Open foramen ovale in newborns treatment. Open oval window in the heart. What is an open oval window for?

I have now found good information in the Internet. Now this diagnosis is made by 80% of children, and up to two years it is normal, it is considered a minor anomaly in the development of the heart.

"YOUR CHILD HAS AN OPEN OVAL WINDOW" -such a diagnosis, some time after the birth of a child, is heard today by about 80% of parents.
WHAT IS AN OPEN OVAL WINDOW?

In a child in the prenatal state, the process of blood circulation does not occur in the same way as in an adult, because. in the womb, the child does not breathe, and his lungs do not work, all the necessary nutrients he receives thanks to the placental circulation. The cardiovascular system functions thanks to three openings: oval, arterial and venous. The foramen ovale is located between the right and left atria, through which blood passes, bypassing the lungs. The blood entering through the open oval window feeds, first of all, the brachiocephalic region, ensuring the rapid development of the brain. After birth, with the first breath of the baby, the pulmonary circulation begins to function. Due to the increase in incoming blood, the pressure in the left atrium increases, and the oval hole is closed by a special valve, like a door. This functional closure occurs in the first 3-5 hours of life, and complete anatomical closure, due to the fusion of the edges of the valve flap and the edges of the hole, after 2-12 months. Sometimes the overgrowing process lasts up to two years, which is also considered normal. ☆☆☆

But that doesn't happen for everyone. The foramen ovale can close even in utero, which leads to an overload of the right heart and simultaneous underdevelopment of the left. A child in such a situation dies either in utero or in the first hours of life.

In some children, the hole does not close completely, or does not grow at all. This often happens in premature babies, and there is also an opinion that those children whose mothers abused alcohol or smoked. Due to genetics, the valve that closes the window may be slightly smaller size than a hole, and unable to completely cover it. Some diseases, accompanied by an increase in pressure in the right side of the heart, may contribute to non-closure foramen ovale, which serves as a compensation message. The right parts of the heart are unloaded, which improves the patient's condition. Such situations arise in the primary and secondary pulmonary hypertension, stenosis pulmonary artery, abnormal pulmonary venous drainage, malformations of the tricuspid valve.

In most cases, having an open foramen ovale is not a major concern. Due to the fact that the pressure in the left atrium is slightly higher than in the right, the valve between the atria is kept closed, which prevents the flow of blood from the right atrium to the left. This usually happens with small hole sizes: up to 5-7 mm. In newborns, a temporary increase in pressure in the right atrium may occur against the background of crying, straining, prolonged anxiety. This is accompanied by a reset venous blood through the foramen ovale and is manifested by short-term cyanosis (blue). In older children, the discharge of blood can occur with paroxysmal coughing, diving, exercises, accompanied by straining and holding the breath. Therefore, such children are not recommended for diving, weightlifting, gymnastics, as well as the choice of professions associated with extreme situations: pilots, divers, miners.

At large sizes oval hole (greater than 7-10 mm) there are violations characteristic of the defect interatrial septum. Such an open oval window is called "gaping". The child should be consulted by a cardiac surgeon to resolve the issue of surgical correction. IN Lately often used to close the defect through femoral vein using a special device - OCCLUDER.

One of the strongest complications arising against the background of a functioning open oval window is paradoxical embolism. Emboli, thrombi, gas bubbles, tumor pieces, foreign bodies, from the right atrium to the left, and, continuing their journey further, they can reach the vessels of the brain and cause a stroke, or be localized in any other organ with the development of thrombosis and heart attacks. Often the source of emboli is thrombophlebitis of the lower extremities and pelvic organs, therefore special attention requires monitoring the course of pregnancy in girls with PFO, especially in the last trimester.

An open foramen ovale is not considered a heart defect. It is referred, rather, to MARS (small anomalies in the development of the heart). Many people, having such an anomaly, lead a normal life for a person, quietly living to old age. Sometimes, in older children with hemodynamically significant PFO, there is fatigue and shortness of breath during physical exertion, pallor, slight cyanosis of the nasolabial triangle, less often - a tendency to faint. At the same time, the noise over the region of the heart may not be heard. X-ray of organs chest does not differ from the norm. ECG may show incomplete blockade right leg Gissa's study (which is also found in absolutely healthy children), less often - overload of both atria.

The main method for diagnosing PFO is echocardiography (ultrasound of the heart). It is better if the device on which the study is being carried out has a prefix for color Doppler cardiography. This will allow you to see the presence of even a small discharge of blood through the open foramen ovale.

The presence of LLC in children under 2 years of age - normal phenomenon and, in the absence of other heart conditions, should not be a cause for concern. If the window has not dragged on after 2 years, this is also no reason to panic. Regular visits to a cardiologist, periodic repetition of an ultrasound of the heart will help parents keep the situation out of control and monitor the size of the hole. In a certain percentage of children, it, nevertheless, overgrows completely. If this does not happen, you need to decide with the doctor what to do next.

★★★★★★★ In general, the main thing is what size it is and whether it will grow by the age of 2. Watch out for coughs and physical activity- I understand.

- incomplete closure of the foramen ovale in the interatrial septum, which normally functions in the embryonic period and overgrows in the first year of a child's life. An open foramen ovale may present with cyanosis of the nasolabial triangle, slowing physical development, shortness of breath and tachycardia, sudden fainting, headache, frequent SARS and bronchopulmonary diseases. Diagnosis of an open oval window includes ECG (at rest and after exercise), normal and Doppler echocardiography, radiography, probing of the heart cavities. With an open oval window, anticoagulant therapy can be used, if necessary, surgical treatment (endovascular occlusion of the defect).

Causes of an open oval window

All babies are born with an open foramen ovale. After the first independent breath, the newborn turns on and begins to fully function the pulmonary circulation, and the need for an open oval window disappears. An increase in blood pressure in the left atrium compared to the right one leads to the covering of the foramen ovale valve. In most cases, the valve closes tightly and is completely overgrown with connective tissue - the open oval window disappears. Sometimes the hole closes partially or does not grow at all and under certain conditions (with a hoarse cough, crying, screaming, tension of the anterior abdominal wall) there is a discharge of blood from the right atrial chamber to the left (functioning foramen ovale).

The reasons for the incomplete closure of the foramen ovale are not always clear. It is believed that an open oval window can lead to hereditary predisposition, prematurity , congenital heart defects , connective tissue dysplasia , exposure to adverse factors external environment, smoking and drinking by a woman during pregnancy. Due to genetic characteristics, the diameter of the valve may be smaller than the diameter of the foramen ovale, which will prevent its complete closure.

An open foramen ovale may be associated with congenital defects mitral or tricuspid valves, open ductus arteriosus.

Risk factors for opening the valve of the oval window can be significant physical exertion in athletes involved in weightlifting, wrestling, and athletic gymnastics. Particularly relevant is the problem of an open oval window in divers and divers diving to a considerable depth and having 5 times more high risk development of decompression sickness. In patients with thrombophlebitis of the lower extremities or pelvis with a history of PE episodes, contraction of the pulmonary vascular bed can cause an increase in pressure in the right heart and the appearance of a functioning open foramen ovale.

Features of hemodynamics with an open oval window

The open foramen ovale is located at the bottom of the oval fossa on the inner left wall of the right atrium, often small in size (the size of a pinhead) and slit-like. The size of the open foramen ovale averages 4.5 mm, but can be as large as 19 mm. An open oval window, in contrast to atrial septal defect, has a valvular structure that ensures the inconstancy of the interatrial message, the ability to discharge blood in only one direction (from the pulmonary circulation to the large).

The clinical significance of an open foramen ovale is ambiguous. An open foramen ovale may not cause hemodynamic disturbances and may not negative impact on the health of the patient due to the small size and the presence of a valve that prevents the shunt of blood from left to right. Most people with an open foramen ovale are unaware of this anomaly and lead a normal life.

The presence of an open foramen ovale in patients with primary pulmonary hypertension is considered to be prognostically favorable in terms of life expectancy. However, the excess pressure in the right atrium compared to the left at an open oval window leads to the periodic occurrence of a right-to-left shunt that passes a certain amount of blood and leads to hypoxemia, transient cerebrovascular accident (TIA), the development of life-threatening complications: paradoxical embolism, ischemic stroke , myocardial infarction , kidney infarction .

Symptoms of an open oval window

The open foramen ovale has no specific external manifestations, in most cases proceeds latently, sometimes it can be accompanied by poor symptoms. Indirect signs open oval window may be: severe pallor or cyanosis of the skin in the lips and nasolabial triangle with physical stress(crying, screaming, coughing, straining, bathing a child); tendency to frequent colds and inflammatory bronchopulmonary diseases; slowing down the physical development of the child ( poor appetite, insufficient weight gain), low exercise endurance, combined with symptoms of respiratory failure (shortness of breath and tachycardia); sudden fainting and symptoms of impairment cerebral circulation(especially in patients young age, with varicose veins, thrombophlebitis of the lower extremities and small pelvis).

Patients with an open foramen ovale may experience frequent headaches, migraine, postural hypoxemia syndrome - the development of shortness of breath and decreased satiety arterial blood oxygen in a standing position with an improvement in the transition to horizontal position. Complications of an open oval window are rare. For paradoxical embolism cerebral vessels aggravating this anomaly, the sudden development of neurological symptoms and the rather young age of the patient are characteristic.

Diagnosis of an open oval window

The study of the anamnesis and physical examination of the patient often does not immediately determine the presence of an open oval window, but can only allow the possibility of this anomaly of the interatrial septum (skin cyanosis, fainting, frequent acute respiratory viral infections, lagging child development). Auscultation helps to identify the presence of heart murmurs as a result of an abnormal shunt of blood from a higher pressure chamber to a lower pressure chamber.

To establish accurate diagnosis open oval window used instrumental research and imaging methods: ECG (at rest and after exercise), conventional and Doppler echocardiography, chest x-ray, probing of the heart cavities.

With an open oval window, changes appear on the electrocardiogram, indicating an increase in the load on the right heart, especially on right atrium. Older people with an open foramen ovale may have radiological signs enlargement of the right chambers of the heart and an increase in blood volume in vascular bed lungs.

In newborns and children early age apply transthoracic two-dimensional echocardiography, which allows you to visually determine the presence of an open oval window and its diameter, to obtain graphic image movements of the valve leaflets in time, to exclude an atrial septal defect. Doppler echocardiography in graphic and color mode helps to clarify the presence and size of an open foramen ovale, to identify turbulent blood flow in the foramen ovale, its speed and the approximate volume of the shunt.

In older children, adolescents and adults, a more informative transesophageal echocardiography supplemented with a bubble contrast test and a strain test (Valsalva test) is used to diagnose an open foramen ovale. Bubble contrast improves the visualization of the open foramen ovale, allows you to determine its exact dimensions, and evaluate the pathological blood shunt.

The most informative, but more aggressive method for diagnosing an open oval window is cardiac sounding, which is performed immediately before surgical treatment in a specialized cardiac surgery hospital.

Testing for a patent foramen ovale should be done in patients with varicose disease thrombophlebitis, cerebrovascular accident, chronic diseases lungs, which are at risk of developing paradoxical embolism.

Treatment of an open oval window

With an asymptomatic course, an open oval window can be considered a variant of the norm. Patients with an open foramen ovale in the presence of an episode of transient ischemic attack or a history of stroke for the prevention of thromboembolic complications are prescribed systemic therapy with anticoagulants and antiplatelet agents (warfarin, acetylsalicylic acid). The method of control of anticoagulant therapy is the international normalized ratio (INR), which, with an open oval window, should be in the range of 2-3.

The need to eliminate an open foramen ovale is determined by the volume of shunted blood and its effect on work of cardio-vascular system. With a small shedding of blood, no concomitant pathology and no complications are required.

With a pronounced pathological discharge of blood from the right atrium to the left, a low-traumatic X-ray endovascular occlusion of the open oval window is performed. The operation is carried out under X-ray and echocardioscopic control using a special occluder, which, when opened, completely clogs the hole.

Prognosis of an open oval window

Patients with an open foramen ovale are advised to have regular follow-up with a cardiologist and echocardiography. The performed endovascular occlusion of the open foramen ovale allows patients to return to their normal rhythm of life without restrictions. In the first 6 months after surgical treatment open foramen ovale, antibiotics are recommended to prevent the development of bacterial endocarditis. Greatest effect from endovascular closure of the open foramen ovale is noted in patients with platypnea who had a pronounced shunt of blood from right to left.

Any problems with a child's heart frighten parents and cause worries, especially if they are congenital malformations. However, among cardiac pathologies in childhood there are also very serious, life-threatening, and not so dangerous, with which the child can live quite normally. The second also includes an open oval window (abbreviated as LLC).

Open oval window - not so terrible diagnosis for the child and his parents

What is this

This is the name of the structural feature of the septum inside the heart, which all children have during prenatal development and is often found in the newborn. The thing is that in a fetus, the heart functions a little differently than in a baby or an adult.

In particular, in the septum that separates the atria, there is a hole called the oval window. Its presence is due to the fact that the lungs of the fetus do not work, and therefore little blood enters their vessels. The volume of blood that in an adult is ejected from the right atrium into the veins of the lungs, in the fetus passes through the hole in left atrium and is transferred to the more actively working organs of the baby - the brain, kidneys, liver and others.

A small valve separates such a window from the left ventricle, fully maturing by the onset of labor. When the baby takes his first breath and his lungs open, after which blood rushes to them, which is accompanied by an increase in pressure inside the left atrium. At this moment, the oval window is closed by a valve, and then it gradually fuses with the septum. If the window closes ahead of time, still in utero, it threatens with heart failure and even death of the child, so the presence of a hole is important for the fetus.

The window between the atria can close even by 5 years

Closing the window occurs in different children in different ways. In some, the valve grows to it immediately after birth, in others - during the first year, in others - by the age of 5. In some cases, the size of the valve is insufficient to close the entire oval foramen, due to which the hole remains slightly open for life, and blood in a small volume is periodically discharged from the small circle into big circle circulation. This situation is observed in 20-30% of children.

A foramen ovale that has not closed completely after birth is not considered a defect in the septum that separates the atria, as the defect is a much more serious problem. It is considered a congenital defect, and LLC is classified as a minor anomaly, representing only individual feature. With a septal defect, the valve is completely absent and blood can be shunted from left to right, which is a health hazard.

A PDO that does not close over time is a congenital heart disease

Causes

Most often, an unclosed foramen ovale in a child's heart is associated with a genetic predisposition, which in most cases is transmitted from the mother. Other reasons for the emergence of an LLC are adverse effects during gestation:

• Bad environmental situation.
• Nicotine.
• Stress.
• Narcotic substances.
• Alcohol.
• Medicines prohibited during pregnancy.
• Malnutrition.

Quite often, non-closure of the oval window is noted in children who were born much ahead of time, as well as in the presence of intrauterine growth retardation in full-term babies.

In the next video, you can see how the blood circulation and heart activity of a child should normally change before his birth.

Symptoms

If the open valve is an isolated problem and the child has no other heart defects, clinical picture scarce enough. You can suspect LLC in a baby by:

• Detection of palpitations.
• Changes in the color of the nasolabial triangle (it turns blue or gray) during feeding or crying.
• shortness of breath.
• Bad appetite.
• Little weight gain.

For preschoolers and children school age possible problems with exercise tolerance and frequent inflammatory diseases respiratory system.

A schoolchild with LLC gets tired quickly and needs a strict daily routine with alternating loads and rest

IN adolescence when the body is actively growing and hormonal changes occur, LLC in children manifests itself:

• Weakness.
• Sensations of interruptions in the heart rhythm.
• Increased fatigue.
• Episodes of dizziness.
• Periodically appearing causeless fainting.

Diagnostics

You can suspect the presence of LLC in a baby after listening to the heart with a stethoscope. If the doctor hears systolic murmurs, he prescribes an ultrasound for the child, since this method is most preferable for detecting the oval window. Pathology is often detected during a routine echocardiography performed in all children at 1 month. In some cases, to clarify the problem, the baby may be prescribed a transesophageal ultrasound, as well as angiography.

Ultrasound signs of an open oval window are:

• Size up to 5 mm.
• Position in the middle of the septum.
• Hole visualization inconsistency.
• Detection of a valve in the left atrium.
• Thinned interatrial septum.

You can see what LLC looks like on ultrasound in the next video.

Komarovsky's opinion

A well-known pediatrician confirms that the oval window is open in almost all newly born babies and in 50% of them remains open until the age of 2. But even at the age of 2 to 5 years, the presence of such a window in the heart is considered a variant of the norm, which practically does not affect the well-being and health of the child.

Komarovsky emphasizes that this is not a heart defect and in most children the window closes on its own in the first years of life without any intervention from doctors.

Treatment

If there is no pronounced clinic and problems with the work of the heart, which is especially often the case in the presence of LLC, no drug treatment not required. The child is recommended measures that are important for general strengthening body:

• Walking on fresh air.
• Balanced diet.
• Proper distribution of loads and rest during the day.
• hardening procedures.
• Physiotherapy.

If there are complaints from the heart, children are prescribed drugs for myocardial nutrition and vitamins. Most often, babies are prescribed l-carnitine, ubiquinone, panangin and Magne B6.

Most effective treatment OOO is the insertion into the right atrium of the patch

If PFO is combined with other defects, the child is treated by a cardiac surgeon, since surgery is often required. One of the effective measures with an open oval window is the introduction of a probe with a patch into the child's femoral vein. When the probe reaches the right atrium, the patch is applied to the window and closes it. While it will resolve within a month, the formation processes are activated in the septum. connective tissue resulting in the oval window being closed.

Forecast

Many parents worry that a "hole in the heart," as they call LLC, will threaten their child's life. In fact, such a problem is not dangerous for the baby, and most children with an open window feel quite healthy. It is only important to keep in mind some limitations, for example, with regard to extreme species sports or professions in which the load on the body increases. It is also important to examine the baby every 6 months with a cardiologist with an ultrasound study.

If the foramen ovale remains open after the child's fifth birthday, it is most likely that it will no longer close and the child will have it for the rest of his life. At the same time, such an anomaly has almost no effect on labor activity. It will become an obstacle only for obtaining the profession of a diver, pilot or astronaut, as well as for strong sports loads such as weightlifting or wrestling. At school, the child will be assigned to the second health group, and when a boy with LLC is called up, they will be counted as category B (there are restrictions in military service).

Many children with LLC feel quite healthy.

It is noted that at the age of over 40-50 years, the presence of PFO contributes to the development of ischemic and hypertension. In addition, with a heart attack, an open window in the septum between the atria adversely affects recovery period. Also, adults with an open window are more likely to experience migraines and often experience shortness of breath after getting out of bed, which immediately disappears as soon as the person lies back in bed.

Among the rare complications of PFO in childhood, embolism may occur. This is the name given to the entry into the bloodstream of gas bubbles, particles of adipose tissue or blood clots, for example, in injuries, fractures or thrombophlebitis. When emboli enter the left atrium, they travel to blood vessels in the brain and cause brain damage, sometimes fatal.

It happens that the presence of an uncovered foramen ovale helps to improve health. This is observed in primary pulmonary hypertension, in which, due to high pressure in the vessels of the lungs there is shortness of breath, weakness, chronic cough, dizziness, fainting. Through the oval window, blood from the small circle partially passes into the large one and the vessels of the lungs are unloaded.

You can learn more about the open oval window from the following video.

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

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

Why do I need an oval window for the fetus?

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

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

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

The exact cause of this pathology does not exist.

Allocate some of the most common factors.

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

Open foramen ovale in children and its symptoms

In most cases, these children do not complain.

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

What can be seen?

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

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

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

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

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

As a rule, there are no pathological changes on the ECG with PFO.

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

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

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

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

These drugs improve myocardial nutrition and exercise tolerance.

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

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

As for sports and a functioning oval window, in the absence of complaints and good indicators of ultrasound of the heart, you can engage in any sport.

Complications

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

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

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

A hole of small diameter, located between the left and right atria, the formation of which takes place even in the womb, is called an open oval window in newborns.

What is its meaning

LLC is a kind of mechanism of a functional nature. Its essence lies in the fact that the lungs of the fetus are inactive, and they do not need to enter a large number blood. Blood enriched with oxygen enters the baby's body through the placenta from the mother.

If the foramen ovale is not closed, the blood moves without affecting the pulmonary CC. She goes immediately to the large CC and the baby's brain. This process is called shunting.

The open oval window in a newborn closes normally a few months after birth. The reason for its closure is an increase in the level of pressure in the left side of the heart.

According to statistics, in 10–25% of people, the oval window remains open for up to 40 years or more.

The reason for this lies in the structure of the window. It has a specific closing sash, which, during left atrial systole, closes the lumen in the window, thereby blocking the reverse flow of blood.

In some cases, the window remains open when frequent cough, sneezing or other kind of overexertion. There are also cases when the reason for LLC is elevated level pressure in the middle of the chest. There are frequent cases of keeping the window in the open position, associated with a violation of the structure.

An open oval window is a physiological pathology that closes a few months after the birth of a child.

Symptoms and danger of anomalies

In practice, if blood returns from the left atrium to the right through the OO window, this process passes in a person without the manifestation of clear symptoms and does not cause him any discomfort.

When blood is directed from the right atrium to the left through an open oval window in the heart of a child or adult, this process is accompanied by the manifestation of some signs that may be permanent or transient:

• blue integument of the skin;
• violation of the structure or size of the left side of the heart;
• development of a symptom of hypoplasia of the LO of the heart;
• paradoxical embolism;
• signs of a stroke;
• symptoms of a transient attack.

The presence of an open foramen ovale increases the risk of stroke by 45–50%.

In order to anticipate this possibility, it is necessary to pay attention to such signs:

• general weakness;
• numbness of the upper or lower limb On the one side;
• weakness of vision or its partial loss;
• loss of speech;
• difficulty in the swallowing process;
• confused mind;
• headache, often for no apparent reason;
• loss of orientation in space;
• development of uneven gait.

There are frequent cases when, in the presence of an open oval window, a condition such as hypoxia manifests itself, which is accompanied by low level oxygen in the blood when a person is located in vertical position as well as shortness of breath.

The cause of this syndrome is a violation of the distribution of blood to the lungs.

If a child's foramen ovale does not close before age 5, there is a good chance that it will remain open for the rest of their lives. At the same time, such an anomaly will not affect its activity and health.

In the event that a PFO, which should normally be closed, is present in a person over the age of 40 or 50, he is likely to develop such diseases:

• hypertension;
• ischemic BS;
• chronic heart failure.

Presence of an open foramen ovale in humans different ages has excellent signs as well as consequences.

Diagnostics

You can establish the presence of this anomaly using normal listening. In this case, systolic murmurs are clearly audible in children.

Other methods are also used to make a more accurate diagnosis:

1. Ultrasound examination. The monitor will clearly show the presence of a violation of the structure of the heart.
2. Echocardiogram. this method makes it possible to obtain a two-dimensional image of the heart, on which the mechanism of its contraction will be clearly visible, as well as to find out the size of the oval window.
3. Transesophageal echocardiography. It is used if the patient has a concomitant disease such as heart disease. The essence of the method is the introduction of a contrast agent into the vessels through the esophagus.

If the diagnosis is confirmed, without the presence of concomitant diseases, the child is registered in the dispensary.

The more methods used in the diagnosis, the more accurate the diagnosis will be. It is on this that the effectiveness of the treatment process depends.

Treatment

In the case when the oval window is not closed, but the patient has not found any complications of such an anomaly, drug therapy is not applied.

For such a child, hardening is recommended, an alternate and balanced combination of physical activity and rest, stay in the fresh air, diet food, LFC.

If the patient complains about the symptoms of the pathology, which have a blurred and irregular nature of the manifestation, specialists prescribe a course of vitamins, as well as medicines, whose action is aimed at ensuring additional food heart muscle.

With the parallel development of an open oval window and heart defects, specialists prefer the correction of defects by surgical intervention. The essence of the operation is the introduction of a probe and a patch through the femoral vein, which close the opening of the oval window.

If labor activity patients with RO window is associated with in a sedentary manner life (driver, programmer, pilot, etc.), they are recommended to take a break from work every 2–2.5 hours and take a short walk, preferably outdoors.

This will help to avoid stagnation of blood and the formation of blood clots in the veins of the upper or lower extremities.

Prescribing an effective course of treatment provides a patient with a diagnosis of OO with a long and active life. Be healthy!