Deficiency of the interatrial septum in newborn infants is an extremely rare disease attributed to congenital heart disease( CHD).It entails a huge number of consequences.
How to recognize the problem on time and how to deal with it? We will tell in this article.
Description
Atrial septal defect - a congenital anomalyheart( congenital malformation).With an incomplete defect, there is an hole between the partitions , and at full - there is no partition at all. Disease is characterized by the presence of a communication between the right and left atria.
Causes of development and risk factors
Atrial septal defect is a genetic disease of .If a child has close relatives who suffer from heart disease, more attention should be paid to his health.
Also this disease can develop due to external causes of .During pregnancy, you should give up smoking and alcohol, take medicines only under the supervision of your doctor. Congenital malformation may appear in cases when the mother of the child during pregnancy was ill with diabetes, phenylketonuria or rubella.
Forms
Defects are distinguished by the size and shape of the holes between the atria:
- Primary.
Usually characterized by a large size( three to five centimeters), localization in the lower part of the partition and the absence of a lower edge. Underdevelopment of the primary interatrial septum and preservation of the primary communication are attributed precisely to this form of the defect. Most often in patients there is an open antyroneventicular canal and splitting of tricuspid and bivalvia valves.
- Secondary.
Characterized by an underdeveloped secondary partition. Usually, this damage is of a small size( one to two centimeters), which is located in the area of the mouth of the hollow veins or in the center of the septum.
- Complete lack of partition.
Such a defect is called a three-chambered heart. This is due to the fact that due to the complete absence of the septum a single common atrium is formed, which may be associated with anomalies of antreeventicular valves or with asplenia.
Complications and consequences
Small defects are difficult to detect - some people find out about their illness only in old age. With a large defect, life expectancy can be reduced to 35-40 years.
This problem with time leads to depletion of the cardiac regenerative resources of , which can lead to the development of pulmonary diseases, heart failure, pulmonary hypertension, and lead to private fainting or even a stroke.
Symptoms of
In childhood and adolescence, it is often difficult to recognize a small and medium defect, since it does not cause any obvious inconvenience. A large defect is much easier to recognize, since it has quite a pronounced symptom:
- dyspnoea, which occurs during physical exertion;
- susceptibility to respiratory infections;
- pallor or even cyanosis of the skin;
- weakness, rapid fatigue;
- cardiac rhythm disturbance.
If the patient observes one of the above symptoms, or if the parents pay attention to the capriciousness of the child, tearfulness, lack of desire to play long with other children, should be consulted to the pediatrician or to the therapist .Then the doctor will conduct a primary examination and, if necessary, give direction for further examination.
On the danger of pulmonary atresia, learn from another article - it is important to know all parents of children at risk of CHD.What is the difference between an interventricular septal defect in a fetus from an interatrial defect? Learn from this article.
Diagnosis
Various methods are used to identify the disease. For further guidance, you need to contact a pediatrician or a therapist who, based on an analysis of complaints by the patient or his parents, can refer you to a cardiologist.
First, a patient's medical history is collected( whether his relatives have congenital heart defects, as the mother's pregnancy has progressed), and then gives the direction for the following analyzes of : general urine analysis, biochemical and general blood analysis. Based on the results obtained, you can find out how other internal organs function, and whether this is due to the work of the heart.
A general examination, auscultation( listening to the heart), percussion( percussion of the heart) is also performed by .The last two methods allow to find out whether there are changes in the shape of the heart and whether noises characteristic of this defect are audible. After the studies, the pediatrician or therapist decides whether there is any basis for further diagnosis.
If the doctor suspects that the patient has congenital heart disease, the uses more sophisticated methods of examining the :
- Chest X-ray examination shows changes in the shape of the heart.
- Electrocardiography( ECG) makes it possible to observe a patient's conduction and heart rhythm disturbances, as well as an increase in the right divisions.
- Echocardiography( EchoCG), or ultrasound. When using the two-dimensional( Doppler) method, one can see where the defect of the septum and its size are localized. In addition, this method allows you to see the direction of the discharge of blood through the hole.
- Probing( insertion of a catheter) helps to determine the pressure in the cavities of the heart and vessels.
- Angiography, ventriculography and magnetic resonance imaging( MRI) are prescribed in cases where the remaining methods of the study were not indicative.
Methods of treatment
One of the ways to treat small vices that do not complicate a patient's life is the conservative method of treatment. In addition, this type of treatment is also used in cases where an inopportune operation was the result of the development of diseases such as myocardial ischemia and heart failure.
Surgical intervention is recommended for patients aged 1 to 12 years old .This is due to the fact that at this age the organism has already adapted to changes that occurred in the body due to a defect of the interatrial septum, and there is already no chance of self-closure of the defect. At the moment there are two ways to close the defect.
Open operation
If the hole size does not exceed four centimeters , then you can perform an open heart operation. During the operation, the device of artificial circulation is used, most often with cardiac arrest.
Depending on the size of the defect, the method of its elimination is determined: suturing the defect( no more than 120 millimeters) or installing a patch from your own pericardium.
The recovery period lasts about a month .At this time, you need to monitor the diet and refrain from physical exertion.
Endovascular occlusion( closed)
This method of surgical intervention is that the inserts a catheter with an occluder( plate) through the femoral vein , which is then directed to the right atrium. Next, the occluder closes the hole, "seals" it.
This method of operation has several advantages over an open operation: does not need a general anesthesia, few injuries, a fast recovery period - just a few days.
You may be interested in learning about dietary rules for deep vein thrombosis in the lower extremities. Such food will be useful and healthy. What is heart dextrocardia, and can right-hearted people live normally? Details here.
Forecasts and prevention measures
In order to prevent the development of an atrial septal defect in children, the mother needs the to register on time in the women's consultation during pregnancy.
Smoking, alcohol consumption, eating habits and taking medications should be excluded only as directed by the doctor. Also it is necessary to tell the gynecologist, who leads your pregnancy, about the presence of relatives suffering from congenital heart disease.
Today, detecting a defect in the atrial septum in children is fairly simple, heart disease in newborns is in most cases detected during an ultrasound study of .If the disease was not detected immediately after birth, but you had suspicions - it is necessary to consult a doctor.
