Pathology is laid in the perinatal period. In the total number of congenital malformations( such as the Eisenmenger syndrome, Ebstein's anomaly, and Fallot's tetrad), this anomaly has less than half the percentage of cases.
SBUG is a heart disease characterized by high mortality in infancy. Therefore, early diagnosis is extremely important.
Features of the
disease In a healthy heart, two coronary arteries branch out from the artery, which are responsible for supplying the heart muscles with oxygen. They are also called coronary arteries.
- The artery, which covers the left side of the heart, its branch runs along the front of the heart and through the lower part turns to the back side, called the left artery.
- The right branch goes through the corresponding half of the heart. From these two arteries there are additional twigs.
Pathology is expressed by the fact that coronary arteries have one of the varieties of an irregular branch. The coronary artery originates not as planned by nature, but from the pulmonary artery.
Such an anomaly jeopardizes the full functioning of the heart muscles associated with their oxygen supply.About what the coronary artery is, you will learn from the following video:
Classification of
Attachment site
There are different types of pathology depending on which artery has an incorrect attachment site in its origin:
- coronary artery has an abnormal departure from the pulmonary trunk,
- pathology of the same kind, but touches the left branch;
- is the same, but the abnormal process affected the additional artery;
- wrong branch have both arteries: both right and left.
Pathology is of an innate nature.
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The opinion of doctors. .. & gt; & gt;
- In case if both coronary arteries depart from the pulmonary trunk, then for the survival of the infants, there is no chance, because the situation is incompatible with life.
- The most common case is the left artery branching off from the pulmonary trunk. This kind of pathology is the most dangerous in its consequences.
- When an erroneous branch falls on the right or additional artery, no significant health problems occur.
Therefore, the greatest attention in medical practice among all types of pathology is given to abnormal departures of the left coronary artery. The left half of the heart in this case, through the branch of the left artery, receives venous blood, unable to provide oxygen to the tissues of the myocardium.
The clinical picture of the disease can develop in two ways.
- Adult. The mechanisms of life saving are included, and an auxiliary( collateral) blood supply is produced. Other connections are being made with arterial blood, which supports the vital activity of the left half.
- Infantile. Option, when there is an abnormal branch of the left artery, but the body has not taken action to adapt to this and facilitate the course of the disease. The ingress of venous blood, which is poor in oxygen, into the channel of blood vessels created to feed the heart muscles, creates a critical situation. A lethal outcome is possible.
In the perinatal period, the pressure in the pulmonary trunk almost corresponds to the pressure in the artery. After birth, the child undergoes a reconfiguration in this area.
Nature laid that the artery pressure is much higher than in the venous trunk. Leaving the left artery from the stem brings another problem: lowering the pressure in the branch that feeds the muscles of the heart. The body can strive to adapt to the problem.
Phases
Specialists distinguish three phases in the development of the syndrome:
- In the pulmonary trunk, high blood pressure is created, so the coronary artery receives sufficient blood filling.
- Pressure in the barrel decreases. Anastomoses begin to form between the right artery and the left branch.
- The third phase occurs when the process of the appearance of anastomoses is completed. Between the arteries, the coronary circulation is obtained, which is communicated with each other. At the same time in the branches of the coronary arteries different pressure.
The pressure in the right artery corresponds to the strength of the aortic pressure. And in the left artery, due to an abnormal branch from the pulmonary trunk, the pressure is much lower. This can trigger the flow of arterial blood along the left artery into the pulmonary trunk by retrograde motion.
Reasons for the occurrence of
What factors affect the appearance of an anomalous structure of this kind of science is not yet known. It is clear only that the wrong departure of the coronary arteries is laid in the period of development of the fetus during the perinatal period, when they are formed. There is no connection with genetic diseases.
Symptoms of
In a child born with a problem with SBH, deviations in health are determined in the first three months.
Often the first concern of parents is caused by problems that arise during the feeding of the child:
- pallor of the skin,
- excessive sweating,
- tachycardia,
- dyspnea,
- regurgitation,
- discomfort of the child, restless behavior;
- snoring breath,
- pulse becomes threadlike,
- the child is screaming strongly,
- pulls the legs,
- angina pectoris.
After the attack passes, there is a brief rise in temperature and a loose stool. Sometimes an attack can lead a child into an unconscious state, which does not last long.
Such crises can bring a baby to death. Up to a year 85% of children die from this pathology.
Diagnosis
The child is examined by a cardiologist and determines the presence of characteristic signs of the disease and if suspicion arises, the study assigns.
- An electrocardiogram can give information whether there are ischemic processes.
- Catheterization - the method gives detailed information about pathological abnormalities in the structure of the heart.
- X-ray scan the chest. You can determine the deformation of the heart shape, its increase.
- Coronary angiography is a necessary method in this pathology. Will help to know the state of myocardial health.
- An echocardiogram shows disturbances in myocardial function, identifies areas of increased and decreased activity.
- Aortography makes it possible to see abnormal artery distances and to determine the degree of development of the collateral pathways.
Treatment of
The main way to help patients with abnormal arterial discharge is surgical intervention.
Operation
Depending on what form the disease has and whether the organism has adapted to the existing pathology, there are several options for surgical intervention.
- Mammarocoronary bypass - create anastomoses between the mammary and coronary arteries. Thus, they produce a kind of restoration of the vessels of the heart muscle. The operation is palliative.
- Operation of the closed type( palliative) - the mouth of the artery, which has an abnormal output: not from the artery, but from the pulmonary trunk, is bandaged. This option is possible with a sufficiently developed auxiliary( collateral) circulation.
- Plastic surgery, which is carried out in an open manner and solves the problem of returning the artery to its correct location.
Prevention of
disease Due to the fact that no factors have been identified which initiate such abnormalities in the perinatal period, there is no direct indication how to avoid the problem. One can only list what should be avoided by any pregnant woman so that there is no harm to the fetus causing its abnormal development:
- is not desirable to be in places with a low level of ecology,
- to avoid contact with harmful chemicals, the
- should not be in the area of ionizing radiation.
Complications of
If a child is born with a pathological lesion of the left artery, time works against it. If you do not make a correction, the process continuously develops, creating a threat to life.
This is due to changes in pressure in the left artery after birth. Oxygen starvation of the right anterior wall, which the left artery should feed, accumulates. Much depends on whether there was a collateral circulation, how the body has adjusted to the problem.
Disturbances in the blood supply to the heart can cause:
- swelling,
- bulging of the chest in the heart, which is called the heart hump;
- reduced weight,
- wet wheezing in the lungs,
- increases the liver,
- is listened to systolic murmur,
- deformity of the heart, its expansion;
- may occur myocardial infarction,
- susceptibility to infectious diseases,
- endocardial fibroelastosis.
Forecast
If newborns with impaired blood supply to the myocardium are not assisted( operation), the chances of survival are small. Only ten percent adapt to the situation and, overcoming the age of the first year, grow older.
However, their health, if not to make a correction, is always in danger. Possible sudden death with increased physical and emotional stress.
Even more useful information on coronary artery anomaly contains the following video: