What should be noted for an atrial septal defect with patent foramen ovale?

Written by Di Zhi Yong
Cardiology
Updated on September 12, 2024
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If the patient presents with a ventricular septal defect or a patent foramen ovale, it is important to maintain a healthy diet and particularly to prevent upper respiratory infections, as these conditions are types of congenital heart disease. They mainly lead to repeated respiratory infections, cyanosis, or lung infections, resulting in changes associated with congenital heart disease. For a ventricular septal defect, early surgical intervention is currently recommended. Patent foramen ovale is also treated surgically. During this period, it is important to monitor changes in the child's height and weight, as such diseases can affect the child's growth and development.

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Written by Zhang Zhi Gong
Cardiothoracic Surgery
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Interventricular septal defect X-ray manifestation

X-ray Manifestations of Ventricular Septal Defect. These are mainly related to the size of the defect. If the ventricular septal defect is relatively small, for example less than three millimeters, the amount of blood shunted from the left ventricle to the right ventricular system is minimal. Consequently, right ventricular congestion is not pronounced, making pulmonary congestion also less obvious. At this point, the X-ray may show no significant changes. However, if the defect is larger, greater than three millimeters, for instance five millimeters, a large volume of high-pressure blood from the left ventricle will flow excessively through the defect into the right ventricular system. This leads to significant congestion in the right ventricle and, thus, in the entire pulmonary circulation. Additionally, the X-ray will show a prominent pulmonary artery segment and increased pulmonary blood flow. Moreover, over time, this condition may lead to compensatory enlargement of the left ventricular system. On the X-ray, enlargement of both the right and left ventricles can be observed. Furthermore, due to sustained high pressure, the distal pulmonary arteries may show signs of severe pulmonary vascular disease on the X-ray, resembling a broken book. This indicates that the pulmonary circulation has reached an end-stage condition.

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Written by Zhang Zhi Gong
Cardiothoracic Surgery
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Ventricular septal defect refers to a defect in the ventricular septum, the wall dividing the left and right ventricles of the heart.

A normal human heart is divided into four chambers: the left ventricle, right ventricle, left atrium, and right atrium. The circulation in a normal person involves venous blood entering the right atrium, passing through the mitral valve into the right ventricle. The right ventricle then contracts and pumps blood into the lungs. After exchanging gases and becoming oxygenated, the blood turns bright red. It then returns to the left atrium. From the left atrium, blood passes through the mitral valve back into the left ventricle, and then the left ventricle contracts and pumps blood throughout the body. Therefore, there is a thick wall between the normal left and right ventricles, known as the ventricular septum. If due to congenital heart disease or other reasons, a small hole appears in the ventricular septum, it is called a ventricular septal defect. If this defect is large, it necessitates active surgical treatment because if the defect exists, the pressure of the blood flow in the left ventricle is higher, causing a large amount of abnormal blood to enter the right ventricle. This leads to a significant accumulation of blood in the right ventricle, causing the patient to have too much blood in the pulmonary circulation, making the patient prone to recurrent colds and infections. Furthermore, these children may easily develop heart failure and even life-threatening conditions such as infective endocarditis.

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Written by Xie Zhi Hong
Cardiology
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Is congenital heart disease with perimembranous ventricular septal defect serious?

Simple congenital heart defects, such as perimembranous defects, generally are not particularly severe. However, there are several scenarios to consider: The first scenario involves a large defect that typical occluders cannot address; in such cases, surgical intervention is required. This type of defect is generally considered severe. Another scenario is when a cardiac defect has been present for an extended period, leading to repeated shortness of breath, heart failure, cardiac enlargement, and even pulmonary arterial hypertension. This situation would be considered a severe ventricular septal defect, caused by the failure to treat the membranous part of the septal defect in time. Thus, the majority of ventricular septal defects are not very severe in the early stages. They become serious if the defect is too large or if there is coexistence with other defects, such as an overriding aorta or poorly developed pulmonary artery, among other complex congenital heart diseases. Regardless, patients with perimembranous congenital heart defects should undergo surgical treatment early to avoid missing the opportunity for surgery.

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Written by Xie Zhi Hong
Cardiology
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What would happen if the ventricular septal defect occluder dislodges?

An occluder generally works like two umbrella surfaces clamped over the orifice of the interventricular septal defect, achieving the method whereby tissue blood flow enters from the left side of the septum to the right side. Once an occluder dislodges, it can lead to a dangerous situation, as the occluder has a membrane that can easily get caught on the tendons of the mitral valve, causing severe mitral regurgitation; it can also get stuck at the mitral valve orifice, obstructing the outflow of blood; it may also lead to aortic valve insufficiency; if it gets caught in the major arteries, it can cause arterial embolism, leading to sudden death in the patient. Therefore, the dislodgement of an occluder is a very dangerous phenomenon.

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Written by Di Zhi Yong
Cardiology
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If a ventricular septal defect is not surgically repaired, what will happen?

If the patient has a history of congenital heart disease, especially ventricular septal defect, it can lead to symptoms such as palpitations and chest tightness. The current recommendation for treatment is primarily symptomatic management; however, it is also advised that patients seek early surgical intervention at a hospital. Medical treatment or drug therapy often does not yield ideal results for this condition, and surgical intervention is necessary to address these symptoms. Currently, minimally invasive surgical treatment can be used. If the patient does not undergo surgery, conditions such as palpitations, chest tightness, and difficulty breathing can occur at any time.