What is Atrial Septum Aneurysm?
Atrial septum aneurysm is an abnormal protrusion of the septum in the area of the oval fossa to the side. This anomaly often develops against the background of systemic connective tissue dysplasia, rarely the general population. This minor abnormality is combined with mitral valve prolapse.
Causes of Atrial Septum Aneurysm
Aneurysm of the interatrial septum develops due to a hereditary factor, as well as violations of the formation of connective tissue in the heart even when the child is in the womb. This disorder is most often caused by intrauterine infections.
In children of preschool age, aneurysmal bulging of the septum appears after spontaneous late closure of the atrial septal defect. Often the anomaly has a favorable outcome and hemodynamic disorders and clinical manifestations are not observed in children; therefore, it belongs to the secondary findings in an echocardiographic study of the patient.
Pathogenesis during Atrial Septum Aneurysm
Note that aneurysm in most cases does not affect the functioning of the heart and blood circulation. Aneurysms have three forms:
- Bulging from left to right atrium
- Right to left invagination
- Has an S-shaped bend, that is, the lower part of the aneurysm bulges in one direction, and the top – in another
Atrial septum aneurysms are prone to secondary infective endocarditis.
Symptoms of Atrial Septum Aneurysm
The onset of the disease does not show any pronounced symptoms, but each age is characterized by changes in the body, to which parents should pay attention, and take the child to the examination.
Children of 1-3 years old with this disease show inhibition of both mental and physical development, children may not gain the necessary weight. Children are prone to seasonal viral diseases. There are first signs of an overload of the right atrium, an increase in the volume of the right ventricle, a reboot of the pulmonary circulation.
In older children, there is a lag in growth, intolerance to physical activity, problems in the development of the reproductive system, sometimes there is arrhythmia, fatigue, weakness, pain in the area of the heart and chest.
In children, pallor of the skin, changes in the chest in the form of protrusion in the heart area, which is caused by muscle atrophy and an increase in the right ventricle, are noted. The pulmonary trunk and the right atrium are enlarged. Pulse and blood pressure may be slightly below normal.
During listening in children, I tone is strengthened, II tone is strengthened mainly in children from 7 years.
Systolic murmur is not coarse, below average volume and flowability. During exercise, the noise in the aneurysm increases.
Children who have already been diagnosed with an atrial septal aneurysm should undergo an ultrasound and an ECG on a regular basis in order to monitor changes in pathology and also to be monitored by a cardiologist. It is dangerous to complicate the disease – aneurysm rupture. It is manifested in older children due to severe stress, cardiac injuries and strong physical activity. When a rupture occurs at the site of the aneurysm, a hole appears that causes hemodynamic disturbances, namely blood outflow from left to right.
The danger of aneurysm is its rupture. All cases are individual and require strict medical supervision. In some cases, when a rupture occurs, a defect is formed, in which people can live for dozens of years without having any consequences. In other cases, there is a risk of circulatory disorders of the brain and stroke. There is a potential risk of blood clots that, if detached, can lead to a stroke.
Children usually reach adulthood, but often after 40 years of age they become disabled due to their illness.
Diagnosis of Atrial Septum Aneurysm
Diagnosis of this disease occurs mainly immediately after birth. The basis for such a diagnosis is the first electrocardiogram and ultrasound of the heart. On ultrasound aneurysm is very easy to detect.
If necessary, the patient is assigned a clarifying examination: transesophageal ultrasound, cardiac catheterization or computed tomography, which allows you to get information about the size and location of the aneurysm. An additional examination is prescribed when there is suspicion not only of the aneurysm, but also of concomitant cardiac anomalies.
Treatment Atrial Septum Aneurysm
If there are no complications of atrial septum aneurysm, then the patient does not need medical and surgical treatment. In cases of growth of the aneurysm or its rupture, hospitalization of the patient, monitoring of his condition and even surgical intervention are mandatory.
In most cases, the aneurysm does not need an operation because of the risk of complications. The operation is indicated only when there is a large discharge of blood, which causes the development of irreversible pulmonary hypertension. The operation involves the insertion of a defect or the plastic replacement of part of the interatrial septum with a hypoallergenic patch of medical synthetic substance.
Prevention of Atrial Septum Aneurysm
Special prevention for patients with atrial septal aneurysm is not developed, but any physical stress is contraindicated in children.