Defects of the septa, both interventricular and interatrial, are frequent heart defects. Such an ailment of the septum, as the presence of one or several openings in it, significantly lowers the overall quality of life of the patient. And the knowledge of manifestations of this pathological condition allows it to be diagnosed in time to start treatment.
What is the defect of the atrial septum and what are the main symptoms of this congenital heart disease?
Features of the disease
This congenital disease is characterized by a high degree of risk in the absence of necessary treatment, because with a constant increased stress on the right ventricle, the cardiac muscle is rapidly depleted, resulting in an average life span of about 45-50 years with a septal defect. In this case, for people with this congenital defect is characterized by the formation of a thrombus, which disrupts the heart system and can cause such serious lesions as a heart attack or stroke.
The disease under consideration has certain manifestations that are characteristic of children, adults and newborns.
- Thus, in newborn children there are no visible abnormalities, however, the obstetrician should be alert to the bluish skin tone - this is due to the fact that during the newborn period, venous and arterial blood is not mixed due to the same thickness of the atrium and ventricular walls and there is no significant increase in the load on any-or part of the heart.
- In children, the first obvious manifestations of the defect begin to occur in the age range from 3 to 5 months: dyspnea appears, the general condition worsens, the child is sluggish and sedentary. A visit to a doctor can not be postponed with the appearance of edema, impaired appetite and blue skin.
- In the adult state, the defect of the interatrial septum manifests itself in the impossibility of carrying a physical load of any intensity, since it immediately develops dyspnea, the condition worsens and a pronounced arrhythmia begins. The frequency of heartbeat increases, oxygen supply to tissues worsens.
This disease has become more studied today, but the reasons for its appearance are not known to the end. There are a number of factors that should be attributed to risk indicators. Also, for a better understanding of this pathological condition, a specific classification of the defect is used, which takes into account hemodynamic disturbances in the work of the heart.
The following video describes the features of the atrial septal defect in more detail:
Forms and classification of
For the convenience of understanding the patient's condition in this type of pathological condition of the heart, the disease is classified and currently distinguishes 3 types of atrial septal defect:
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- open oval window - this condition is typical of the period of the embryo in the womb. The window is necessary for gas exchange at the moment when the lungs do not begin their work. Then the window is closed by a special valve, which tightly grows to the septum inside the heart. However, sometimes the valve does not grow to the partition, or its size exactly coincides with the size of the oval window, and then, at the slightest emotional or physical load, the valve departs and the blood flows to the right ventricle from the left;
- primary defect of the interatrial septum - while the valves that divide the atria from the ventricles are also affected by the defect, and their dimensions do not allow the holes to be tightly closed;
- secondary secondary defect of the interatrial septum, in which the anomaly of the hollow superior vein is observed in the newborn.
Photo-diagram of atrial septal defect
Causes of atrial septal defect
To predisposing factors causing non-closure of the valve between the atrium and the ventricle, it is necessary to attribute a genetic predisposition, and their effect is observed during the formation of the baby's embryo, that is, even during the mother's pregnancy. The following conditions should also be included in the risk indicators:
- rubella, representing a viral disease, very often causes the appearance of heart defects, in particular the defect of the interatrial septum, if it was carried by the expectant mother during pregnancy;
- excessive intake of alcohol during pregnancy also often causes the development of newborn heart defects;
- preparations containing elements such as lithium, tretinoin, progesterone;
- mother's diabetes.
These factors greatly influence the formation of the future child's cardiac system, therefore, if any of them exist, it is necessary to undergo an appropriate examination for the possible occurrence of this defect in the cardiac septum.
Symptoms of
The most common manifestations of the defect in question are the appearance of dyspnea, even with a little physical exertion( it can also occur with emotional overloads), blushing of skin, cyanosis of the skin. The swelling of the extremities and the face should also be alerted, since they can become a symptom of this condition.
- For children, also the characteristic manifestations of this defect should be considered the reluctance to play for a long time in active games, long-term bronchitis with the transition to pneumonia, the baby refuses to suck the chest, he may lack the air even with the slightest physical movement.
- Preschool children with this pathology of the cardiac system are poorly developed physically, they have pale skin, they do not aspire to mobile games and have a poor appetite. They have a palpable heart pulse in the left part of the chest, noises in the heart.
- Adults can also often suffer from pneumonia and bronchitis for a long time.
Diagnosis
In the cases described above, both children and adults should be examined by a cardiologist. To determine the defect of the interatrial septum, an appropriate examination is carried out, allowing to identify existing pathologies in the development of the cardiac system and begin the necessary treatment.
The most effective diagnostic measures include the following:
- chest X-ray - this method can detect changes in the size of the heart and its individual parts, which may indicate the appearance of the defect in question, as well as the presence of blood stagnation in large veins( they are visible in the pictureas enlarged in size);
- cardiogram - this method allows diagnosing congestion of the right side of the heart: ventricle and atrium;
- echocardiography - the method provides the ability to detect a hole in the septum and increase the volume of the right ventricle;
- insertion of a catheter into the heart. With the help of this method of research, it is possible to detect a greater enrichment with oxygen from the right atrial blood in comparison with the left atrium, and also the possibility of introducing a catheter from the left atrium into the right;
- angiocardiography provides the ability to obtain data such as the presence or absence of a hole in the interatrial septum. For this, a special coloring substance is injected into the blood of one atrium, which in the picture of the heart ensures the visibility of the movement of blood in the heart.
- For children during the newborn period, also methods for diagnosing the disease are used, such as listening to the heart. With the help of a stethoscope, a doctor discovers the presence of extraneous noise that occurs when narrowed valves pass through the cardiac septum with swirling blood.
- An X-ray can detect a newborn with an increase in the size of the heart and enlargement of large arteries in it.
- Cardiac electrocardiography and ultrasound also reveal the presence of enlarged heart and stagnation of blood in large veins, and if there are indications for an urgent operation, cardiac catheterization is performed.
After diagnosis of the defect of the interatrial septum, the physician is assigned appropriate treatment, and the timeliness of the measures taken allows not only to improve the quality of life of the patient, but also to increase the maximum period of life. Thanks to proper treatment, it is possible to quickly restore the normal state of the patient as a whole and the work of the cardiac system in particular.
On how the atrial septal defect is treated in newborns and adults, read on.
On how the defect of the interatrial septum looks, the following video will tell:
Treatment of
Today, there are several most effective approaches to curing this defect. All of them are based on the reduction of hypervolemia in a small circle of blood circulation, which allows to significantly reduce the load on the heart muscle.
When a newborn is diagnosed with this heart condition, the doctor prescribes observation of the condition, as often small holes in the heart grow independently to a certain age. If there are several openings or heart defects combined, then surgical intervention is prescribed.
Several main directions of treatment of this condition should be distinguished. Consider them more carefully.
Therapeutic
Therapeutic method of treatment of atrial septal defect is prescribed with insignificant hole sizes in the heart. Here the calculation is carried out taking into account the possibility of their self-infestation;However, this method is applicable in the absence of several holes and their small size.
Also, surveillance can be shown for children and newborns with a small hole in the heart - most patients recover to 18-22 months. However, regular visits to the doctor and the conduct of appropriate examinations will be mandatory.
Medicated
No drug can lead to openings in the heart. But their competent application normalizes the heart rhythm, stabilizes the patient's condition and promotes the soonest elimination of the defect of the septum in the heart.
Drugs used to treat the defect in question include:
- beta-blockers;
- digoxin;
- means, reducing the degree of coagulation of blood - anticoagulants, reducing the risk of blood clots and, as a consequence, strokes and heart attacks. The most commonly used is aspirin.
In some cases, the diagnosis of an atrial septal defect is prescribed treatment with an operative intervention.
You will find out how the operation to close the atrial septal defect occurs.
Operation
Surgical intervention is indicated with an increase in the symptoms of the disease, the increase in heart rhythms. However, a contraindication may be cardiac hypertension of the 4th stage.
The operation can be performed by two main methods:
- cardiac catheterization - this technique is considered to be minimally invasive, whereby a probe is inserted through the vein in the thigh, which is brought to the site of the septal lesion and a so-called patch-grid is placed on the hole in the cardiac septum. There are a number of consequences of this method of surgical intervention, which include pain, infection at the site of insertion of the probe;
- open intervention is performed by cutting the thorax and sewing into the heart of a synthetic patch in the heart. The disadvantage of the method can be considered a long period of rehabilitation of the patient.
The operation to close the atrial septal defect is presented in the following video:
Prevention of
As prevention of an atrial septal defect, a pregnant woman should avoid any alcoholic beverages, as well as medicines that can cause any defects in the child's cardiac system.
A healthy lifestyle for the mother and psychological and emotional hygiene will be the key to the birth of a healthy child.
Complications of
After treatment, if there is an atrial septum defect, certain complications may occur. During the surgical intervention, the doctor should be urgently called for redness of the joints and a rise in temperature above 38 ° C, it is also necessary to pay a visit to the doctor if heart rhythms are changed and tachycardia occurs, and the right heart is inadequate.
Absence of treatment can cause thrombus formation, which can lead to a stroke or a heart attack - a detailed outcome is not excluded. Therefore, timely diagnosis and treatment are mandatory in the presence of this pathology. Treatment also allows you to significantly increase the life of the patient and improve the quality of his life.
Forecast
With the time spent on the examination and the beginning of the treatment prescribed by the doctor, the prognosis is maximally favorable: the life expectancy of the patient is significantly increased, and the risk of recurrent disease becomes minimal.
Five-year survival rate with adequate treatment is about 85-92%. Postoperative lethality when closing the hole in childhood is almost 0%, while the same treatment in the adult state, the risk of death is slightly increased - it is no more than 2-5%.
Proper rehabilitation after treatment allows to further reduce risks and restore the patient's health.