WFP aneurysm in adults and children
Aneurysm of the interatrial septum is a rare cardiac defect that is usually discovered during echocardiography. It can be isolated or combined with other heart defects, which most often patent foramen ovale. Complications associated with an aneurysm of the interatrial septum, are atrial arrhythmias and arterial embolism.
What is the interatrial septum?
Interatrial septum (WFP) is dividing, separating the left and right atrium. In normal adults, the two chambers of the heart are not connected to each other directly. Blood from the right atrium enters the right ventricle where is expelled into the pulmonary artery. In the lungs it is oxygenated and pulmonary veins enters into the left atrium.
However, in children during fetal development, there are certain features of the circulation. They have no need to breath because the oxygen they receive from the mother through the placenta and the umbilical cord. Therefore, the fetus in the expressed blood circulation in the lungs makes no sense. In order to reduce the flow of blood to the lungs, in the fetus, there are the following connections between the left and right half of the heart:
- Oval hole in the WFP, through which the blood goes directly from the right atrium to the left.
- The ductus arteriosus, through which blood passes from the pulmonary artery into the aorta.
Shortly after the birth of a newborn child of the oval hole and ductus arteriosus are closed in norm. In place of the oval window remains deepening. It features congenital septal determine the development of her aneurysm.
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What is aneurysm of the interatrial septum?
WFP heart aneurysm is a saccular deformity of the interatrial septum. (mostly in the area of oval indentations), which stands in the right or left atrium. All aneurysm MPP can be divided into two groups – primary and secondary. Secondary aneurysm MPP is the result of increased pressure difference in the left and right atrium. Most often this occurs in the context of complex congenital heart defects. For example, when the pressure in the right heart due to pulmonary artery stenosis may develop secondary aneurysm MPP with the protrusion towards the left atrium. If you increase the pressure in the left departments of heart as a result of atresia of the aortic valve may occur, WFP aneurysm with protrusion towards the right atrium.
The primary aneurysm MPP is not associated with an increase in the pressure difference in the right and left Atria. Most often this disease is observed in adults, the causes of its origin often cannot figure out. There is speculation that it is associated with common congenital disorders of connective tissue.
The relationship of the aneurysm MPP with other diseases of the heart
The child with an aneurysm of the MPP, this pathology is sometimes combined with an open oval hole, WFP defects, defects of the interventricular septum, mitral valve prolapse, open arterial duct, Ebstein’s anomaly, tricuspid atresia and pulmonary valves. Adults can also be acquired valvular disease, cardiomyopathies, systemic and pulmonary hypertension, ischemic heart disease, arrhythmias and blood clots.
Diagnosis of aneurysm MPP
Until the development of echocardiography aneurysm of MPP were found only during autopsy. At the present time to identify this pathology is most often used transesophageal echocardiography, which allows to visualize the structure of the WFP. If routine transthoracic echocardiography in most cases, this pathology can not be identified. In addition, WFP aneurysm can be detected during the cardiac catheterization, CT and magnetic resonance imaging.
The clinical picture and the risk of aneurysm MPP
The clinical picture the aneurysm of the WFP depends on its size and the availability of the open oval window. Usually a small aneurysm MPP without the discharge of blood (without the presence of a patent foramen ovale), is not accompanied by any symptoms, it can be detected only during instrumental examination.
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Aneurysm MPP dangerous development of atrial arrhythmias and arterial embolism. It can be a source of arrhythmia, generating focal atrial tachycardia in more than 20% of patients. The mechanism of these arrhythmias is not completely understood. They appear and pricechecker rapid heartbeat, dizziness, weakness and fluctuations in blood pressure.
Arterial embolism is another complication associated with an aneurysm of the WFP. Its presence leads to stagnation of blood in the left half of the heart and the formation of small blood clots. In the majority of patients with arterial emboli due to aneurysm WFP has also observed an open oval hole. Scientific studies also indicate that WFP aneurysm in combination with an open oval hole may be the cause of cardioembolic strokes. The clinical picture of arterial embolism depends on which artery is blocked.
Patients with uncomplicated and isolated aneurysm of the WFP specific treatment is not necessary, they need a simple observation. They need to be evaluated for the presence of thrombus in aneurysm. In the presence of the risk of developing stroke is assigned to prophylactic treatment with antiplatelet agents or anticoagulants and surgical or percutaneous elimination of the defect. In the case of the development of arrhythmias is specific antiarrhythmic therapy, which the doctor chooses.