Open oval window in the heart of a child

Parents may find it concerning when they discover an open oval window in their child’s heart, but this condition is actually rather common. All babies have this tiny hole in their hearts before they are born, and it usually closes on its own during the first year of life.

But in some kids, this window never closes completely or stays open for a longer period of time. Although this may raise concerns, a lot of kids who have an open oval window go on to lead healthy lives free from any obvious problems.

This article will explain what an open oval window is, why it occurs, and potential health implications for your child. We’ll also talk about when you might need to see a doctor and what options you have if you do.

What is it

This is the term for the anatomical characteristic of the heart’s septum, which is present in all children during intrauterine development and is frequently seen in a newborn. The problem is that a fetus’s heart beats somewhat differently than an adult or infant’s.

Specifically, the oval window refers to an aperture in the septum that divides the atria. It exists because the fetus’s lungs are still developing and not enough blood is getting into its blood vessels. Blood that is expelled from the right atrium into the lungs’ veins in an adult is transferred to the baby’s more actively functioning organs, such as the brain, kidneys, liver, and others, through the opening into the left atrium in a fetus.

A tiny valve that separates this window from the left ventricle fully matures by the start of labor. A baby’s lungs open for the first time when it breathes, allowing blood to flow to them and causing the left atrium’s pressure to rise. Currently, the oval window closes with a valve and then grows with the septum over time. The fetus needs an opening because if the window closes too soon, even while it is still in utero, the child could suffer from heart failure or possibly die.

Every child closes the window a little bit differently. Some people have their valve grow to it right away after birth, while others have it by the time they are five years old. A tiny amount of blood is periodically released from the pulmonary circulation into the systemic circulation when the valve is too small to completely close the oval window. As a result, the opening remains slightly open for life. Twenty to thirty percent of kids are in this circumstance.

Since the defect is much more serious, an oval window that has not closed completely after birth is not thought to be a defect in the septum that divides the atria. PFO is categorized as a minor anomaly that merely is an individual feature and is thought to be a congenital defect. A septal defect causes the valve to completely fail, allowing blood to flow from the left to the right, which is harmful to health.

Causes

• Poor environmental conditions.
• Nicotine.
• Stress.
• Narcotic substances.
• Alcohol.
• Medicines prohibited during pregnancy.
• Malnutrition.

Both intrauterine growth retardation in full-term babies and children born significantly prematurely are frequently associated with the inability to close the oval window.

You can observe how a child’s heart rate and blood circulation should typically alter prior to birth in the video below.

Symptoms

The clinical picture is not good if the child has no other heart defects and the open valve is the only issue. When a baby has PFO, you can suspect it by:

• Detection of rapid heartbeat.
• Changes in the color of the nasolabial triangle (it becomes blue or gray) during feeding or crying.
• Shortness of breath.
• Poor appetite.
• Little weight gain.

Children in preschool and school age may experience issues with their tolerance to physical exertion as well as recurrent respiratory inflammatory diseases.

PFO in children appears during adolescence, when the body is changing hormonally and growing rapidly.

• Weakness.
• Feelings of interruptions in the heart rhythm.
• Increased fatigue.
• Episodes of dizziness.
• Periodically occurring causeless fainting.

Diagnostics

After using a stethoscope to listen to the baby’s heart, you can suspect PFO. The best way to find the oval window is with an ultrasound, so if the doctor notices systolic murmurs, he will recommend one for the child. During routine echocardiography, which is done on all infants at one month old, pathology is frequently found. In rare circumstances, angiography and transesophageal ultrasonography may be recommended for the infant in order to diagnose the issue.

Signs of an open oval window audibly are as follows:

• Size up to 5 mm.
• Position in the middle part of the septum.
• Inconstant visualization of the opening.
• Detection of a valve in the left atrium.
• Thinned interatrial septum.

The following video shows you what PFO looks like on ultrasonography.

A common congenital condition known as an open oval window occurs when a small opening between the heart’s chambers fails to close completely after birth. It usually doesn’t result in symptoms or health issues, but in certain kids, it can cause issues. Parents can feel more prepared and informed if they have a better understanding of this condition, its possible effects, and when medical intervention is required.

Komarovsky"s opinion

According to a renowned pediatrician, the oval window is open in nearly all newborns and stays open in 50% of them until they are two years old. However, even in children between the ages of two and five, the existence of such a cardiac window is regarded as a typical variation that essentially has no bearing on the child’s wellbeing or health.

Komarovsky stresses that this is not a cardiac condition and that, in the majority of cases, the window closes on its own during the early years of life without the need for medical assistance.

Treatment

Medication is not necessary if there are no obvious clinical symptoms or heart issues, which are particularly frequent when PFO is present. The following actions are suggested for the child and are crucial for the body’s overall strengthening:

• Walks in the fresh air.
• Balanced nutrition.
• Correct distribution of loads and rest during the day.
• Hardening procedures.
• Physiotherapy exercises.

Children are prescribed medications for myocardial nutrition and vitamins if heart-related complaints arise. Babies are typically prescribed panangin, ubiquinone, L-carnitine, and magnesium B6.

A cardiac surgeon treats the child if PFO is accompanied by other defects, as surgery is frequently necessary. In the event of an open oval window, inserting a probe with a patch into the child’s femoral vein is one of the most effective treatments. The window is closed and the patch is applied when the probe reaches the right atrium. The oval window closes because the septum’s connective tissue formation processes are triggered, even though it will be absorbed in a month.

Parents may have concerns about an open oval window in their child’s heart, but this condition typically goes away on its own with time. The majority of kids lead trouble-free, typical lives that are full of health.

But it’s crucial to keep yourself updated and consult your child’s physician again later. Frequent examinations guarantee that any possible problems are tracked and quickly resolved when necessary.

If the window isn’t closing on its own, there are medical procedures that can help. The medical staff caring for your child will help you decide which course of action is best for their overall health.

Video on the topic

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Pediatric Echocardiography (ultrasound of the heart) – Open oval window (interatrial communication) in a child

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Open oval window: what is the danger? Answers endovascular surgeon Andrey Tereshchenko

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Open oval window in a child. Norm or pathology?

OPEN OVAL WINDOW | Norm or pathology?

Open oval window in the heart of a child. Norm or pathology?