What Is The Significance Of Dividing Heart Into Different Chambers?

What Is The Significance Of Dividing Heart Into Different Chambers
To prevent oxygen-rich blood from mixing with carbon-dioxide rich blood.

Contents

What is the significance of partition between the chambers of heart?

Introduction – A mature mammalian heart has four valves and four chambers, with the wall of each chamber consisting of three tissue layers: endocardium, myocardium and epicardium ( Fig.1 ). The cardiac chambers and valves are organized such that they separate systemic from pulmonary circulation and ensure directional blood flow.

  • The formation of these structures requires multiple cell types and complex morphogenetic processes, which often go awry in the developing human fetus.
  • Heart malformations account for as many as 30% of embryos or fetuses lost before birth ( Hoffman, 1995 ), and the incidence of heart defects in live births varies from 0.4% to 5% in different studies, depending on the severity of heart defects included in the statistics ( Hoffman and Kaplan, 2002 ).

On top of these statistics, another 2% of newborns have bicuspid aortic valves (BAVs; see Glossary, Box 1 ) or other defects ( Hoffman and Kaplan, 2002 ), which may cause significant morbidity and mortality later in life ( Brickner et al., 2000a ). Congenital heart malformations, therefore, constitute an important medical issue challenging our society.

Box 1. Glossary Atrial septal defect (ASD). A congenital heart defect resulting from incomplete atrial septation. Atrioventricular canal (AVC). The junction between developing atria and ventricles. Atrioventricular cushions. The four endocardial cushions located at the AV canal: superior, inferior, left-lateral and right-lateral cushions.

Atrioventricular septal defect (AVSD). A congenital heart defect resulting from incomplete septation of the atrioventricular canal. Bicuspid aortic valve (BAV). A congenital heart defect in which the aortic valve has only two cusps. The term BAV is also used broadly to describe any malformation of the aortic valve cusps.

  1. Dorsal mesenchymal protrusion (DMP).
  2. A mesenchymal tissue that protrudes into the atrial chamber through the dorsal mesocardium.
  3. Double-outlet right ventricle (DORV).
  4. A congenital heart defect in which both aorta and pulmonary trunk arise from the right ventricle.
  5. First heart field (FHF).
  6. A population of mesodermal cells that form the cardiac crescent located in splanchnic mesoderm underlying the head folds.

Progenitors of the FHF give rise to myocardium of the left ventricle, part of the right ventricle and part of the atria. Interruption of the aortic arch (IAA). A congenital heart defect in which a segment of the aortic arch is occluded or absent. Mesenchymal cap (MC).

A mesenchymal tissue that caps the growing (inferior) edge of the primary atrial septum. Outflow tract (OFT). The outflow region of the embryonic heart that develops into the left and right ventricular outlets, as well as the aorta and pulmonary trunk. Overriding aorta (OA). A congenital heart defect in which the aortic root connects with both the left and right ventricle and receives blood from both ventricles.

Patent ductus arteriosus (PDA). A congenital heart defect in which the ductus arteriosus fails to close after birth. Persistent truncus arteriosus (PTA). A congenital heart defect in which the aorta fails to separate from the pulmonary trunk, resulting in a single arterial trunk that emerges from the ventricles.

Pulmonary stenosis (PS). A congenital heart defect in which the pulmonary valve is malformed, causing narrowing of the pulmonary trunk and hindrance of blood flow. Secondary heart field (SHF). A population of mesodermal cells located medially and posteriorly to the first heart field, then behind the heart tube, and extending into pharyngeal mesoderm as the embryo develops.

Progenitor cells of the SHF give rise to myocardium of the right ventricle, cardiac outflow tract, and part of the left ventricle and atria. Tetralogy of Fallot (TOF). A congenital heart defect characterized by right ventricular outflow tract obstruction, right ventricular hypertrophy, ventricular septal defect and overriding aorta.

  1. Total or partial anomalous pulmonary venous return (TAPVR or PAPVR).
  2. A congenital heart defect in which pulmonary veins are misconnected and drained into the systemic venous circulation.
  3. Transposition of the great arteries (TGA).
  4. A congenital heart defect in which the right ventricle connects to the aorta, and the left ventricle connects to the pulmonary trunk.

Tricuspid atresia (TA). A congenital heart defect in which the tricuspid valve is missing, hence blocking the blood flow from right atrium to right ventricle. Ventricular septal defect (VSD). A congenital heart defect resulting from incomplete ventricular septation The structure of a mammalian heart. A mature mammalian heart contains four chambers (right atrium, left atrium, right ventricle, left ventricle) and four valves (pulmonary valve, PV; tricuspid valve, TV; atrial valve, AV; mitral valve, MV). The wall of each chamber consists of three tissue layers: endocardium, myocardium and epicardium.

  1. The heart of developing embryos originates from mesodermal cells located in the anterior part of the primitive streak ( Lawson et al., 1991 ; Tam et al., 1997 ) ( Fig.2 ).
  2. During gastrulation, these cardiac mesodermal cells migrate from the streak to the splanchnic mesoderm underlying the head folds to form cardiac crescent (the first heart field, FHF; see Glossary, Box 1 ) ( Abu-Issa and Kirby, 2007 ; Vincent and Buckingham, 2010 ) ( Fig.2A,B ).

As the embryo grows, the crescent of the FHF fuses in the ventral midline, forming a trough-like structure, which then closes dorsally to form a primitive heart tube ( Fig.2C ). The heart tube is suspended from the body wall by dorsal mesocardium ( Fig.2D ), and the tube elongates on both the arterial and venous poles via the addition of progenitor cells originating from the secondary heart field (SHF; see Glossary, Box 1 ), which lies medially and posteriorly to the crescent ( Kelly et al., 2001 ; Mjaatvedt et al., 2001 ; Waldo et al., 2001 ; Cai et al., 2003 ).

  1. Concurrent with heart tube elongation, the dorsal mesocardium dissolves except at the poles, liberating the majority of the heart tube and allowing it to undergo rightward looping.
  2. The looped heart tube, composed of an inner endocardial lining and an outer myocardial layer, is segmented into the atrium, the atrioventricular canal (AVC; see Glossary, Box 1 ), the ventricle and the outflow tract (OFT; see Glossary, Box 1 ) ( Fig.2E ).

In the lumen of the AVC and proximal OFT, local tissue swellings, termed endocardial cushions, are formed by the accumulation of abundant extracellular matrix (cardiac jelly) in between the endocardium and myocardium ( Fig.2F ). These endocardial cushions are subsequently populated by mesenchymal cells that descend from the endocardium.

  1. In addition, within the lumen of the distal OFT, local tissue swellings (termed truncal cushions) arise and are later populated by mesenchymal cells originating from the neural crest.
  2. While the cushions are developing, a sheath of cells, which originate from the proepicardial organ, grows over the myocardium of the heart tube to form the outermost epicardial layer of the heart ( Fig.2E-G ).

Later in development, the atrial and ventricular chambers divide into two atria (left and right) and two ventricles (left and right), forming a prototypic four-chamber heart ( Fig.2G ). Along with chamber septation, the AVC separates into left (mitral) and right (tricuspid) orifices, forming ventricular inlets that connect the respective atrium to the ventricle.

  • The outflow tract divides into the left and right ventricular outlets that connect the left and right ventricle, respectively, to the aorta and pulmonary trunk.
  • These septation events segregate the systemic from pulmonary circulation.
  • In addition, the AVC endocardial cushions develop into atrioventricular (mitral and tricuspid) valves, whereas the OFT endocardial cushions give rise to semilunar (aortic and pulmonic) valves ( Fig.1 ).

The formation of heart valves ensures that blood flows in one direction from the atria to ventricles and then to the arteries. The formation of a mouse heart. ( A ) Ventral view of a mouse embryo at E6. The heart originates from mesodermal cells in the primitive streak. During gastrulation, mesodermal cardiac progenitor cells migrate to the splanchnic mesoderm to form the cardiac crescent.

B ) Ventral view at E7. One subset of cardiac progenitors forms a horseshoe-shaped cardiac crescent (the first heart field, FHF; red). Another subset of cardiac progenitor cells forms the secondary heart field (SHF; blue), which is located posteriorly and medially to the FHF. ( C ) Ventral view at E8.

Cells in the FHF merge in the midline to form the heart tube, which then elongates on both arterial and venous poles via the addition of progenitor cells from the SHF. ( D ) Transverse section at E8. The developing heart tube is suspended from the body wall by the dorsal mesocardium, which later dissolves except at the poles of heart tube, allowing the tube to loop rightward.

  • E, F ) Ventral (E) and left lateral (F) views at E9.
  • The looped heart tube contains four anatomical segments: atrium, atrioventricular canal, ventricle and outflow tract (OFT).
  • Within the AVC and OFT, AV cushions (yellow) and OFT cushions (orange) develop.
  • The proepicardial organ (purple) houses epicardial progenitors that later migrate to the heart and give rise to the epicardium.

( G ) Transverse section at E11. At this stage, the heart is partially partitioned by the primitive atrial septum (PAS), interventricular septum (IVS) and atrioventricular cushions (AV cushions) into a prototypic four-chamber heart. The AVC is divided into tricuspid and mitral orifices, forming ventricular inlets that connect the respective atrium to the ventricle.

  • The opening between the PAS and AVC is the ostium primum.
  • RA, right atrium; LA, left atrium; RV, right ventricle; LV, left ventricle.
  • Multiple cells of distinct developmental origins contribute to the formation of a heart.
  • Lineage tracing and clonal analyses in mice show the existence of two distinct myocardial lineages arising separately from the FHF and SHF.
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The FHF lineage contributes primarily to the myocardium of the left ventricle ( Buckingham et al., 2005 ; Srivastava, 2006 ), whereas the SHF lineage contributes to the myocardium of the atria ( Cai et al., 2003 ; Galli et al., 2008 ), right ventricle and outflow tract ( Kelly et al., 2001 ; Cai et al., 2003 ; Zaffran et al., 2004 ; Verzi et al., 2005 ).

By contrast, the epicardium arises from the proepicardial organ, which is located near the venous pole of the heart tube and originates from the coelomic mesenchyme of septum transversum ( Männer et al., 2001 ) ( Fig.2E ). Cells in the epicardium give rise to mesenchymal cells that migrate into the myocardium and differentiate into fibroblasts and coronary smooth muscle cells ( Merki et al., 2005 ).

The origin of endocardium, however, has been controversial: the endocardium may arise from the heart fields or vascular endothelial progenitors ( Harris and Black, 2010 ; Vincent and Buckingham, 2010 ; Milgrom-Hoffman et al., 2011 ). The mesenchyme of cushions arises from two distinct origins.

Endocardial cushions in the AVC and proximal OFT lumen derive their mesenchyme from the local endocardium that overlies the cushions ( Eisenberg and Markwald, 1995 ), whereas the distal OFT cushions are populated by mesenchymal cells that migrate from the distant neural crest ( Jiang et al., 2000 ).

Here, we review the interactions between these different progenitor cells and their derivatives that are essential for cardiac septation and valve development. We also highlight the key signaling pathways that are known to regulate cardiac septation and valve development.

Why is the heart divided into four chambers?

Overview – The heart consists of four chambers in which blood flows. Blood enters the right atrium and passes through the right ventricle. The right ventricle pumps the blood to the lungs where it becomes oxygenated. The oxygenated blood is brought back to the heart by the pulmonary veins which enter the left atrium.

From the left atrium blood flows into the left ventricle. The left ventricle pumps the blood to the aorta which will distribute the oxygenated blood to all parts of the body. Updated by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, WA.

Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

Why is the heart divided into two helps by a thick wall?

Chambers of the Heart – The internal cavity of the heart is divided into four chambers:

Right atrium Right ventricle Left atrium Left ventricle

The two atria are thin-walled chambers that receive blood from the veins, The two ventricles are thick-walled chambers that forcefully pump blood out of the heart. Differences in thickness of the heart chamber walls are due to variations in the amount of myocardium present, which reflects the amount of force each chamber is required to generate.

What would happen if the heart were not divided into four chambers?

– a). If the heart were not divided into four chambers,the oxygen rich blood and carbon dioxide rich blood would have mixed with each other. ▁▁▁▁▁▁▁▁▁▁▁▁▁▁▁▁▁▁▁▁▁▁ b). Damage to the values between the right atrium and the right ventricle will cause backflow of the blood to the right atrium. ▁▁▁▁▁▁▁▁▁▁▁▁▁▁▁▁▁▁▁▁▁▁

What is one advantage of a four-chambered heart over a three-chambered heart?

23, Define a closed circulatory system and compare the differences in heart structure for animals with closed circulatory systems.

A closed circulatory system is a system in which the blood mixes with the interstitial fluid. Fish have a two-chambered heart. Amphibians and reptiles have a three-chambered heart. Mammals and birds have a four-chambered heart and double circulation. A closed circulatory system is a system in which blood is separate from the interstitial fluid. Fish have a two-chambered heart. Amphibians and reptiles have a three-chambered heart. Mammals and birds have a four-chambered heart and double circulation. A closed circulatory system is a system in which blood is separate from the interstitial fluid. Amphibians have a two-chambered heart. Fishes and reptiles have a three-chambered heart. Mammals and birds have a four-chambered heart and double circulation. A closed circulatory system is a system in which blood mixes with the interstitial fluid. Amphibians have a two-chambered heart. Fishes and reptiles have a three-chambered heart. Mammals and birds have a four-chambered heart and double circulation.

24, A circulatory system is the main method for transporting gases and nutrients throughout the body. What happens in a closed circulatory system, and how does a closed circulatory system compare to an open circulatory system?

Blood in a closed circulatory system is present inside blood vessels; it follows a unidirectional path from the heart and around the systemic circulatory route, and then returns to the heart. It is less controlled and structured than an open circulatory system, but it transfers nutrients and waste products more efficiently. Blood in a closed circulatory system is not enclosed in blood vessels; it is pumped into a hemocoel, which circulates around the organs, and then reenters the heart through ostia. It is more structured and controlled than an open circulatory system, and it transports nutrients and waste products more efficiently. Blood in a closed circulatory system is not enclosed in blood vessels; it is pumped into a hemocoel, which circulates around the organs, and then reenters the heart through ostia. It is less controlled and structured than an open circulatory system, but it transports nutrients and waste products more efficiently. Blood in a closed circulatory system is present inside blood vessels; it follows a unidirectional path from the heart around the systemic circulatory route, and then returns to the heart. It is more structured and controlled, and transports nutrients and waste products more efficiently than an open circulatory system.

25, What is one advantage of a four-chambered heart over a three-chambered heart?

In a four-chambered heart, oxygenated blood carried by the left side of the heart is more effectively separated from deoxygenated blood carried by the right side, which assists in more efficient movement of oxygen around the body. In a four-chambered heart, oxygenated blood carried by the right side of the heart is more effectively separated from deoxygenated blood carried by the left side, which assists in more efficient movement of oxygen around the body. In a four-chambered heart, oxygenated blood carried by the left side of the heart is less effectively separated from deoxygenated blood carried by the right side, which assists in more efficient movement of oxygen around the body. In a four-chambered heart, oxygenated blood carried by the right side of the heart is less effectively separated from deoxygenated blood carried by the left side, which assists in more efficient movement of oxygen around the body.

26, What are red blood cells also known as?

lymphocytes monocytes erythrocytes basophils

27, How does the structure of mammalian red blood cells allow them to deliver oxygen to the cells of the body?

Their size and shape allow them to carry and transfer oxygen. Their disc shape contains many small vesicles that allow them to carry and transfer oxygen. They have nuclei and do not contain hemoglobin. They contain coagulation factors and antibodies.

28, Which of the following best describes plasma?

It is a protein synthesized in the liver. It is a liquid that contains only lipids and antibodies. It is a blood component that is separated by spinning blood. It is an antibody produced in the mucosal lining.

29, What is the heart’s internal pacemaker?

It is an internal implant that sends an electrical impulse through the heart. It is the part of the heart that initiates an electrical impulse, called the sinoatrial node. It is the excitation of cardiac muscle cells at the atrioventricular and sinoatrial nodes. It is the contracting of muscles that starts in the aorta.

30, Cardiomyocytes are similar to skeletal muscle because _.

they beat involuntarily they are attached to bones they pulse rhythmically they are striated

31, This diagram shows the internal anatomy of the heart. How would blood circulation beyond the heart be most directly affected if the pulmonary valve could not open?

Blood could not reach the rest of the body. Blood could not reach the lungs. Blood could not return from the lungs. Blood could not return from the rest of the body.

32, The diagram shows the internal anatomy of the heart. How would blood circulation beyond the heart be affected if the tricuspid valve could not open?

Blood could not enter the pulmonary veins; therefore, it could not reach the lungs. Blood could not enter the pulmonary artery; therefore, it could not reach the heart. Blood could not enter the pulmonary artery; therefore, it could not reach the lungs. Blood could not enter the pulmonary veins; therefore, it could not reach the heart.

33, Why is it useful for blood to travel slowly through capillary beds?

To allow antibodies to enter infected cells and to promote the diffusion of fluid into the interstitial space. To assist with gas and nutrient exchange and to prevent the diffusion of fluid into the interstitial space. To assist with gas and nutrient exchange and to promote the diffusion of fluid into the interstitial space. To allow antibodies to enter infected cells and to prevent the diffusion of fluid into the interstitial space.

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What is the difference between 3 and 4 chambered heart?

Three-chambered hearts have one ventricle and two atria. four-chambered hearts have two ventricles and two atria.

What is the significance of the thickness of the wall in the heart?

Causes – Hypertrophic cardiomyopathy is usually caused by changes in genes (gene mutations) that cause the heart muscle to thicken. Hypertrophic cardiomyopathy typically affects the muscular wall (septum) between the two bottom chambers of the heart (ventricles).

  1. The thickened wall might block blood flow out of the heart.
  2. This is called obstructive hypertrophic cardiomyopathy.
  3. If there’s no significant blocking of blood flow, the condition is called nonobstructive hypertrophic cardiomyopathy.
  4. However, the heart’s main pumping chamber (left ventricle) might stiffen.

This makes it hard for the heart to relax and reduces the amount of blood the ventricle can hold and send to the body with each heartbeat. People with hypertrophic cardiomyopathy also have a rearrangement of heart muscle cells (myofiber disarray). This can trigger arrhythmias in some people.

What is the importance of wall and layers of heart?

These layers of the heart form the wall and protect and aid in the improved function of the valves. There are three layers that comprise the wall, epicardium the outer protective layer, myocardium the middle muscular layer and the endocardium the thin innermost layer.

What is the significance of the difference in thickness between the walls of the ventricles which is thicker and why?

The left ventricle has thicker walls than the right because it needs to pump blood to the rest of the body while the right ventricle pumps blood only to the lungs.

What are two advantages of having a four chambered heart?

It makes sure complete segregation of deoxygenated and oxygenated blood within the heart. It permits a highly effective supply of oxygenated blood to all the body parts.

What is can happen if the chambers of the heart do not work properly?

Overview – Heart failure — sometimes known as congestive heart failure — occurs when the heart muscle doesn’t pump blood as well as it should. When this happens, blood often backs up and fluid can build up in the lungs, causing shortness of breath. Certain heart conditions, such as narrowed arteries in the heart (coronary artery disease) or high blood pressure, gradually leave the heart too weak or stiff to fill and pump blood properly.

  1. Proper treatment can improve the signs and symptoms of heart failure and may help some people live longer.
  2. Lifestyle changes — such as losing weight, exercising, reducing salt (sodium) in your diet and managing stress — can improve your quality of life.
  3. However, heart failure can be life-threatening.
  4. People with heart failure may have severe symptoms, and some may need a heart transplant or a ventricular assist device (VAD).

One way to prevent heart failure is to prevent and control conditions that can cause it, such as coronary artery disease, high blood pressure, diabetes and obesity.

Why is 4 chambers better than 3?

As the heart develops in the unborn child, it takes on several distinct appearances, each resembling other animal hearts and each a step higher on the evolutionary ladder. At first, the tube-like heart is much like a fish heart. When it divides into two chambers, it is similar to a frog heart; with three chambers, a snake or turtle heart.

Finally, with four chambers, the fully formed heart looks like what it is: the heart of a human being, the most highly evolved mammal. The four-chambered heart has a distinct advantage over simpler structures: It allows us to send our “dirty” blood to the cleaners-the lungs-and our “clean” blood to the rest of the body without having to mix the two.

That system is very efficient. The blood coming from the left side of the heart is pure, fully oxygenated, and ready to fuel the muscles. A fish heart, on the other hand, has to pump blood, which is only half as pure, to the body because it doesn’t have separate chambers that enable it to clean the blood in one cycle and distribute it in the next.

What is the disadvantage of a 3 chambered heart?

Hint: The circulatory system in the multicellular organisms are involved in the exchange of respiratory gases which transport oxygen and food to cells and removal of carbon dioxide and metabolic wastes. The heart is the main part of circulatory systems.

  • The heart is three-chambered in the amphibians and in mammals, the heart consists of the four chambers.
  • Complete answer: The heart is a muscular organ that is part of the circulatory system found in most animals.
  • The heart pumps blood through the blood capillaries of the circulatory system.
  • The pumped blood carries oxygen and nutrients to different parts of the body.

It also carries metabolic waste such as carbon dioxide to be removed through the lungs. In the heart of a frog three chambers are present consisting of two atria and a single ventricle. The three-chambered heart is also known as a transitional heart. The right atrium receives deoxygenated i.e.

  • Impure blood from the blood veins and drains the various organs of the body.
  • The left atrium receives oxygenated i.e.
  • Pure blood from the lungs and skin.
  • Both atria empty into the single ventricle.
  • In this system the deoxygenated and oxygenated blood are mixed in the ventricle before being pumped out of the heart.

It is a very inefficient method when compared to the mammalian heart. The heart of a human is four chambered and it is also called a double circuit heart. This type of heart is divided into four chambers consisting of two atria and two ventricles. The atria receive the blood, while the ventricles pump blood to different parts of the body.

  1. In the mammalian heart which is a four-chambered and the heart is divided completely.
  2. The atrium and ventricle of the heart are completely separated in four-chambered which prevents the mixing of the oxygenated and deoxygenated blood.
  3. This property of the four chambered hearts is highly efficient in nature and provides an advantage to the warm-blooded mammals.

Therefore, the correct answer to the option A. Note: The heart, a muscular organ, is a part of the circulatory system which mainly pumps blood and through the blood, it helps to transport oxygen and other metabolic waste. In the case of the frog, the heart is three chambered.

Why is a 3 chambered heart better than a 2 chambered heart?

Solution. When compared to a two-chambered heart, a three-chambered heart is more advantageous since it is able to direct more pressure within the blood vessels to ensure that the oxygenated blood goes into the body, while the deoxygenated blood is directed into the lungs.

Can humans have 3 chambered heart?

This story is from June 16, 2014 VARANASI: An infant born with three chambered heart like reptiles and amphibians has left the doctors surprised. Pediatricians are working round-the-clock to keep him healthy. According to reports, Vandana of Singrauli gave birth to a baby at Government Hospital Baidhan in Sonebhadra about 10 days back.

  1. Soon after the birth, the child’s health started deteriorating.
  2. The doctors referred him to Varanasi, where he was admitted to ICU of a private hospital.
  3. Pediatricians Dr Alok C Bhardwaj and Dr AK Kaushik said during medical examination it was found that the baby had only three chamers in his heart.
  4. This is quite rare in mammals.

Human heart has four chambers,” they said. The four-chambered heart separates oxygen from the oxygen rich blood and sends it to different destinations. The oxygen rich blood is pumped throughout the body while the blood in need for oxygen is pumped to the lungs, they said.

  • The three chambered heart contains only one ventricle in which oxygen poor and oxygen rich blood intermingle but not entirely.
  • In amphibians, they said, the pulmonary respiration is improved because they absorb oxygen through skin too.
  • The pediatricians believe that the three-chamber heart was the source of deterioration of baby’s health and added that experts were being consulted for proper treatment of the baby.

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Who has 5 chambered heart?

A Five (5) chamber heart (Cor Triatriatum) in Infancy: A rare congenital heart defect Department of Paediatrics, Federal Medical Centre, Owerri, Nigeria Find articles by Department of Paediatrics, Federal Medical Centre, Owerri, Nigeria Find articles by Department of Paediatrics, Federal Medical Centre, Owerri, Nigeria Find articles by 1 Department of Family Medicine, Federal Medical Centre, Owerri, Nigeria Find articles by : © Nigerian Medical Journal This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Five-chambered heart is extremely rare in children. We report a case of asymptomatic five chamber heart detected in infancy. The patient is 2-day-old and managed in a special care baby unit (SCBU) for neonatal sepsis. During routine follow-up at the age of 1 month, she was found to have an asymptomatic murmur.

Echocardiograph reported five-chambered heart, concluding that it is Cor triatriatum, supravalvular pulmonary stenosis and secundum atrial septal defect. The child is still been followed-up and is still asymptomatic at 7 months. Five-chambered heart, although rare, can occur even if asymptomatic.

Eywords: Asymptomatic, five chamber heart, infancy Heart defects are among the most common birth defects. Worldwide, congenital heart defects/diseases contribute substantially to morbidity and mortality in childhood, especially in the third-world countries where facilities for management are often deficient.

About 35,000 infants (1 out of every 125) are born with heart defects every year in the United States. The incidence in the tropics is not expected to differ from the 8-10 per 1000 live-births documented in the developed world. The defect may be so slight that the baby may be asymptomatic for many years after birth, or so severe that it is life threatening.

  1. Heart defects are the leading cause of birth defect-related deaths.
  2. However; the use of echocardiography has improved description of congenital heart diseases and their early diagnosis.
  3. This, has led to dramatic increases in survival of children with serious heart defects.
  4. Cor triatriatum is a rare congenital cardiac anomaly, in which a fibromuscular membrane divides the atrium in two.

It was first reported in 1868. Cor triatriatum, a heart with 3 atria (triatrial heart), is a congenital anomaly in which the left atrium (cor triatriatum sinistrum) or right atrium (cor triatriatum dextrum) is divided into 2 parts by a fold of tissue, a membrane, or a fibromuscular band.

  • However, variable types of subtotal cor triatriatum are also noted, with only the right or left pulmonary veins draining into the upper chamber.
  • Cor triatriatum represents 0.1% of all congenital cardiac malformations and may be associated with other cardiac defects in as many as 50% of cases.
  • Examples of associated cardiac defects include atrial septal defect, persistent left superior vena cava with an unroofed coronary sinus, partial anomalous pulmonary venous connection, ventricular septal defect and more complex cardiac lesions such as tetralogy of Fallot, atrioventricular canal and double outlet right ventricle.

Associated bicuspid pulmonary valve, aortic valve atresia and heterotaxy have also been described. Congenital pulmonary vein stenosis is a very rare association with cor triatriatum. The morbidity and mortality of cor triatriatum sinistrum is high in those who are symptomatic in infancy.

This is due to the severely restrictive opening in the accessory membrane and the association with major cyanotic or acyanotic congenital heart lesions. Mortality may exceed 75% in untreated symptomatic infants. Significant sequel is unusual with cor triatriatum dextrum as it is not commonly associated with life-threatening symptoms or major congenital cardiac defects.

A female baby seen on the second day of life was delivered by a 25-year-old primiparous Youth Corper. The mother attended antenatal clinic in Federal Medical Centre Owerri from the 16 th week of gestation. However, during the 8 th week of pregnancy, the mother had threatened abortion for which some drugs were given (injections and tablets names unknown) at a hospital in Lagos.

She also had some liquid herbal preparation at 8 months of gestation; other drugs she took were essentially haematinics. She denied a history of alcohol, coffee and cigarette use. The pregnancy was carried to term. She went into spontaneous labour with an 18-h history of rupture of membrane. Delivery was spontaneous, vertex and supervised by medical personnel.

She gave birth to a 3.6-kg baby girl who cried immediately after, and breastfeeding commenced. The child was transferred to the Special Care Baby Unit from the postnatal ward on account of history of fever on day 2 of life. Examination revealed a full-term newborn, febrile (38.1 © ) with a respiratory rate of 100 cycles per minute, acyanotic, heart rate of 110 beats/min heart sound- I and II only no murmur heard.

  • At 1 month of life, a review of ECG showed:
  • heart rate: 128 beats/min,
  • RR: 468 mS,
  • P: 70 mS,
  • PR: 94 mS,
  • QRS: 54 mS,
  • QT: 290 mS,
  • QTc: 426 mS,
  • Axis P-39 ©,
  • QRS-147 © and
  • T-18, which suggested supraventricular arrhythmia, abnormal right superior axis deviation.

Chest radiograph showed perihilar mottling on both the lung fields. Heart and thoracic cavity were within normal limits. An impression of bronchopneumonia was made by the Consultant Radiologist.

  1. Murmur was still grade 3/6, pansystolic maximal at the left-lower sternal edge.
  2. Echocardiograph was subsequently requested and the result showed that a 2D echocardiogram was done with the following results:
  3. Situs solitus
  4. Separate left atrium with dividing membranous running in the direction of long axis of left atrium close to the lateral wall.

No evidence of flow across the septum. Mitral valve draining the larger, more medial chamber, normal atrio-ventriculo-arterial connection. Normal relationship of aortic root to the pulmonary trunk. Supravalvular pulmonary membrane causing stenosis noted.

  • Normal wall motion and thickness, good global left ventricular contractility.
  • Normal pericadium.
  • Conclusion
  • Cor Triatrietum.
  • Supravalvular pulmonary stenosis.
  • Secundum atrial septal defect

The child is presently being followed-up regularly. During her last visit, at 7 months of age, she weighed 9.6 kg, length was 73 cm, occipito-frontal circumference was 47 cm and mid-upper-arm circumference was 15 cm (all within normal for age). Cardiovascular examination revealed a child with heart rate of 120 beats/min, apex beat located at the 4 th left intercostals space, with a grade 3/6 systolic murmur heard loudest at the upper left sternal edge.

The respiratory rate was 42 cycles/min and no organs palpably enlarged on digestive system examination. This was the first case of a five-chambered heart seen and managed in the Federal Medical Centre Owerri. The case demonstrates the need for comprehensive evaluation of patients and provision of cardiac investigative facilities (X-ray, ECG and Echocardiograph machines) in health facilities.

In our patient, it was an incidental finding at a routine follow-up clinic. Subsequent investigative evaluations led to the confirmation of the diagnosis of a five-chambered heart in a child who has remained asymptomatic. The dearth of facilities in our hospital is obvious here, where the patient had to be referred to the University of Nigeria Teaching Hospital Enugu for echocardiograph.

  • Clinical manifestations are often delayed due to the presence of a large opening; and include an asymptomatic murmur.
  • Finding is mostly incidental on routine cardiac imaging; it therefore highlights the need for exhaustive evaluation and management because such conditions, although rare, can still be found here.

In conclusion, we reported a case of an asymptomatic congenital-heart defect A five-chambered heart-cor triatriatum, an extremely rare condition. Source of Support: Nil Conflict of Interest: None declared.1. Ibadin MO, Sadoh WE, Osarogiagbon W. Congenital heart diseases at the University of Benin teaching Hospital.

Nig J Paediatr.2005; 32 :29–32.2. National Heart, Lung and Blood Institute. Congenital Heart Defects.2007 Dec 3. Okoroma EO. Congenital heart diseases and arrhythmias. In: Azubuike JC, Nkaginaeme KE, editors. Paediatrics and Child Health in a Tropical Region.2nd ed. Vol.72. Owerri: African Educational Services; 2007.

pp.273–92.4. Jenkins KJ, Correa A, Feinstein JA, Botto L, Britt AE, Daniels SR, et al. American Heart Association Council on Cardiovascular Disease in the Young. Noninherited risk factors and congenital cardiovascular defects: Current knowledge: A scientific statement from the American Heart Association Council on cardiovascular disease in the young.

Circulation, 2007; 115 :2995–3014.5. Wiles HB. Imaging congenital heart disease. Pediatr Clin North Am.1990; 37 :115–36.6. Church WS. Congenital malformation of heart: Abnormal septum in left auricle. Trans Path Soz- 1868; 19 :188–90.7. Jennings RB, Jr, Innes BJ. Subtotal cor triatriatum with left partial anomalous pulmonary venous return.

Successful surgical repair in an infant. J Thorac Cardiovasc Surg.1977; 74 :461–6.8. Bladt O, Vanhoenacker R. Cor triatriatum. JBR-BTR.2008; 91 :62.9. Vaideeswar P, Tullu MS, Sathe PA, Nanavati R. Atresia of the common pulmonary vein-A rare congenital anomaly.

What is the thick wall that divides the heart into two sides?

S – septum (SEP-tum) : The septum is a thick wall of muscle that divides the heart. It separates the left and right sides of the heart. stent: A tiny tube that props a blood vessel open and helps blood flows freely. stethoscope (STETH-eh-skope) : The instrument doctors use to hear a heartbeat and other sounds that the inside of the body makes.

  1. By listening to the heart, lungs, and belly, the doctor gets information about how things are working inside.
  2. Stress test: For this test, a person exercises (usually on a treadmill) while the doctor checks breathing, heart rate, blood pressure, and electrocardiogram to see how the heart muscle reacts.

stroke : A stroke can happen when part of the brain doesn’t get enough blood due to a clot or a burst blood vessel. top

Which heart chamber has thicker wall and why?

The left ventricle has the thickest wall out of all the chambers. The left ventricle is responsible for pumping the blood towards the tissues of the heart. This is why more muscles contracting inside the left ventricle helps produce a higher force to move the blood towards the system.