At your kid during ultrasound the doctor found an open oval window in the heart. What does this diagnosis mean and is it dangerous for the child? Can an open oval window for newborns pass at all and how long will it take? We'll talk about all this today.
Content
Symptoms are absent. Two views on the problem. What should I do?An open oval window is a small anomaly of the heart, in which the communication between the left and right atrium is partially or completely preserved, which is natural for the period of intrauterine development. At the child the blood flow provides blood supply through through a wide oval window, first of all, the brachiocephalic region. This is necessary to maintain the rapid development of the brain. After birth, the gradient of pressure between the atria changes with the first inhalation of the child, and under optimal development conditions, the process of joining the edges of the valve with the hole occurs. Somewhere in the second half of the first year of the baby's life, the oval window is closed. But it does not happen to everyone. According to many authors, by the first year of life the oval window is closed only in 50-60% of children; believe that it can spontaneously close in any period of a person's life. According to various sources, an open oval window is revealed in 17-35% of adults.
No Symptoms
In most cases, the open oval window has almost no symptoms, it is difficult to identify by some specific manifestations. A general practitioner can only suspect this cardiac anomaly if the child:
- When coughing, crying or physical exertion, especially static ones, cyanosis appears, i. e. blueing (even minor) of the lips or nasolabial triangle;
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persistent predisposition to frequent catarrhal and inflammatory diseases of the bronchopulmonary system; - there are signs of slowing physical development, low endurance to physical exertion, especially in combination with symptoms of respiratory discomfort or respiratory failure;
- there are unexplained loss of consciousness, fainting, symptoms of cerebral circulation (especially in young people).
Two views on the problem
The approach to assessing the clinical role of a small anomaly in the form of an open oval window in the heart of newborns is today ambiguous. Until recently, the point of view about the complete harmlessness of the open oval window was prevailing, this anomaly was considered as a variant of the norm. And until now, supporters of this position believe that with this blemish there is no hemodynamic disturbance and no surgical correction is required.
However, there is another point of view pointing to the possibility of serious, life-threatening complications of this "innocent" heart anomaly. First of all, we are talking about paradoxical embolism and the development of hypoxemic conditions. Particular importance is attached to the identification of an open oval window in athletes experiencing large physical and psychoemotional loads in terms of intensity and volume. It should be noted that the development of paradoxical embolism is possible in those sports where exercises with straining are often used - weightlifting, athletic gymnastics, wrestling.
It is natural to combine an open oval window with another heart anomaly - an atrial septal aneurysm, which is a recognized risk factor for the development of cardioembolic complications. Movable aneurysms significantly increase the probability of throwing microembols from the right atrium to the left, that is, increase the risk of paradoxical embolism.
What to do?
The main methods for identifying an open oval window are the usual echocardiographic and doppler echocardiographic examinations of the heart. Perhaps the main question that needs to be discussed with a doctor is what should be the tactics of parents' behavior if a child has this anomaly of the heart?
First of all, you need to regularly observe a pediatric cardiologist, establish a permanent contact with him. Periodically (once a year) repeat research, track the size of the oval window. If they start to decrease (more often than not, it happens) - wonderful. When this does not happen, you need to solve the problem with a specialist, what else to do. Modern treatment of an open oval window suggests an endovascular transcatheter closure of the opening with a special device.