A gap in the heart (open oval window). Open foramen ovale in the heart of a child; heart defect; window

With the advent of ultrasound diagnostics in medicine, young parents increasingly began to learn from doctors that the baby’s oval window remained open. Having heard such a diagnosis, you should not panic, because the baby reacts sharply to the mother’s emotions. All parents should be aware of what a patent foramen ovale in a child’s heart means, what symptoms the pathology causes, why it is dangerous and what are the ways to eliminate it.

The foramen ovale in some babies' hearts does not close with a valve after birth.

What is the 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 begins to cry for the first time, the lungs open, the flow of blood to them increases, and the pressure in the left atrium becomes greater, and the oval window in the newborn’s heart is covered with a valve. Over time, it becomes firmly fused with the interatrial septum. However, an important point is that each person’s body is individual and not everyone experiences this at the time of birth.

Many parents are frightened by this phenomenon and ask doctors when the oval window in the child’s heart will close. In reality, it prevents the blood circulation from functioning properly, so it must gradually close. This happens through the growth of the valve to the edges of the interatrial septum.

Patent foramen ovale is an anomaly of the heart, 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 others after five years. This is absolutely normal, and if there are no other diseases associated with the cardiovascular system, then there is no need to worry.

Sometimes it happens that the valve size is not enough to completely cover the gap. Under such circumstances, an open foramen ovale in the heart of an adult or 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, upon reaching 3 years of age, receive a second disability group.

The video explains what the oval window is in the heart of the fetus and newborn:

Why does the oval window not close?

An open foramen ovale in newborns is an absolutely natural phenomenon, since when a child develops in the mother’s womb, it is vitally necessary for him. However, if the functioning oval window has not closed 5 years after the birth of the child, it is worth thinking about. Let's consider why this pathology can occur:

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

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

• with regular stressful and depressive states in which the woman was while carrying a baby;
• if there were toxic poisonings during pregnancy;
• when a child is born ahead of schedule.

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

How does the deviation manifest itself?

Whatever disease a person faces, they all manifest themselves differently and cause certain symptoms; an open foramen ovale in the heart in children or adults is no exception. However, the severity of the symptoms depends on the size of the hole:

• if the open oval window in the child’s heart 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 manifests itself as follows:

• when a child cries, tenses or coughs, his nasolabial triangle, tip of the nose or fingertips may turn blue;
• the skin of such children is paler than that of others who do not have pathologies;
• Infants also experience increased heart rate.

Symptoms of the pathology depend on the size of the hole

In adults who have had this 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 activity;
• in the presence of diseases associated with the lungs;
• if there are any other heart pathologies.

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

• systematic loss of consciousness occurs;
• the skin turns blue even in the absence of strong physical activity;
• general weakness throughout the body, dizziness;
• the child may be very developmentally behind his peers.

The skin of babies with heart abnormalities is pale in color.

Diagnostic methods

During a standard examination, the cardiologist is not able to diagnose a patent foramen ovale in a child, because there is no heart murmur when listening. To diagnose pathology, the following procedures exist:

• Echocardiography (ultrasound of the heart). Thanks to this study, the doctor is able to understand in which direction blood circulation occurs, how much blood flows between the right and left atria, and also determine the presence of other serious pathologies. These points are very important during diagnosis; with their help, the specialist understands what stage the disease is at and prescribes effective therapy.
• Contrast echocardiography. This procedure shows whether there is a patent foramen ovale in the heart of a child or an adult. To identify the pathology, the patient is given intravenous 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 the other.

Ultrasound of the heart allows you to identify in detail abnormalities 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. The procedure also determines whether there are any complications such as inflammation in the 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 is stagnant in the lungs.

Why is pathology dangerous?

An open foramen ovale in the heart of a newborn is diagnosed very often, and this is normal, but if it does not close after some time, 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 activities or life expectancy.

Heart abnormality caused by the formation of a patent window requires observation by a cardiologist

However, it should be remembered that a foramen ovale in the heart 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 parts of the brain, which can lead to a stroke.
• Impaired functioning of the heart causes areas of muscle tissue to die, which can lead to myocardial infarction.
• Due to impaired blood circulation, kidney cells may die - an organ infarction will occur.
• If there are circulatory disorders in the brain, a person may have deformed speech, memory loss, and numbness in the upper and lower extremities. Symptoms last for 24 hours, after which they disappear on their own.

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

If a child has complaints, he is prescribed medication.

Treatment options

If an open foramen ovale in the heart of an infant is diagnosed, then no medical therapy is required before the child turns 5 years old, due to the fact that during this time it can close on its own. If this does not happen, and the pathology does not make itself felt in any way and does not interfere with the child’s normal development, then there is no need to treat the problem.

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

• The condition is alleviated by anticoagulants. One of the most effective medications in this group of drugs is Warfarin. If the patient takes this drug, then there is a need for frequent blood tests so that doctors can monitor the state of the hemostatic system in order to avoid formation.

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

• The person is also prescribed treatment with antiplatelet agents or antiplatelet drugs. One of the most common and effective drugs in this category is aspirin, which must be taken daily at 3–5 mg per 1 kg of body weight. If you adhere to this treatment method, it is possible to prevent venous insufficiency, blood clots, and ischemic stroke.

If the foramen ovale in the heart of a newborn has not closed, and the symptoms are severe, X-ray endovascular occlusion of the open orifice is required. Throughout the operation, the doctor monitors the patient’s condition using special X-ray and echocardiological devices.

Patients after surgery due to a large oval hole in the heart are forever freed from pathology

Prognosis for an open foramen ovale in the heart

A small functioning foramen ovale in newborns does not interfere with either social or work activities throughout their lives. However, people with this diagnosis need to avoid extreme sports, intense physical activity and professions that are associated with it.

A large patent oval window requires surgical intervention. For six months after completion of the operation, in order to avoid bacterial endocarditis, patients are recommended to take antibiotics and regularly visit a cardiologist. However, after the recovery period, a person can continue to live without limiting himself in anything.

Modern diagnostic methods make it possible to identify diseases whose presence was not even suspected before. An open foramen ovale in the heart of a child is a disorder of the heart muscle, which is increasingly observed in medical practice.

While the fetus is in the mother's womb, there is a functioning window in the heart, and this is a natural manifestation. After the baby is born, it usually closes.

Purpose of a window in the heart

During intrauterine development, the fetus is nourished by the mother's blood. On the heart muscle between the atria there is a small oval window, it is thanks to it that nutrients and a sufficient amount of oxygen come from the blood to the cells of the central nervous system.

After birth, the child’s respiratory system begins to work, the oval window, having fulfilled its function, tends to close. Most often this happens in the first few days of life.

Approximately 30% of children live with it until they are 1 year old; in some situations, the hole cannot close for certain reasons, then the child needs professional medical help.

When should the foramen ovale close?

Parents who are faced with a similar anomaly have a question: when does the foramen ovale close normally? If the development of the newborn is observed without certain disturbances, then the valve begins to close in the first few hours of life, the closure of the oval window continues longer.

On average, complete overgrowth is completed between the ages of two months and a year; in certain groups of children it can last up to two or even five years. For some people, the hole does not heal until the end of their lives; this is already a pathology.

An incompletely closed hole after 5 years of age is more often diagnosed in premature infants and in children with congenital diseases.

This type of disorder is not classified as an organ defect, but as a minor anomaly in the development of the heart (). In this case, it is necessary to constantly monitor the doctor.

The presence of these disorders does not pose a major threat to health. Often people live with them and have no idea about the presence of such a pathology. The disorder is discovered by chance when diagnosing other diseases.

Another problem is determined when the window is completely open, when the interatrial valve is not able to perform the necessary functions.

This disease is called “atrial septal defect.” After 3 years of age, children are given disability group II, young people of military age are assigned fitness category “B”, which exempts them from military service.

Causes of pathology

Statistics show that the number of diseases has increased in recent years. More often, the disorder occurs in premature babies and with a genetic predisposition.

An unclosed oval window can be caused by:

• Loose closure due to the anatomical features of the valve structure (it is smaller than normal).
• Unfavorable conditions of intrauterine development (taking medications, exposure to increased radiation, hypoxia).
• Heart defects.
• Abnormal development of myocardial connective tissue.
• Severe lung diseases.
• Regular physical activity.
• Thromboembolism of the pulmonary artery.
• Unfavorable environmental conditions.
• Abuse of alcoholic beverages and tobacco products by the mother during pregnancy.

Symptoms

If the hole is not completely closed, then the pathology may not manifest itself with certain symptoms. The degree of danger is determined by the treating specialist.

In an infant, an abnormal phenomenon can be suspected by the following symptoms:

• Cyanosis is a bluish discoloration of the lips, nose, and fingers, especially when coughing, straining, or crying.
• Pale skin.
• Increased heart rate in a newborn.

In case of disorders in adults, blue lips appear when exposed to a number of factors:

• Strong physical overload, sports.
• Loads that increase pressure in the pulmonary vessels (holding your breath, swimming).
• Pulmonary pathologies (pneumonia, emphysema, asthma).
• Heart defects.

If the opening exceeds 7 mm, this is manifested by a number of external signs:

• Regular fainting conditions.
• Manifestation of cyanosis of the skin even with minor physical exertion.
• General malaise.
• Frequent dizziness.
• Physical development disorders.

Normally, the size of the window should not exceed the head of a pin and be blocked by a valve, which becomes a barrier to the release of functioning blood into the systemic circulation from the pulmonary circulation.

When the patent oval window measures 4.5-19 mm, as well as when the valve is not completely closed, disturbances in blood flow in the brain and a decrease in the oxygen content in the blood often appear.

More often, the pathology occurs without specific symptoms, or the signs are vague. Indirect manifestations that indicate the presence of pathology have been identified:

• A sudden appearance of pallor, cyanosis of the skin during crying or bathing.
• Decreased appetite, anxiety.
• Poor weight gain.
• The appearance of symptoms of heart failure (lack of air, shortness of breath, rapid contraction of the heart muscle).
• Frequent diseases of the respiratory system.
• Fainting states.
• When listening to the heart, murmurs are detected.

Diagnosis of pathology

A specialist may suspect something is wrong when conducting a physical examination, detecting bluish skin, deviations in physical development, and also when noises are detected after listening. The doctor relies on the identified symptoms: frequent acute respiratory viral infections, acute respiratory infections, and fainting conditions.

The most accurate research method is considered to be ultrasound examination of the myocardium, which is carried out not through the chest, but through transesophageal echocardiography.

ECHO signs are determined by inserting an ultrasound probe into the esophagus, while the structural structure of the heart is clearly visible. This is especially helpful in diagnosing pathology in obese people, when visual examination is difficult.

Except for ultrasound of the heart, an accurate diagnosis occurs after the following diagnostic methods:

1. Electrocardiogram. It reveals symptoms of severe stress on parts of the heart muscle.
2. X-ray of the chest, which determines the enlargement of the myocardium.
3. Probing of the cardiac cavities. Prescribed before surgery.

Treatment

The use of therapeutic measures is not always required; in children under five years of age, the window may close on its own.

The need for treatment is determined by the attending physician, and it is necessary to regularly do a cardiogram and Echo-CG.

If the formation of blood clots is diagnosed, medications that have a thinning effect on the blood are prescribed; exposure to heavy loads is not recommended.

In some cases, an operation is required, which consists of inserting a tube with a special valve at the end, which closes the hole between the atria. For six months after surgery, it is necessary to take antibiotic drugs, which will make it possible to prevent the formation of bacterial endocarditis.

Many experts advise maintaining a daily routine for children and avoiding strong physical and psycho-emotional stress. It is necessary to include protein-rich foods in your diet, consume more fresh vegetables and fruits, and natural freshly squeezed juices.

It is important to avoid infection entering the child’s body, since any disturbances can adversely affect the functioning of the heart.

Danger of pathology

Medical scientists have proven that the risk of developing pathology increases in people with constant physical activity and active swimming.

The danger of this condition is that it leads to disturbances in the physical and mental development of children.

Thromboembolism poses a threat to the patient’s health, for this reason it is necessary to urgently take measures to prevent it.

What complications can there be?

The consequences of the disease are rare, but if the foramen ovale is not closed, serious complications can occur:

• Thromboembolism. A clot from venous vessels penetrates the aorta of the systemic circle due to an open foramen ovale, which can cause blockage of blood vessels in vital organs (heart, kidneys, brain). This often becomes the cause of human death.
• Endocarditis is inflammation of the inner lining of the heart.
• Infarction, renal infarction.
• Stroke.

Minor anomalies do not pose a threat to the health and life of patients. But in order to avoid any complications and consequences, it is necessary to be observed by a specialist.

In the modern world, parents very often hear from doctors that their baby has an open foramen ovale in the heart. Just the name of the diagnosis makes you feel uneasy. Parents who are faced with such a diagnosis for the first time may panic. Let's see how dangerous this diagnosis is? Is this dangerous for the child? What is this, a dangerous pathology or a congenital feature?

A patent foramen ovale is an opening between the atria. Its dimensions can reach up to 5 mm. If the hole dimensions exceed 5 mm, then this is already a defect of the interatrial septum. Thanks to the oval window, blood from the fetal veins flows into the circulation.

After the baby is born, he takes his first breath. The lungs begin to work. Under air pressure (pressure difference), the oval window is closed by a valve. Very often the valve is smaller and is unable to completely close the hole.

The main thing you need to know is that an open oval window in a newborn baby is not a pathology, it is most likely a kind of heart anomaly. In most cases, this anomaly goes away as the child grows up.

No one can name a definite reason for the fact that the oval window in the heart of a newborn is not overgrown. . There are several factors that can influence this:

All these factors can cause the oval window in the child’s heart to not heal.

Symptoms of an open oval window in newborns

In most cases, a patent foramen ovale occurs without symptoms. Sometimes this can only be determined by ultrasound of the heart during a routine medical examination. Therefore, it is very important that parents closely monitored the condition of their child. The slightest deviations and changes in the child’s behavior are a reason to contact a specialist.

What features might there be?, indicating an open hole in the baby’s heart:

When should it close?

The oval window in the heart of a newborn closes for each individual O. For some, complete closure can occur as early as 2 months, for others at 1 year, for others at 2 years, and sometimes it can close even after 5 years. Experts say that there is no reason to worry, that this is normal. If the child does not have any heart disease, then there is no reason to worry.

Closing occurs as follows: the valve gradually grows to the edge of the oval fossa. In 20% of children, the valve does not grow tightly and an open oval window may remain for life.

Very rarely happens that the oval window remains open completely. If closure does not occur, then this is already considered an atrial septal defect. It turns out that the difference is that the oval window has a working valve, but with an atrial septal defect there is no valve.

If you have been diagnosed with an open foramen ovale in the heart, then you need to know that this is not a defect. This diagnosis is classified as minor anomalies of cardiac development. When the child turns three years old, he will be assigned a second health group. What about young people? of military age, then they are fit for military service, only with minor restrictions.

Diagnostics

If your child has symptoms described above in our article, then to confirm the diagnosis you need to contact a pediatrician. If a pediatrician detects a heart murmur, he will prescribe an ultrasound (ultrasound) of the heart. Only with the help of ultrasound can the diagnosis be confirmed or refuted.

When an ultrasound is performed, a valve is clearly visible in the left atrium, which is located in the area of ​​the fossa oval. The hole can be from 2 mm to 5 mm.

During the examination, they determine how much blood moves in the wrong direction and what load is placed on the heart. And experts also determine, whether there are any concomitant heart pathologies (most often, a patent foramen ovale in newborns is accompanied by concomitant cardiac anomalies, and this undoubtedly complicates treatment).

Treatment

It turns out that a patent oval window in a newborn is a normal phenomenon. And if it doesn’t close immediately, there’s no need to panic. In most cases, closure occurs before the age of two. For about twenty percent, the window remains open for up to 5 years. And a very small percentage of the population remains with an open window for the rest of their lives.

What to do if the child is 5 years old and the closure has not occurred? The patent foramen ovale in a newborn is very small, so it cannot create an overload of the atrium (overload of the atrium leads to heart failure). It is enough just to be observed by a pediatric cardiologist, undergo an ultrasound scan every year and monitor the baby’s condition.

If a child has complaints, he is prescribed medication. Treatment includes taking cardiotropic drugs . Such drugs help improve myocardial nutrition and also help to better bear loads.

Paradoxical embolism can be a great risk to life. Paradoxical embolism is a condition where emboli enter the left atrium through a patent foramen ovale. And after they have penetrated the left atrium, they enter the systemic circulation, heading towards the brain. Emboli can cause ischemic stroke. The saddest thing is that no one can predict the penetration of an embolus; it happens suddenly. Most often, embolism occurs in people aged 30 to 40 years.

Operation

If the foramen ovale has not closed before the age of five, then constant monitoring by a specialist is necessary. Due to the high risk of complications, each case must be considered individually.

It happens that an open oval window can lead to heart failure and circulatory problems. In such cases, surgery is prescribed. In order not to cut the chest and not stop the heart using deep anesthesia, a catheter is installed on the right thigh, with the help of which an occluder is delivered through the vessels to the heart. An occluder is a special device similar to an umbrella. When the occluder arrives on site, it opens and closes the hole and the problem in the unclosed oval window disappears.

If a child under the age of 6 months has undergone surgery, then he is prescribed antibiotic therapy. This is done to prevent bacterial endocarditis.

Complications

Complications are very rare and are associated with impaired blood flow. These could be strokes, heart attacks. But it is worth saying that such complications can only occur in an adult.

In most cases, this heart anomaly does not harm the child’s health. There are no restrictions for playing sports, except for scuba diving and parachute jumping. When jumping or diving, the pressure changes sharply, and this can lead to the oval window becoming larger and then there will be an atrial septal defect.

There are athletes who have this anomaly and feel great. This does not stop them from playing sports and becoming champions. There are doctors who are inclined to believe that an open oval window is a normal phenomenon.

If your child is diagnosed with an open oval window, then do not despair and be upset. It is enough to simply monitor the baby’s condition and undergo an annual examination.

Modern diagnostic procedures are able to identify even minor deviations and anomalies in the structure of organs and tissues of the body. Such opportunities help to begin the necessary treatment in a timely manner.

However, there are many conditions whose detection does not require immediate therapy or surgery. This is worth remembering for young parents who fall into a kind of panic when informed that there is a small hole at the site of the fetal message in the heart of a newborn baby.

Often, when explaining the diagnosis, this is called a patent oval window.

Anatomical background

The unborn child spends the intrauterine period of its development in amniotic fluid.

Accordingly, there is no need for active breathing, and the lungs are in a closed state. The baby receives oxygen through the umbilical vessels from the mother.

The heart initially consists of 4 chambers and is ready to work on both circulations, but the lung tissue does not function. Therefore, the right ventricle is practically switched off from activity, and for the life support and development of fetal organs, nature provides for the discharge of oxygenated blood from the right atrium to the left and further along the systemic circulation to all structures.

This interatrial communication is called the oval window or foramen (foramen ovale).

Is it pathological?

With the birth of the baby and the first cry (inhalation), the lungs expand, the pressure gradient between the chambers of the heart changes, and the fetal window slams shut. Subsequently, connective tissue grows in this place, leaving only a hole.

There are many situations where the closing process is delayed. The hole remains open until 2 years of age in 50% of children, and up to 5 years in 25% of children. Approximately every fourth to sixth adult in the population can live peacefully, unaware of the presence of such an anomaly in the heart.

Based on various studies, doctors agreed that the fundamental criterion for alertness in the presence of communication between the atria is not the fact of the presence of a defect, but the age of the patient, the clinical picture and the size of the open opening itself.

When should you not worry?

If the hole in a newborn in the area of ​​the oval window has a diameter of up to 7 mm, there are no manifestations of disorders, then cardiac intervention is not resorted to. The baby is observed at the prescribed time. After a certain amount of time, a repeat echo-CG is performed to assess the dynamics of the size of the open window.

If the hole does not close in the first months and has borderline dimensions (5–6 mm), the doctor may prescribe drugs that improve metabolism in the heart, vitamins and restorative procedures. Such drug support, good organization of the daily routine and nutrition help speed up the process of overgrowth of the small communication between the atria.

Possible signs

An open oval window can manifest itself as cyanosis of the nasolabial triangle during feeding, crying of the baby, or straining while passing stool. The child does not gain enough weight, is capricious, and does not breastfeed well.

Quite often, the fetal opening between the atria becomes a finding only when listening to heart sounds and/or performing an echocardiogram. At the same time, there are no complaints from the parents of the baby.

Preventive measures

An open oval window of small size is considered a normal variant until a certain age of the child. As the baby grows, the hole should close on its own.

Genetic malfunctions or disruption of intrauterine ontogenesis can become a reason that interferes with the normal growth and functioning of the unborn child. That is why, while carrying a baby, a mother should think about the correct diet, daily routine, use of vitamins and minerals, and it is also important to follow the recommendations of an obstetrician-gynecologist.

Surgical treatment

If the oval window has hemodynamically significant dimensions (with mixing of blood), there is no decrease in the lumen of the communication over time, the child is referred for consultation to a cardiac surgeon.

New techniques make it possible to quickly and minimally invasively install a special “shutter” (occluder). Through a small puncture in the femoral vessel, under hardware control with the help of a guidewire, a synthetic implant is brought to the interatrial septum, which closes the existing fetal communication.

Forecast

Most identified cases of PFO in newborns subsequently regress and end with complete closure of the interatrial communication in the first 2–5 years of life, without causing obvious reasons for concern.

An open foramen ovale, which is small in size, is already considered in older children as MARS (minor anomaly of cardiac development), and can limit excessive physical activity and extreme sports for them.

Our article is devoted to this common pathology. This material will reveal to you the essence of the problem of a functioning oval window.

In 1930, scientists studied about 1,000 children's hearts, and as a result, about 35% of the subjects had a patent foramen ovale (PFO). Nowadays, the frequency of this phenomenon reaches 40% in the pediatric population.

Why does the fetus need an oval window?

In the womb of the mother, the child does not breathe in the literal 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 oval window, blood from the veins flows into the single large circulation of the fetus.

After birth, the baby takes his first breath, the lungs begin their work. Under the influence of the 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 in no way a defect.

There is no exact cause for this pathology.

Highlight Some of the most common factors.

1. In almost all premature and immature newborns, the window remains open.
2. Smoking, maternal substance abuse.
3. Prolonged labor, asphyxia of the baby during childbirth.
4. Adverse environmental factors.
5. Mother's stress.
6. Genetic predisposition.
7. Congenital heart defects.
8. Occupational exposure to toxic substances in the mother.

Open oval window in children and its symptoms

In most cases, such children do not complain.

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

What can you notice?

1. The appearance of blueness around the mouth of a newborn. This cyanosis appears after crying, screaming, sucking, or bathing.
2. In older children, tolerance (resistance) to physical activity decreases. The child rests and sits down after regular outdoor games.
3. The appearance of shortness of breath. In general, a child should normally be able to easily climb to the 4th floor without any signs of shortness of breath.
4. Frequent colds in infants, namely: bronchitis, pneumonia.
5. Doctors listen for a heart murmur.

PERSONAL EXPERIENCE. The child is 10 days old; during bathing, the mother notes the blueness of the nasolabial triangle. The child was born full-term, weighing 3500. The mother admitted 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 of 3.6 mm was revealed. The child has been registered.

Ultrasound of the heart is of primary clinical significance. The doctor clearly sees a small hole 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 for this type of examination.

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

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

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

What to do if the window has not closed after 5 years? Basically, nothing. The open foramen ovale in a newborn is too small in size to ensure overload of the atria with the development of heart failure. Therefore, it is necessary to dynamically monitor the baby, undergo an annual heart ultrasound and be examined by a pediatric cardiologist.

PERSONAL EXPERIENCE. At the reception there was a 13-year-old boy. For 4 years the child has been involved in active sports – rowing. By chance, during a medical examination, an ultrasound of the heart was performed, where an oval window measuring 4 mm was first discovered. At the same time, the child did not show any complaints throughout his 13 years and coped well with physical activity. He even took first place in competitions.

If a child has complaints, drug therapy is prescribed 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) promotes rapid closure of the oval window if taken for 2 months in a course 3 times a year. True, it is not entirely clear what this is connected with. From personal experience, I can say that I did not see a clear connection between Elkar’s appointment and the closure of the LLC.

But it still happens that the oval window can lead to poor circulation 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 to close this hole is decided. A small patch is applied endovascularly (that is, using a catheter) through the femoral vein.

As for sports and a functioning oval window, if there are no complaints and good cardiac ultrasound indicators, you can engage in any kind of sport.

Complications

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

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

Minor heart anomalies 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 normal. But it should be remembered that annual supervision by a specialist is necessary.