

Medicines containing magnesium ("Magne-B6", "Magnerot");
Drugs that improve the conductivity of the nerve impulse ("Panangin", "Karnitin", vitamins of group B);
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.

Currently, endovascular surgery is widely used.

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. When the region of the oval window is reached, the so-called occluders (or grafts) are passed through the catheter, which are a “patch” that closes the gaping hole. The only drawback of the method is that the occluders can cause a local inflammatory reaction in the heart tissue.

endovascular closure of the foramen ovale in the heart

In this regard, in Lately BioStar absorbable patch is 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 is highly effective and has already become 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 of the abdominal cavity and closer to childbirth puts a lot of pressure 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 also increases. In this regard, adverse complications are possible in women with this anomaly in the heart. 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.

In connection with the development of additional research methods, the detection of 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.

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In a healthy person, the heart consists of four chambers, two of which are separated by a thickened septum that prevents blood from flowing from the left to the right. Sometimes the connecting fragment is modified and turns into a gap, causing defectiveness. The oval window in the heart is congenital disease in a newborn child, which is characterized by the formation of an opening between the right and left atrium. Pathology can be caused by a hereditary factor and, in especially rare cases, chronic diseases that disrupt the proper flow of blood through the chambers of the heart.

In children under the age of five, the presence of a gap in the heart is the norm, but if the anomaly develops at an older age, then it is necessary to be regularly examined by a doctor, because the disease has severe complications.

The open foramen ovale in the heart in children is usually closed by a valve immediately after birth due to an increase in pressure in the first atrium, and subsequently fuses with the wall of the septum. But in some cases, the valve is very small in order to close the gap, and then the pathology becomes aggravated.

Open oval window in the heart

The causes of an open oval window in the heart in a child of 6-7 years old are determined by several factors:

bad ecology;
heredity;
bad habits during pregnancy;
poor nutrition during gestation;
the use of drugs prohibited during pregnancy;
stress.

In rare cases, the pathology develops against the background of disorders that increase the tension in the right atrium and, thereby, open the valve to the left. Such processes include persistent lung disease, vein thrombosis, other disorders of the heart, as well as gestation and childbirth.

An open oval window in the heart in a child under the age of five does not cause any concern from the doctor, however, an examination by a cardiologist is mandatory at least once a year. If this requirement is not taken into account, then the disease can be diagnosed at an older age with acquired abnormalities in the functioning of the cardiovascular system and other aggravating consequences.

An open oval window in the heart in an adult is a consequence of the neglect of medical methods in detecting a disease or a lack of diagnosis throughout life, caused by the incompetence of research methods. Sometimes a defect is detected in the study of other heart defects, when a violation of the functions of the interatrial septum is detected and, accordingly, the valve opens.

Symptoms

An open foramen ovale in the heart has mild or pronounced symptoms, depending on the size of the hole. With a gap of no more than 5-7 mm, no signs are observed, with the exception of cyanotic lips (skin acrocyanosis) after physical exertion and pallor of the face.

Symptoms of an open oval face are actively manifested when the connector between the right and left atrium is more than 7 - 10 mm:

regular cyanosis of the lips and the area around the mouth, regardless of previous actions;
lag in physical development;
violation of coordination of movement;
cardiopalmus;
dyspnea;
unexpected fainting;
migraines and other types of headaches;
frequent colds;
the appearance of blood clots;
VVD - vegetative vascular dystonia;
numbness of the limbs;
pressure surges;
an increase in blood volume in the lungs.

The acquisition of a pale blue tint on the lips and in the mouth area is the main indicator of pathology, especially if a change in the skin appears after holding your breath under water, strong physical exertion, as well as other heart and lung diseases.

Cyanosis of the nasolabial fold is a pronounced symptom of heart disease.

At characteristics pathologies, additional studies are carried out to determine the size of the gap and the risks of complications.

Diagnosis of an open oval face in the heart is carried out only by instrumental methods:

Ultrasound (ultrasound examination) of the heart through the esophagus, which allows to identify in detail violations in the structure of the heart;
probing the cavities of the heart to study the interatrial fissure and assess the patient's condition for surgical interventions;
electrocardiogram to obtain information about the interaction of all parts of the heart;
ultrasonic dopplerography to study the blood flow of vessels near the oval window;
x-ray showing enlarged atria in the picture if there is a large hole between them;
duplex scanning, with which you can find out about the patency of the veins of the lower extremities and identify the presence of thrombosis.

The sounding method has a number of contraindications and cannot be prescribed to patients with increased blood clotting, renal failure, thrombosis and embolism. If the method is incompatible with the patient's state of health, another type of study is used - ultrasound of the heart.

A routine examination of the patient and clinical blood tests cannot indicate a pathology, so doctors immediately resort to a visual examination of the damaged segment.

With a small size of the gap and the absence of symptoms that interfere with the quality of life, medication and inpatient treatment are not prescribed.

increase the immune protective functions of the body due to hardening;
take a contrast shower to stimulate the heart;
organize walks in the fresh air;
visit a sanatorium for cardiovascular diseases at least once a year;
do not disturb the biological clock;
use only healthy foods in food, excluding fried meat, canned drinks and fast food from the supermarket;
engage in physical therapy.

An open oval window in the heart can affect the cardiovascular system, causing disturbances in the conduction of the organ and sudden pressure surges.

In such cases, it is mandatory to appoint drug treatment, allowing to stabilize the work of the heart:

preparations containing magnesium;
vitamins and medicines that improve the interaction between the chambers of the heart;
pills that stimulate the production of energy by the point sections of the heart.

With a large hole with the formation of blood flow in the left atrium, surgical intervention is indicated, on the eve of which thrombosis is prevented. Some time before the operation, the patient is put on elastic bandages on the lower extremities and prescribed drugs that inhibit blood clotting processes.

During surgery, a patch is inserted through the femoral vein using a catheter into the right atrium. When ingested, it opens in the shape of an umbrella and covers the surface of the hole. Within a month, the patch is resorbed and activates the formation of connective tissue at the site of the gap. Thus, the open oval window in the heart is closed. The operation is recommended only in difficult cases, when the size of the gap portends complications and is quoted as a heart disease.

The method of treatment with a patch is an innovation in Russian medicine, but is already widely applicable. However, if such intervention is not available under external circumstances, then an occluding device is used during the operation, which is inserted according to the same principles as the patch.

The occluder inside the body opens in the form of an umbrella and completely closes the oval window. The operation is used extremely rarely, because inflammation of the tissues around the occluder may occur. Preference is given to surgical interventions using a patch.

Types of occluders for closing an open oval window

If blood clots are found in the veins of the legs, the treatment of an open oval window is determined by constant monitoring by a phlebologist and control of blood coagulation.

Complications

In the absence of compliance with the recommendations from the doctor, even a slight gap in the chambers of the heart can lead to serious illnesses leading to sudden death. To avoid aggravating consequences, it is necessary to exclude excessive physical exertion, including immersion under water, be constantly monitored by a hematologist for the appearance of blood clots, and visit a cardiologist at least once a year.

Among the complications of congenital pathology are:

decompression sickness, which destroys the walls of cells, blood vessels and leads to paralysis, death;
paradoxical embolism, during which a blood clot breaks off, clogging vital arteries and posing a threat of death in case of its large size;
septic endocarditis, affecting the heart channels and causing death;
a stroke that occurs when a blood clot forms in a cerebral artery;
myocardial infarction caused by blockage of the coronary arteries of the heart by a thrombus;
kidney infarction with blockage of the corresponding vessels;
violation of cerebral blood supply, in which motor and auditory functions are damaged and memory disorder occurs.

The patient is obliged to warn the attending physician about a congenital pathology so that the risk of complications can be reduced or the existing symptoms can be eliminated.

If you follow the doctor's requirements and see a cardiologist once a year, then the prognosis of an open oval window in the heart will be quite favorable. You can be sure of longevity and not feel the tormenting symptoms, if you do not overwork in exercise, do not dive under water and try to fly less on an airplane. Any actions that cause an increased load on the circulatory and respiratory system lead to complications.

Patients who have undergone surgery for a large oval window get rid of the defect forever and do not put their body at risk during surgery. After the operation, they lead a full life and after some time they can forget about the previous restrictions in their lifestyle. However, if the size of the gap does not go beyond the normal range, it is not recommended to perform the operation, because the pathology, to a greater extent, is in the nature of structural features of the heart, and not a serious illness. The threat to the patient's life is caused only by complications that have developed against the background of pathology.

Risk group

There are a number of professions that can have a fatal effect on the health of people with an open oval window in the heart.

It is sad that untimely diagnosis of pathology or neglect of one's own well-being leads to death. And all because with a strong immersion or rise, blood clots can form in the artery, blocking the vessel and portending instant death.

People with an open oval window in their heart should exclude the following professions and even a one-time hobby from their lives:

pilot;
astronaut;
diver;
diver;
scuba diver;
driver;
driver;
submarine crew;
caisson workers;
army officer.

When serving in the armed forces, conscripts must perform powerful physical activity daily. Since the number of deaths in the army has increased, and the main reason for this is heart disease, the medical examination began to carefully examine each conscript. When diagnosing an open oval window in the heart, they become unfit for service and are sent for treatment in order to avoid separation of a blood clot and blockage of blood vessels that pose a threat to life.

The pathology of the heart caused by the formation of an open oval window is not a sentence, but it requires constant monitoring by a doctor and unquestioning adherence to the treatment regimen.

If you take care of yourself, do not overexert yourself, exclude active sports and eat right in the presence of such an anomaly, then you can feel like a completely healthy person and live a long life.

If you take risks, knowing about your disease, and dive under water, fly an airplane, experience exhausting physical exertion, then you can predict the development of an embolism with a probability of 80%, in which disability or death occurs.

During the prenatal period, the unborn baby receives a set of essential nutrients from the mother. This also applies to oxygen supplied with placental blood flow through an open oval window 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, the door in the form of a valve no longer has the ability to open, tightly pressed against the interatrial septum and gradually overgrown.

Important! The window usually closes completely between 3 months and 2 years of age. But sometimes it happens at a later date. IN last years an open window was often 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 a physiological feature of the body. 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. The choice of appropriate therapy is the responsibility of an experienced specialist, who takes into account a number of signs 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 occurs by the age of two. But sometimes it depends individual features organism 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 of various medications, hypoxia and radiation);
underdevelopment of the connective tissue of the heart and various defects;
severe lung disease;
constant physical activity and overvoltage;
pulmonary embolism.

Important! Specialists do not consider an open oval window as a heart defect. It is usually referred to as minor anomalies in the process of heart formation (MARS). 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 intake leads to oxygen starvation of the body, which is accompanied by characteristic symptoms.

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

Diagnostic measures

Often suspect the presence open window allows a routine physical examination by a specialist. It allows you to detect cyanosis of the skin and lag in physical development. Additional signs will be heart murmurs during auscultation (listening with a phonendoscope) and the study of anamnesis (frequent SARS and fainting).

To establish an 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 signs of a stroke or transient ischemic attacks, 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, endovascular occlusion is performed under the control of X-ray and 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. This 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 conduct the necessary research. Under the constant supervision of a doctor, 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, the expectant mother should lead healthy lifestyle life, eat right and eliminate all bad habits.

In addition, any contact with chemicals(paints, varnishes, dangerous drugs) 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 significantly increase the risk of heart disease 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;
work with the doctor to develop the right diet;
try to go to the sea every year.

Important! You need to show your child your confidence and calmness. No need to scare him with medical terms and show excessive concern about health. 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 after a certain time it should close on its own. But in some cases this does not happen, which requires professional help from specialists. And only the comfort and quality of life of a growing baby directly depends on the timely identification of the problem and its competent solution.

Now, quite often, at the first examination, parents can be informed that an open oval window has been found in the heart of a child. Initially, such a hole between the atria is still in the womb of the fetus in order to ensure normal blood supply.

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

Features of the disease

heart diagram with ooo

The interatrial septum in humans performs an important function - it prevents the blood from mixing with each other. But in newborns, this partition is not always an integral structure. Initially, this is necessary for better oxygenation of the brain, but in the normal state of the newborn, the hole should already be completely closed. At the moment of the first cry, the pressure in the lungs increases and the valve completely closes the window.

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

At the same time, it should be understood that the closing of the “window” in the heart of a child is individual for each baby and therefore it is impossible to clearly define the standard period when exactly the valve should grow to the walls.

For some babies, this happens in a year, two, three, five - it all depends on the individual characteristics of the organism. Ideally, if the closing of the oval window in the heart of a newborn occurs in the first 3 months after the birth of the baby.

Hole dimensions

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

2-3 mm - with such a deviation from the norm, there can be no serious consequences and therefore there is no need for any treatment;
small size - 5-7mm. In this situation, everything depends on the accompanying provoking factors;
over 7mm ( maximum size- 19mm) - a gaping hole. Requires surgical intervention;

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

Causes

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

These include:

genetic predisposition. This is the most common cause of this problem. Maternal predisposition is especially often manifested;
frequent stress during pregnancy;
the birth of a baby prematurely;
impact on the pregnant woman's body of negative environmental factors;
alcohol, drugs, illicit drugs, smoking.

Symptoms of the disease

Often, an open oval window in newborns can be detected during a routine examination. But sometimes a number of basic symptoms can indicate a pathology:

blue around the mouth (cyanosis of the nasolabial triangle). Blue appears often when coughing, crying, screaming and disappears during the rest period;
fast fatigue, lethargy. This symptomatology is especially acute during intense physical exertion;
dizziness, loss of consciousness;
weak body resistance to viral infections. Frequent colds;
palpitations, shortness of breath;
disturbed heart rhythm, heart murmurs;
poor weight gain.

Diagnosis of the disease

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

These studies are carried out only in a specialized cardiological hospital. Such examinations allow not only to confirm the diagnosis of an open oval window in a newborn, but also to establish the degree of risk for the baby and find out how serious the disease is in this case. X-rays may also be required to establish the boundaries of the heart and the thickness of the vessels.

Treatment Method

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

You should be serious about the daily routine of the baby, not overloading him not only physically, but also psychologically. The baby's diet should primarily include vegetables and fruits, as well as protein foods. If any infections are detected, it is necessary to start treatment as soon as possible, since any advanced disease has heavy load on the heart.

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

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

Surgical intervention consists in maintaining a special catheter through the artery. At the end of this catheter is a special device that allows you to close the hole.

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

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

Features of the operation

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

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

scheme of surgical treatment of an open oval window

The advantage of this operation is that there is no need to open the chest, stop the heart and apply deep anesthesia. Postoperative antibiotics are required to prevent bacterial endocarditis.

Additional reasons when surgery is required in any case:

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

These are the cases when the operation is most likely to be avoided, yet it will not be possible.

According to statistics, LLC, which persists after the age of five, is likely to accompany a person all his life. Often, a window in the heart of a child does not have any special symptoms and does not interfere with the normal functioning of a person. Therefore, if the child does not want to engage in intensive sports in the future, then in everyday life the window will not interfere with him in any way.

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

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

There is no cause for concern if the baby does not have additional diseases (other heart defects, diseases of the pulmonary system, circulatory disorders).

This is due to the fact that an unclosed area of \u200b\u200bthe septum can disturb only if there are other provoking factors.

Also, in the presence of this pathology, it is prohibited:

do weightlifting;
scuba diving;
dive to great depths from a springboard.

Also, girls may experience heart problems during pregnancy in the future.

Possible Complications

Embolism can also be a rare complication of this pathology. Emboli are small particles of adipose tissue, blood clots or gas bubbles. In the normal state, they are absent in the bloodstream, but with chest injuries, fractures, or other problems, they can enter the bloodstream.

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

Although this is a rather rare problem, nevertheless, if a long course of treatment is necessary in case of injuries or planned operations, it is imperative to warn the attending physician about this feature of the body.

Results and conclusions

Summing up, it is worth noting once again that the prognosis and treatment method directly depends on the presence of other provoking factors. Each case is individual and should be considered separately by a cardiologist.

But at the same time, there are no particular reasons for concern if there are no additional heart defects.

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

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Why does it appear?

At the birth of a child, the lungs expand, pulmonary blood flow increases, pressure in the left atrium increases and contributes to the closure of the foramen ovale. Physiological closure does not occur with prematurity, alcoholic embryopathy, connective tissue dysplasia.

According to some assumptions, the reasons for abnormal development may be the use of alcohol by a woman during pregnancy, as well as smoking, ecology, drug use, heredity, fetal malformations.

An open oval window in the heart is diagnosed in adults and children by the results of an ECG, x-ray, contrast echocardiography, or by listening to rhythms with a phonendoscope.

Signs and symptoms

There are practically no specific manifestations in adults. The doctor can only suspect that the patient has this disease. An adult may complain of severe headaches, but not everyone has them. Most often, the disease is detected incidentally during other examinations or when complications occur.

But there are symptoms of an open oval window, according to which a preliminary diagnosis is established:

Blueness with coughing, physical exertion of the nasolabial triangle or lips (cyanosis);
Predisposition to acute respiratory infections and respiratory diseases (frequent bronchitis, pneumonia, asthma);
Unexplained fainting, thrombophlebitis, varicose veins, cerebrovascular accident;
physical intolerance. stress, respiratory failure, discomfort;
palpitations, shortness of breath, headaches (migraines);
The mobility of body parts is impaired, periodic numbness of the limbs;
The ECG shows changes in the right atrium;
Increased blood volume in the lungs.

What is dangerous?

Usually, an open foramen ovale in the heart in adults does not affect their activity or life expectancy. But it is dangerous during pregnancy, as well as for people with varicose veins, pulmonary diseases, thrombophlebitis.

Due to PFO, the risk of blood clots in the heart increases and the likelihood of some complications increases:

Stroke. With this severe disease, parts of the brain die;
Myocardial infarction. With such a violation of the work of the heart, a section of muscle tissue dies;
Kidney infarction. Due to a violation of the blood supply, a part of the kidney dies;
Violation of the blood supply to the brain. A person’s speech and memory are disturbed, hands and feet go numb, mobility and other symptoms are disturbed, which last no more than a day, then disappear without a trace.

Any treatment for an open foramen ovale will not reduce the risk of these complications.

How to treat?

In most cases, treatment of an open foramen ovale is not required. According to statistics, 10-15% of people live with an LLC and do not experience any inconvenience. When symptoms of an open foramen ovale do not appear, then no treatment is prescribed.

If complications of the disease appear, then drugs are prescribed that prevent thrombosis in the heart or blood vessels.

In case of reaching a significant size of the hole, surgical intervention is possible. Usually, grafts are inserted to close it - permanent "patches". But they can cause tissue inflammation. Relatively recently, they began to use an absorbable patch. Although it is a temporary “patch”, which resolves in a month, it effectively stimulates tissue repair. Thus, the hole is completely overgrown.

Cardiology. oval window

The open foramen ovale in the heart is located between the atria. This small hole during embryonic development takes part in the blood circulation of the fetus. At its core, the oval window in the heart is an adaptive-physiological mechanism. Due to the inactivity of the lungs, there is no need for a large blood supply to them; oxygen-enriched blood penetrates to the fetus through the placenta.

An open hole between the atria allows you to bypass the small (pulmonary) circle. This process is called "shunting". In addition, blood circulation along this path contributes to the direct flow of enriched blood to the brain, which is actively developing in the embryonic period.

As a rule, the oval window closes after birth. This is due to increased pressure (arterial) in the left side of the heart.

It should be noted that all newborns are always born with an open foramen ovale. As practice shows, normally, the hole closes during the first months. However, about 15-20% of patients survive to the age of forty with an open foramen ovale. This indicator is associated with some features in the structure of the hole itself. The fact is that the oval window has a sash, which is covered in the process of contraction in the left atrium. Thus, the penetration of blood into the right atrium is prevented.

But in some situations associated with an increase in pressure in the chest against the background of physical stress (during the act of defecation, sneezing, coughing and other stress), the sash opens. Some structural defects of the septum, as well as the size of the oval window itself, also contribute to the preservation of the open hole.

As observations show, shunting from left to right of blood from the atrium of the left to the right is not accompanied by any signs indicating its presence, thus proceeding asymptomatically. Along with this, the ejection of blood in the opposite direction (from the right to the left atrium) can provoke permanent or transient symptoms of cyanosis. As a rule, this condition is caused by an increase in the vascular resistance of the pulmonary artery system against the background of an apnea attack, breath holding, screaming and other stresses. In connection with the pathological release of blood into the left atrium, throughout the entire newborn age, constant cyanosis (bluish coloration of skin and mucous membranes) may persist. The condition is eliminated after the start of a decrease in resistance in the artery of the lungs.

A foramen ovale that closes prematurely can cause various malformations. So, early closing of the hole may be accompanied by a disorder in the development of the left half of the heart, the occurrence of hypoplasia in these parts of it.

An enlarged foramen ovale can provoke the formation of a paradoxical embolism, accompanied by signs of a transient attack (ischemic) or stroke. According to studies, an open window increases the likelihood of ischemic stroke by about 40%.

Signs of the presence of an open window in the heart also include paroxysmal migraine headache. Today, the mechanism of development of such a state against the background of an unclosed hole has not yet been sufficiently studied. Most often, the occurrence of pain is explained by microembolization in the brain with blood clots (small blood clots), as well as the influence of substances that form in the vein system and penetrate directly into the vessels of the brain.

Rarely, in the presence of an open hole in the heart, orthodeoxia platypnea syndrome can develop. This condition is characterized by a decrease in saturation (saturation) of blood with oxygen in the vertical position of the body, accompanied by shortness of breath.

What parents of children with congenital heart disease and other diseases of the cardiovascular system need to know

What is the danger of an open Oval Window?

Open oval window is a normal element of the structure hearts which is obligatory element fetal cardiovascular system(the fetus is a period of development of the future child from the formation of the placenta to birth, that is, this is the period when the child is in the womb). OOO necessary in order to reduce blood flow to the non-working lungs in the prenatal period and transfer part of the blood to blood vessels to other organs and tissues. In this article, we will try to find out why it is dangerous to have an open oval window after birth and, in general, Is LLC a heart defect?

After the baby is born and takes its first breath, the lungs expand and begin to work. pulmonary circulation. In this case open oval window will interfere with normal blood circulation through the pulmonary system. Therefore, nature provided for its cover with a special fold, which gradually grows, closing oval window tightly. If it is not tightly closed, its presence is recognized by the noise that is heard in a heart. and on ultrasound, the doctor finds the window open. This situation can be considered as minor anomaly of heart development. it is important that after three months in healthy full-term mature children with normal development oval window closes and the noise disappears.

If open oval window is not accompanied by other signs of heart failure, then you should not worry about this. It is only necessary to periodically monitor the child's condition by a pediatrician and pediatric cardiologist and regular echocardiography. the multiplicity of which will be determined for each individual child by a specialist. But if the child develops shortness of breath and palpitations during feeding, a sharp pallor of the skin, or, conversely, cyanosis(bluish discoloration of the skin), the child does not eat well, does not gain enough weight - an urgent need to seek help from a pediatric cardiologist: in this case, an in-depth examination, clarification of the diagnosis and exclusion will be required congenital heart disease .

One of the serious complications that can occur in case of non-closure of the open oval window is the so-called paradoxical embolism. The essence of this phenomenon is that emboli(small foreign particles, blood clots, bacteria or gas bubbles) coming from the venous system or arising directly in the right atrium can penetrate the left heart, and then the systemic circulation. If in the future emboli get into the vessels that feed the brain, then a stroke or a bacterial complication may occur. That is why it is very important to conduct a thorough examination in a timely manner upon detection Open Oval Window .

During intrauterine development, certain "failures" of the program may occur, due to which some disturbances occur in the human body. One of them is the presence of an opening in the heart, which is called the oval window.

Most often, a defect is discovered by chance, during a comprehensive or profile examination, when contacting a clinic with complaints of other health problems. This is due to the fact that in most cases the condition does not manifest itself in any way, or the symptoms are so minor that they are attributed to another disease.

Our heart is made up of four cavities, or chambers: two ventricles and two atria. In the process of formation in the womb, an opening may remain between these chambers that have not closed. If it is formed between the atria, then it is called an open oval window in the heart in an adult.

Most often, it is small in size and does not outwardly give clear symptoms of the disease, so most people do not suspect the presence of a pathology until it is discovered. medical statistics states that approximately 30% of all adults have such a structural disorder.

In most cases, defects in cardiac anatomy are discovered in childhood, but sometimes they go unnoticed until adulthood.

Such violations are dangerous for their owner., since the hole between the atria poses a threat of disruption to the functioning of the heart, blood vessels and lungs due to the difference in blood pressure that occurs due to the message of the atria.

An open window cannot be considered a simple hole in the wall of the heart, since it works like a valve, allowing blood to move in only one direction - from the small to the systemic circulation. The hole has microscopic dimensions, most often no more than a pinhead. The average defect size is up to 4.5 mm. The body is able to compensate for such dimensions. But the window can be up to 19 mm in diameter, this already affects the health and well-being of the patient.

Causes and symptoms of the condition

A hole in the septum between the cavities of the heart is formed during the formation of tissues and organs of the fetus in the mother's body. At the time of the birth of a child, his lungs straighten, fill with air, the blood flow accelerates, the pressure in the left atrium increases, which contributes to the closure of the existing hole.

In cases where the open foramen ovale in the heart of an adult does not close naturally, it is believed that the main reasons for this are the use of pregnant alcoholic beverages, certain drugs and drugs, smoking.

Also among the reasons for the appearance of pathology is a poor environmental situation, burdened heredity, impaired fetal development at different stages. Another reason why the communication between the heart chambers remains open is the birth of a premature baby who has not had time to fully form all the organs.

The opening of the oval window affects people who, due to their profession or hobbies, experience constant significant overloads. These are mainly athletes, as well as people suffering from frequent pressure drops. Of the athletes at risk are weightlifters, bodybuilders, wrestlers.In another group are divers, especially deep-sea divers, scuba divers, divers, submariners, climbers, pilots, astronauts, testers. They constantly suffer from very strong pressure drops, which can provoke the development of a defect.

In adulthood, a person rarely feels the presence of such a pathology. Basically, the presence of an open oval window is detected by chance or during a routine examination for another reason.

More information about congenital heart defects can be found in the video:

The following symptoms may be present:

Cyanosis of the lips and / or nasolabial triangle during physical exertion, severe coughing.
Too frequent diseases of the respiratory system, the presence of chronic bronchitis, bronchial asthma.
Severe headaches, migraines.
Dyspnea.
Increased heart rate.
Cerebral circulation disorders.
Unreasonable fainting.
Numbness of limbs.
Mobility disorders.
Increased blood volume in the lungs.
Changes in the right atrium, noticeable on.

One person may not have all the signs at once, but only some of them. Sometimes they exist in such a blurred form that it is impossible to suspect the presence of a serious pathology.

Diagnostic methods

In order to identify a defect, the patient is assigned to undergo electrocardiography, radiography,. Additionally, the doctor can listen to heart rhythms with a phonendoscope.

All these diseases can lead to severe consequences and problems up to disability and death.

Treatment of pathology is not a guarantee of protection against the manifestation of complications. However, in most cases, people with such disorders live a normal full life and do not suffer from the presence of an open foramen ovale.

The main way to prevent the formation of such a defect is pregnancy hygiene. A woman should take a responsible approach to bearing a fetus, completely giving up smoking, drinking alcohol, and using medications other than those prescribed by a doctor for health reasons.For adults, it is important to avoid very strong physical overload, which can lead to the opening of the oval window and the occurrence of complications, side effects, and lead to poor health.

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

The foramen ovale in the heart of some babies does not close with a valve after birth

What is a disease

In the area of the left ventricle, the window is closed thanks to a small valve, which is finally formed by the time the baby is born. When a newborn starts screaming for the first time, the lungs open, blood flow to them increases, and the pressure in the left atrium increases, and the oval window in the heart of the newborn is covered with a valve. Over time, its strong fusion with the interatrial septum occurs. However, the important point is that the body of each person is individual and not all of them happen at the time of birth.

Many parents are frightened by this phenomenon and they are interested in the doctors when the oval window in the child's heart closes. In fact, it interferes with the proper functioning of the blood circulation, so it must gradually close. This happens with the help of valve growth to the edges of the interatrial septum.

An open foramen ovale is a heart anomaly, not a heart defect.

The duration of this process is different for all children - for some, the hole closes immediately, for others - after a year or two, and for someone - after five years. This is absolutely normal, and if there are no other diseases associated with cardiovascular system, then there is no need to worry.

Sometimes it happens that the 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 an anomaly in the maturation of the heart.

Children with this diagnosis, reaching the age of 3, receive the second group of disability.

What is an oval window in the heart of the fetus and newborn is described in the video:

Why won't the oval window 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 has not closed 5 years after the birth of the child, it is worth considering. Consider why this pathology can occur:

most often this problem is hereditary, which is transmitted mainly from relatives of the first line;
if, when carrying a baby, a pregnant woman allowed herself to regularly drink alcohol or smoke often;
the problem can be provoked by the bad ecology in which a woman is expecting a baby;
if, future mom ate wrong;

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

with regular stressful and depressive conditions in which a woman was while carrying a baby;
if there were toxic poisoning during pregnancy;
when a child is born before the due date.

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

How deviation manifests itself

Whatever 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 the signs depends on the size of the hole:

if the open oval window in the heart of a child is from 2 mm to 7 mm, such a deviation is considered insignificant and makes itself felt only during strong physical exertion;

Bad habits of the mother during pregnancy can provoke the development of heart abnormalities in the baby

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

In newborns, an anomaly in the development of the heart is manifested as follows:

when a child cries, strains, or coughs, his nasolabial triangle, tip of his nose, or fingertips may turn blue;
the skin of such children is paler than that of others who do not have pathologies;
infants also have a rapid heartbeat.

Symptoms of pathology depend on the size of the hole

In adults who have had such a pathology, lips may also turn blue under certain circumstances:

when a person holds his breath for a long time, swims or dives, this is explained by the fact that during such procedures the pressure in the pulmonary vessels increases;
due to 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 the pathology are as follows:

there is a systematic loss of consciousness;
the skin turns blue even in the absence of strong physical exertion;
worries about general weakness throughout the body, dizziness;
the child may lag far behind in development from their peers.

The skin integuments in babies with an anomaly of the heart are pale in color.

Diagnostic methods

On a routine examination, the cardiologist is unable to diagnose a patent foramen ovale in a child because there is no heart murmur on auscultation. To diagnose pathology, there are the following procedures:

Echocardiography (ultrasound of the heart). Thanks to this study, the doctor has the opportunity to understand in which direction blood circulation occurs, how much blood flows between the right and left atria, and also to determine the presence of other serious pathologies. These points are very important in the course of diagnosis, with the help of them the specialist understands at what stage the disease is and prescribes effective therapy.
Contrast echocardiography. This procedure shows if there is an open foramen ovale in the heart of a child or an adult. To identify the pathology, the patient is injected intravenously with saline. If a gap is present, then the reaction will occur immediately, and the doctor will see how air bubbles penetrate through this hole from one atrium to another.

Ultrasound of the heart allows to reveal in detail violations in the structure of the organ

Transesophageal echocardiography. This study is carried out if it is necessary to find out exactly where the gap is located and what size it is. Also, with the help of the procedure, it turns out whether there are any complications in the form inflammatory processes in heart valves, blood clots, or enlargement of the heart.
Chest x-ray. It shows the size of the patient's heart, the diameter of the heart vessels, and also determines whether blood has stagnated in the lungs.

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 contact a cardiologist.

There is no need to panic with this diagnosis, since such an anomaly almost never affects a person’s activity or life expectancy.

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

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

The disease can cause the death of some areas of the brain, which is fraught with a stroke.
Impaired functioning of the heart causes the death of sections of muscle tissue, which can cause a myocardial infarction.
Due to impaired blood circulation, kidney cells can die - an organ infarction will occur.
In case of circulatory disorders in the brain, a person’s speech can be deformed, memory lapses are noted, the upper and lower limbs go numb. Symptoms last for a day, after which they disappear on their own.

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

When a child complains, he is prescribed medication

Methods of treatment

If an open oval window in the heart of an infant is diagnosed, then before the child is 5 years old, no medical therapy is not required, this is due to the fact that during this time it can close on its own. If this did not happen, and the pathology does not make itself felt in any way, and does not prevent the child from developing normally, then there is no need to treat the problem.

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

The condition is relieved by anticoagulants. One of the most effective drugs 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 hemostasis system in order to avoid education.

By the age of 5, in most young patients, the foramen ovale closes.

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

If the foramen ovale in the heart of the newborn has not closed, and the symptoms are severe, 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 X-ray and echocardiological devices.

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

Prognosis for an open foramen ovale in the heart

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

Non-closure of a large foramen ovale requires surgical intervention. For six months after the completion of the operation, 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 limiting himself in anything.

An open foramen ovale is not a heart defect. Every child is born with it. When the baby takes his first breath, his blood circulation will begin to work normally, and the need for it will disappear. The window disappears when the pressure in the left atrium becomes higher than that in the right. Usually, the valve is overgrown with connective tissue, after which the LLC disappears.

If the hole is not completely closed or not overgrown at all, blood is discharged from the right chamber to the left. Then they talk about the diagnosis of "open oval window" in infants. According to statistics, more than 40% of adults suffer from it. Is it that dangerous? Let's consider in more detail.

Features of the disease

Depending on age, the disease may differ. So, in infants, a window that is not completely closed due to physical overstrain cannot open, so only pathologies can become the cause of LLC.

Symptoms also vary across ages.

For example, babies do not gain weight well, become irritable, and cyanosis may occur.
In older children, there is a developmental delay, restlessness.
OOO in adolescence characterized by low stamina, fatigue, headaches and dizziness.

If the open oval window is closed, then it will no longer be able to open.

You can see what an open oval window looks like in the following video:

Classification of an open oval window

The LLC is located on the inner side of the left wall of the right atrium, namely at the bottom of the oval fossa. Most often, it has a small size (up to 2.5 mm) and an elongated shape, similar to a gap. By size and classify the oval window, which can be:

small;
average;
large;

A large window can reach 20 mm, then they talk about complete non-closure, which is a wide rounded hole.

Causes

The causes of the disease are not fully understood. Several factors can lead to the appearance of an open oval window in an infant:

hereditary predisposition;
prematurity;
heart defects;
connective tissue dysplasia;
negative impact of the external environment;
use of drugs, tobacco and alcohol during pregnancy;
genetic abnormalities;

There is a risk of opening the oval window. So, in athletes who are fond of weightlifting, wrestling and similar sports, due to heavy physical exertion, an oval window may open. Also included in the risk group are:

divers and divers;
patients with thrombophlebitis;
patients with PE;

It should be noted that the opening of the oval window is observed in people with an uncovered hole. The reasons for the failure are not fully understood.

Symptoms

In most cases, POD proceeds without specific signs with very poor symptoms. Indirect signs of the disease include a whole group of symptoms such as:

pallor of the skin;
cyanosis in the lips with physical. load;
slow physical development in children;
fainting;
dizziness;
headaches;
shortness of breath;
low endurance;

However, these symptoms are indirect and it is impossible to diagnose the disease from them.

Diagnostics

To diagnose an open oval window, it is necessary to undergo hardware examinations, which are directed by a doctor. The doctor collects an anamnesis of complaints and signs, evaluates the patient's nutrition, conducts a physical examination and, based on the results of the research, prescribes:

General an-zy of blood and urine to assess the condition and identify concomitant diseases.
Biochemical an-z blood to determine the level of cholesterol, triglycerides and sugar.
Coagulogram to assess the likelihood of blood clots.
EchoG with dopplerography to detect the valve of the open joint stock company, anomalies of the heart.
ECG, which reveals the pathology of the heart.
X-ray of the chest to clarify the size of the heart muscle.

It is also possible to consult with other doctors, for example, a general practitioner. We will talk about the treatment of an open oval window further.

Treatment

If the patient does not have pronounced disorders in the work of the heart, then the treatment of PFO can be limited to therapeutic methods and medication. In severe pathologies, endovascular treatment may be required.

Therapeutic way

Limit physical. loads.
Eat a balanced diet, 4-5 meals a day. Pay special attention to vegetables and herbs.
Observe the mode of work and rest, do not overwork.

It is also important to observe the correct sleep regimen, not to overwork the body.

medication

Together with therapeutic measures, patients are also prescribed medication if there are signs of malaise:

Anticoagulants such as warfarin. Designed to prevent thrombosis and thromboembolism.
Antiplatelet agents or antiplatelet drugs, such as Aspirin for prophylaxis, or.

Drugs with other effects may also be prescribed, depending on the concomitant diseases.

Endovascular procedure

Now the surgical operation is not performed, since it has been completely replaced by an endovascular procedure.

During endovascular treatment, a catheter is inserted into an artery. An occluder is installed at the end of the catheter, which clogs the oval window during insertion.

Disease prevention

There is no specific prevention of PFO. In order to prevent the opening of an ungrown window, it is important:

Keep a balanced physical activity and do not overexert yourself.
Treat emerging diseases in time, prevent their complications.

Drivers and divers need to refrain from excessive workloads and strictly observe safety precautions when working.

About whether they take to the army, if there is an open oval window, read on.

Do they join the army?

An open oval window fits article 42, according to which the patient is partially or completely exempted from military service with categories:

B, is of limited use if the disease is with blood shedding. The conscript is unfit for service in peacetime.
B, eligible with minor restrictions if disease without shedding.

However, it must be remembered that now there is a strict selection in the army, and often people with any form of LLC are exempted from service. final decision will be accepted by the recruiting committee.

If there is a risk called an open oval window during pregnancy, it is worth taking care of prevention.

Prevention during pregnancy

There are precautions that a pregnant woman must take to reduce the risk of a disease in a born child, for example:

Rejection of bad habits.
Compliance proper nutrition. It is necessary to limit the consumption of fried, smoked and spicy, to pay Special attention products with high content fiber, that is, vegetables, herbs, beans, etc.
Avoid contact with strong ionizing radiation.
Avoid contact with caustic chemicals. things, for example, varnishes, paints, liquid medicines.
Avoidance or timely treatment infectious diseases especially rubella.

IN general principles Prevention comes down to following the principles of a healthy lifestyle.

Complications

By itself, an open foramen ovale often leads to the formation of blood clots in the heart. Due to thrombus formation, there is a high risk of:

which leads to brain damage.
Myocardial infarction leading to damage to the tissues of the heart muscle.
Kidney infarction leading to death of kidney tissue.
Transient disorder of cerebral circulation, which temporarily disrupts the functioning of the brain.

It must be understood that insufficient blood circulation affects all human organs, and therefore can lead to other pathologies.

Forecast

With proper treatment, the prognosis for patients is positive. After the operation, it is recommended to take medications prescribed by the doctor and lead a healthy lifestyle in order to increase the positive effect. It is also recommended to regularly visit a cardiologist and undergo echocardiography.