Anomalies of veins flowing into the heart
Of the numerous variants, the following three are the most frequent:
1. Pulmonary veins flow into the upper, lower hollow veins, other large veins or into the preserved left upper vena cava.
2. Pulmonary veins flow through the coronary sinus into the right atrium.
3. Pulmonary veins flow directly through the posterior wall into the right atrium.
This developmental anomaly does not affect the fetal circulation. In the extrauterine life, the fate of the child is decided by the fact that how many pulmonary veins fall into the right atrium incorrectly. If this developmental anomaly concerns only one or two pulmonary veins, this, although it is an additional burden for the right half of the heart and for the small circle of blood circulation, but the amount of blood flowing into the left half of the heart can be sufficient to sustain life. If most of the veins flow into the right atrium, only the oxygen-enriched blood flowing through the defect of the septum gets to the left half of the heart and into the large circle of circulation.
Of the symptoms of this developmental abnormality, a physical examination can detect only those that result from a significant overload of the right side of the heart. The right half of the heart because of the huge amount of blood flowing through it expands, the stupidity of the heart is increased in all directions. The huge right half of the heart, largely located in the left half of the chest, squeezes the lung. The left half of the heart is smaller than normal. The results of auscultation are not characteristic. If noise is heard at all, then it is usually characteristic of an atrial defect.
Blood pressure is low. The pulse is low and rare.
When X-ray examination shows a huge expansion of the entire right side of the heart. The right atrium occupies a large part of the right side of the chest. The right ventricle displaces the small left ventricle to the left and back. Thus, in the sagittal direction, the shadow of the heart is wholly and completely formed by the right half of the heart. The shadow of the pulmonary cone and the pulmonary artery protrudes forward. The apex of the heart is elevated. At the researches spent in oblique positions, also expansion of the right half of heart also rushes into eyes. If the pulmonary veins flow into the left upper superior vena cava, then the vessel on the right side expands the median shadow. Bloodflow of the lungs is enormous, often a stagnant pattern and "gypsum dance" are often observed.
The ventricular ECG complex shows such a deviation, as with various forms of cyanotic disease. The P wave is usually enlarged, its duration is longer than normal.
Diagnosis is facilitated by cardiac catheterization, although this does not always solve the problem. If only a part of the pulmonary veins falls into the right atrium, we get data similar, in the case of a defect in the atrial septum. If all the pulmonary veins flow into the right half of the heart, then the oxygen saturation of the blood of the right atrium and peripheral arteries is the same. Through the defect of the atrial septum, a mixture of arterial and venous blood enters the left atrium, the oxygen saturation of the arterial blood is lower than normal, but there is no cyanosis. A very large diagnostic help is provided by the circumstance that a cardiac catheter can be drawn from the right atrium to any of the pulmonary veins.
The operational treatment of this developmental abnormality is known.
Other anomalies of veins development .Of the numerous other abnormalities of veins, there is almost no such that would affect the fate of the patient. The left upper vena cava itself does not matter, but it can interfere with angiocardiography and cardiac catheterization.
Women's magazine www. BlackPantera.en: Jozsef Kudas