What Should Be Done When a Newborn Has Incomplete Heart Closure?

Update Date: 2024-05-28 Source: Network

Minor regurgitation in neonates with incomplete heart closure does not require immediate surgery, but follow-up observation is necessary. Echocardiography should be performed annually to assess the condition of the mitral valve. Waiting until symptoms appear to undergo surgery may be too late, as the heart often undergoes organic changes and dilation by that time. The optimal timing for surgery is when regurgitation reaches moderate levels and the heart has not yet expanded, as this can allow the heart to fully recover.

Heart valves play a crucial role in the continuous blood flow of the heart, preventing blood from flowing backwards. Issues with heart valves can lead to incomplete heart closure and regurgitation, posing significant health risks to children. Valve surgery, including mitral valve repair and replacement, is often necessary for treatment.

Severe mitral valve dysplasia, calcification or absence of valve leaflets, or limited movement of the valve leaflets may require mitral valve replacement if valve repair is not feasible or if significant regurgitation persists after repair. For pediatric or childhood patients, bileaflet mechanical valves are preferred, as biological valves may be unsuitable due to tissue decay or calcification.

During the compensatory phase of heart valve dysfunction, patients may be asymptomatic. However, symptoms such as palpitations, shortness of breath, and fatigue may occur during left heart failure. The heart boundary may expand towards the left, and a loud, rough systolic blowing murmur may be audible in the apical region, often radiating to the axilla or back. A third heart sound and hypertrophic second heart sound in the pulmonary valve area may also be heard.

Typically, patients may remain asymptomatic for a long period, even up to 10-15 years in cases of significant heart valve regurgitation before developing overt symptoms. Once heart failure occurs, the progression can be rapid. Palpitations, a discomfort associated with heart contractions, may be the earliest complaint, resulting from enlarged left ventricles and enhanced apical pulses, particularly when lying on the left side or in a prone position. Emotional excitement or physical activity can trigger tachycardia or ventricular premature contractions, making palpitations more apparent. Due to significantly increased pulse pressure, patients may also experience a strong sensation of arterial pulsation throughout the body, especially in the head and neck. Dyspnea, particularly exertional dyspnea, is an early sign indicating reduced cardiac reserve. As the condition progresses, orthopnea and nocturnal paroxysmal dyspnea may occur.