Description atrial septal defect and ventricular
It is a congenital heart defect ventricular or atrial septum, which is created by communication between the right and left side of the heart and leads to mixing of deoxygenated blood from the right ventricle and oxygenated blood from the left ventricle. Thus, the mixed blood is also distributed throughout the body. These defects are often discovered in childhood, but it can be found even in adulthood, especially in the case of opening in the atrial septum. Much depends on the size of the defect, in the case of a small defect may not be detected at all, the patient may not have any symptoms or problems. On the other hand, large defects make themselves known before. Fortunately, some defects, in particular ventricular openings in the bulkhead have the tendency to spontaneous closure.
Atrial septal defect is the most common heart disease in adulthood revealed, unlike ventricular defect, which is the most common heart defect in newborns and children. Unfortunately, these defects are sometimes accompanied by other heart defects, such example is the malformation of the heart valves (congenital malformations = deviation shape).
Very often, these defects part of genetic syndromes. A typical example is Down syndrome.
Rarely may be congenital ventricular septal defect, but obtained. May arise as a complication of acute myocardial infarction, when after the death of muscular ventricular septum may cause it to rupture and form a communication between the two chambers. This is a very serious condition complicating underlying diseases.
Risk factors for atrial septal defects and ventricular
Septal defects and ventricular fibrillation are congenital defects that are caused by many factors, or a combination of genetic factors and environmental factors. Unfortunately, often we do not find any cause, that we could have avoided. For genetic factors, we find these heart defects as part of genetic syndromes, such as Down syndrome. Unfortunately, genetic factors can not be influenced.Of the environmental factors would emphasize smoking (active and passive) and alcohol use mother during pregnancy.
In the case of ventricular septal defect obtained after acute myocardial infarction risk factors are generally known. This is a poor diet, lack of exercise, unhealthy diet, excessive intake of energy, high blood pressure (hypertension), high cholesterol. The following are excessive salt intake, overweight, smoking and others.
Prevention of atrial septal defects and ventricular
It is extremely difficult if not impossible to identify risk factors, it is difficult to define any preventive measures.
However, it is very important to avoid drinking alcohol during pregnancy, especially during the first trimester, which leads to the development of the heart and vascular system.
It is also recommended not to smoke throughout pregnancy and how actively and passively. It is important to avoid smoky spaces.
In the case of ventricular septal defect obtained after acute myocardial infarction is contrary prevention very important. Czech Republic is among the countries whose people are suffering very often myocardial infarction and other diseases of the circulatory system. We recommend a healthy diet, sufficient exercise, a healthy diet with less fat, sugar and more fiber. It is also important to treat high blood pressure and high cholesterol, and watch your salt intake. We must avoid smoking and becoming overweight.
Symptoms of atrial septal defect
If the patient has lung disease and blood vessels (especially the improvement of the blood pressure in the pulmonary vascular bed) results in mixing the blood, whose rate depends on the size of the defect. Hence the presence and severity of symptoms. In this case (absence of elevated pressure in the pulmonary vascular bed) leads to blood flow from the left atrium to the right. This means that oxygenated blood from the left atrium does not flow into the left ventricle and into the body, but mixes with the deoxygenated blood in the right atrium. Thus, the mixed blood flows back to the lungs where it is oxygenated again. Simply put oxygenated blood is oxygenated again.
Quite a large group of people can be completely asymptomatic, had no problems or symptoms are so insignificant that many patients may not even notice.
In the event of serious flaws patient is tired, often present exertional dyspnea (breathing = increased activity due to lack of oxygen in the body aggravated by physical exertion or unease).Dyspnea intensity increasing with age. Further may be present a fast heart rate (tachycardia). For children is a common symptom of failure to thrive (retarded physical growth and slow increase in weight). A large number of defects giving rise to a heart murmur. With advancing age may develop cardiac arrhythmias, particularly atrial fibrillation, as well as long-term overloading the heart can lead to heart failure to failure (the heart is not enough to distribute the required amount of blood around the body).
In the presence of elevated blood pressure in the pulmonary vascular bed is contrary to the flow of blood from the right atrium to the left and to the previously mentioned symptoms, combined with acyanosis (bluish skin, lips, oral mucosa and nail bed psoriasis), clubbing. And there is an overall deterioration of the situation.
Symptoms of ventricular septal defect
Again, very dependent on the size of the defect. The smallest defects can be symptom-free and self-heal. If the defect manifests itself, a very common symptom is exertional dyspnea andgeneral failure to thrive. For larger defects may be more common respiratory infections.
These symptoms occur in the absence of pulmonary hypertension (increased blood pressure in the pulmonary vascular bed). In this case, a flow of oxygenated blood from the left ventricle to the right ventricle where it is oxygenated blood mixed with deoxygenated blood. Thus, the mixed blood further flows again into the lungs.
In case the patient is suffering from pulmonary hypertension, conversely the blood flows from the left ventricle to the right, and may occur more symptom cyanosis (bluish skin, lips, oral mucosa and nail beds).
Generally, the defects in the ventricular septum are worse, since there is more mixing of the blood than in case of defects between the atria. This is due to greater pressure difference between the chambers than the halls.
Diagnosis of ventricular septal defects and atrial
Initial suspicion arises when the discovery of the basic signs on physical examination of the patient, such as a heart murmur, shortness of breath and general failure to thrive.
Basic examination ECHO = echocardiography (an ultrasound test of the heart). It is also normal chest x-ray (heart and lungs) and ECG (electrocardiography).
Prior to surgery on the heart may be performed invasive cardiac catheterization, during which is introduced into the heart and great vessels of the peripheral vascular catheter, most often from thigh. The aim of this investigation is to obtain accurate data on the state of the blood pressure in the riverbed, saturation (oxygen), etc.
Treatment of ventricular septal defects and atrial
When significant defect is selected catheter cap opening in the bulkhead when the correction of the defect is used a flexible catheter inserted through the femoral arteries for example. Another option is cardiac output = heart surgery. It is important that patients before catheterization or surgery suffer from severe high blood pressure in the pulmonary vessels (pulmonary hypertension), or that this disease was in its infancy.
If the defect is insignificant without serious symptoms, it is important to prevent complications, especially infectious endocarditis (inflammation of the lining of the heart, including valves).
How can I help treat ventricular septal defects and atrial
Unfortunately, the only treatment is surgical or transcatheter heart performance. Therefore, using the treatment is adherence to the advice and recommendations of the physician.
In the case of pregnant women are advised not to smoke and abstain.
Complications of atrial septal defect and ventricular
One of the most severe complications of these defects is called Eisenmengerův syndrome, which increases blood pressure in the pulmonary vessels (pulmonary hypertension arises), which greatly complicates the patient’s condition and prognosis. In this disease there is a change in blood flow through the defect. The blood starts to flow from the right heart to the left so that the deoxygenated blood is mixed with the oxygenated in the left heart, and is then distributed throughout the body.The problem is that this blood is poorer in oxygen and heart is forced to accelerate the flow of blood to many did not reduce the oxygen delivery organs of the body. The heart is overloaded and is susceptible to failure or other diseases. Furthermore, damage to lung blood vessels that are subject to so-called fibrosis, which involves impaired oxygen transfer, a blood oxygenation. Eisenmengerův syndrome is a very serious complication mainly due to the inability of his treatment. If it is already fully developed, it is the only hope for Heart and Lung Transplantation, which houses a large number of complications.
Another severe complication of heart defects generally endocarditis when bacteria or other infectious agents including challenged heart lining flaps. Infective endocarditis greatly complicates the treatment of the primary disease and may worsen the patient’s overall condition. Therefore it is extremely important preventive antibiotics at the slightest surgery, including dental surgery.
Very serious complication may be paradoxical embolism. In this case, the embolus (= embolus = torn blood clot) travels most of the lower limbs or pelvis, which often arises in the heart. In the heart passes through the defect in the partition, and further travels to the body. In the worst case can reach the brain, where it could cause a stroke (cerebrovascular accident).
Often may arise thrombus in the heart of the damaged endothelium, or after surgery. Today it is preceded by an active clotting and antiplatelet therapy (in layman’s terms with medication to thin the blood).
