Babies are born with an open oval window in the heart. As soon as they take their first breath, the pulmonary circulation begins to work normally, and the need for an open window disappears. Due to the increase in blood pressure in the left atrium, the valve eventually closes and over time is completely overgrown with tissue.
An open oval window is a common problem
What is this pathology
Sometimes the hole between the heart atria can only partially close or not overgrow at all. In a similar scenario of the development of events, with any effort (screaming, sneezing or coughing), a certain amount of blood is transferred from one chamber to another through the slightly opened valve. Upon detection of such a pathology, the child patient is diagnosed with an open window.
What is dangerous
An open oval window in the heart of a newborn is one of the normal options. If over time it does not begin to gradually close, In adulthood, a range of well-being and health problems can easily arise:
- heart attack;
- stroke;
- transient circulatory disorders inside the brain.
Prerequisites for development
The main prerequisites according to which an open oval window in a child's heart may not close completely have not been clarified for certain. A number of experts believe that the following factors provoke a dangerous ailment:
- the birth of a baby premature;
- heredity;
- congenital heart disease;
- abuse by the mother during the period of bearing a child of alcohol, tobacco, drugs;
- exposure to factors of an unfavorable environment.
Most pathologies develop during the carrying of a child by the mother
Why doesn't the hole close
Most often, an unclosed valve is due to a hereditary predisposition. In this situation, the valve is smaller in size than the hole diameter. This can mean only one thing: complete closure of the oval window in the heart of a newborn is impossible in principle.
When it comes to physiological norm
The gradual closure of the hole in the heart in the first month or even a year of the baby's life is considered normal.
Important! Medicine knows cases when a small window in a baby's heart closed by 3 or even 5 years.
Not in all cases, a hole in the heart of a small child turns out to be a real cause for serious concern. A person can have an open valve and live a full life without even realizing that he has a problem, because it is really possible to find out about it only by doing an ultrasound.
The heart can function fully if the hole is not too large in diameter. When the window is opened no more than 2-3 mm, in the complete absence of other serious pathologies, there is no reason to worry. This condition has almost no effect on the well-being of the child.
In most cases, an open window does not affect the well-being of the baby.
If the size of a hole in a child's heart varies in the range from five to seven millimeters, the anomaly is still considered hemodynamically insignificant, but it can already begin to show itself during intense physical exertion.
When the hole diameter is between 7 and 10 mm, this is far from the norm. Such a patient is usually diagnosed with a gaping open window. In terms of symptoms, this condition is largely reminiscent of a congenital heart disease. The patient should undergo regular examinations by a cardiologist.
The main symptoms
If the baby suffers from the pathology of an unclosed window, this can be understood by the following symptoms:
- slow weight gain;
- noticeable blue discoloration of the periubital triangle during coughing, crying or screaming;
- susceptibility to bronchial and pulmonary colds.
In older childhood, if the window does not close, the growing child may develop shortness of breath and tachycardia, even not with the most serious physical exertion.
Closer to adolescence and throughout adulthood, pathology will manifest itself in the following signs:
- fast fatiguability;
- chronic fatigue;
- dizziness;
- weakness;
- migraine;
- frequent respiratory diseases.
When the window closes
In more than half of newborns, the window closes safely in the first year (more often before they reach the age of three months). Somewhat less often, the process turns out to be longer and takes up to five years. In most of the recorded cases, pathology is considered a minor anomaly in the development of the heart. At the same time, the prevalence of the disease was and remains quite high. According to official statistics, an open oval window is present in 50% of completely healthy children and in 10-15% of adults.
Diagnosis of pathology
Physical examination of a small patient, as well as the study of his anamnesis, often makes it impossible to accurately determine the presence of an open oval window. They can only assume the likelihood of the presence of an anomaly. To establish an accurate diagnosis, additional examinations are required:
- ECG;
- Echocardiography;
- chest x-ray;
- probing of the cavities of the heart.
If a baby or a young child is examined, transthoracic two-dimensional electrocardiography is most often used for diagnosis. This type of examination allows you to see if the valve is closed or not. Upon confirmation of the presence of an open oval window, the procedure makes it possible to determine its diameter. In addition, using transthoracic electrography, it is easy to obtain a graphical image of the movement of the valve leaflets in time and to exclude or confirm the presence of an atrial septal defect.
Doppler echocardiography is an even more accurate procedure that provides information not only in graphic, but also in color mode. The study allows you to clarify the size of the opening in the heart and to reveal the speed of turbulent blood flow in the area of the foramen ovale, to understand the approximate volume of the shunt.
Serious diagnostics are needed to detect an open window
The most capacious, in terms of obtaining information, and the most aggressive diagnostic method is heart sounding. The procedure is performed immediately before surgery in a specialized cardiac surgery hospital. In the case of infants, probing is extremely rare.
Possible complications
The presence of an open window in the heart can lead to a variety of complications. As the baby grows up, his heart muscle begins to grow. The problem is that the valve remains the same size in this case. With increased blood flow in the socket of the oval window and free penetration of blood from one atrium to another, the load on them significantly increases.
Particularly attentive and vigilant parents need to be if an open window in the heart of a child is diagnosed against the background of other heart problems that increase the pressure in the right atrium. The consequence may not be the most pleasant - such pathologies increase the risk of additional opening of the heart valve in the direction of the left atrium.
Important! Sometimes a pathology such as an open oval window in a child's heart may even be beneficial to health. So, in pulmonary hypertension, moving blood to the other atrium reduces pressure and thereby has a positive effect on health in general.
The opinion of Dr. Komarovsky
The famous Russian pediatrician and TV presenter, Dr. Evgeny Komarovsky, agrees with the fact that almost every baby has a hole in the heart. Its complete closure during the first breath occurs in a very small percentage of babies. In most cases, this takes time. In half of the cases, the window is completely overgrown up to two years. Closer to the age of five, the anomaly mostly disappears on its own, without causing any harm to the child.
In children under one year old, the hole is more common, since their lungs are not yet fully functional. As they unfold, the pressure inside the right atrium will gradually decrease. As a result, due to the pressure difference, the valve will press against the wall and begin to overgrow.
Dr. Komarovsky especially emphasizes the fact that the hole in the heart septum is not dangerous for life and health. This anomaly is one of the developmental features and in most cases proceeds without symptoms, closes without the help of doctors.
If you suspect a problem with a visit to the doctor, you should not delay
If a child has been diagnosed with this disease, parents should not panic. The risk that the problem will develop into a serious pathology is extremely small. Nevertheless, until the valve is overgrown with connective tissue, it is periodically necessary to examine the baby. This will keep the situation under control and take the necessary measures in a timely manner if something suddenly goes wrong.
