Description

An atrial septal defect (asd) is a heart condition that one is born with. That means that it is a congenital defect of the heart. People with ASD have a hole between the upper chambers of the heart. The hole increases the amount of blood that goes through the lungs.

Small atrial septal defects may be found by chance and never cause for concern. Others may close during infancy or early childhood.

A large, long-term atrial septal defect may cause damage to the heart and lungs. Surgery may be needed to repair an atrial septal defect and to prevent complications.

Types of

Types of atrial septal defects (Asds) are:

  • Secundum. This is the most common type of autism spectrum disorder . Occurs in the middle of the wall between the upper chambers of the heart. This wall is called the atrial septum.
  • Primum. This type of ASD affects the lower part of the wall between the upper chambers of the heart. Could occur with other problems with the heart present at birth.
  • Sinus venosus. This is a rare type of the cia . This happens most often in the upper part of the wall between the chambers of the heart. Often occurs with other heart changes in the structure present at birth.
  • The coronary sinus. The coronary sinus is part of the system of veins to the heart. In this rare type of the cia , the part of the wall between the coronary sinus and the left upper chamber of the heart is missing.

Symptoms

A baby who was born with an atrial septal defect (ASD) may have no symptoms. Symptoms can begin in adulthood.

Atrial septal defect symptoms may include:

  • Shortness of breath, especially when exercising.
  • Fatigue, especially with the activity.
  • Swelling of the legs, feet, or the belly area.
  • Irregular heartbeat, also called arrhythmias.
  • Irregular heartbeat or feelings of a fast, pounding, or fluttering heartbeat, called palpitations.

When to see a doctor

Serious congenital heart defects are often diagnosed before or shortly after a child is born.

Get emergency help immediately if a child has trouble breathing.

Call a health care professional if these symptoms occur:

  • Shortness of breath, especially during exercise or activity.
  • Easy to strenuous, especially after the activity.
  • Swelling of the legs, feet, or the belly area.
  • Irregular heartbeat or feelings of a fast, pounding heartbeat.

Causes

The cause of the atrial septal defect is not clear. The problem affects the structure of the heart. This occurs when the baby's heart is forming during pregnancy.

The following factors may play a role in the cause of congenital heart defects such as atrial septal defect:

  • The changes in the genes.
  • Some medical conditions.
  • Certain medications.
  • The habit of smoking.
  • The misuse of Alcohol.

How the heart works

To understand the cause of the defect of the atrial septum, it may be useful to know how the heart works normally.

The typical heart consists of four chambers. The two upper chambers are called atria. The two lower chambers are called the ventricles.

The right side of the heart moves the blood to the lungs. In the lungs, the blood picks up oxygen and then returns to the heart from the left side. The left side of the heart pumps blood through the body's main artery, called the aorta. Then, the blood goes to the rest of the body.

A large atrial septal defect can send more blood to the lungs and cause the right side of the heart to work too hard. Without treatment, the right side of the heart grows larger over time, and becomes weaker. The pressure of the blood in the arteries of the lungs may also increase, causing pulmonary hypertension.

Risk factors

Atrial septal defect (asd) occurs when the baby's heart is forming during pregnancy. It is a congenital defect of the heart. Things that can increase the baby's risk of atrial septal defect or other heart problems that are present at birth include:

  • German measles, also called the rubella during the first months of pregnancy.
  • Diabetes.
  • Lupus.
  • Alcohol or tobacco use during pregnancy.
  • The use of cocaine during pregnancy.
  • The use of some medications during pregnancy, including those for the treatment of seizures and mood conditions.

Some types of congenital heart defects occur in families. This means that they are inherited. Tell your healthcare team if you or someone in your family has had a problem of the heart present at birth. A research done by a genetic counselor can help to show the risk of certain birth defects of the heart in the future of children.

Complications

A small atrial septal defect could never cause any concern. Small atrial septal defects often close during childhood.

Most atrial septal defects can cause serious complications, including:

  • Right-sided heart failure.
  • Irregular heartbeats, called arrhythmias.
  • Stroke.
  • The early death.
  • High blood pressure in the arteries of the lung called pulmonary hypertension.

Pulmonary hypertension may cause permanent damage to the lungs. This complication is called Eisenmenger syndrome, most often occurs over many years. Sometimes occurs in people with large atrial septal defects.

Treatment can prevent or help manage many of these complications.

Atrial septal defect and pregnancy

If you have an atrial septal defect and are pregnant or thinking about becoming pregnant, talk with a professional care of the first. It is important to have a proper prenatal care. A health professional may suggest repair the hole in your heart before you get pregnant. A large atrial septal defect or its complications can lead to a high-risk pregnancy.

Prevention

Because the cause of the atrial septal defect (asd) is not clear, prevention may not be possible. But to get good prenatal care is important. If you were born with an autism spectrum disorder , make an appointment for a health checkup before you get pregnant.

During this visit:

  • Talk about the current health conditions and medications. It is important to closely control the diabetes, lupus and other health conditions during pregnancy. Your health care professional may suggest to change the doses of some medications or stop them before pregnancy.
  • Review your family medical history. If you have a family history of congenital heart defects, or other genetic conditions, you can talk with a genetic counselor to find their risks.
  • Questions about the performance of a test to see if you have had German measles, also called rubeola. Rubella in pregnant women has been linked with some types of congenital heart defects in the baby. If you has not yet had the German measles or the vaccine, receive the recommended vaccines.

Diagnosis

Some of atrial septal defects (Asd) were found before or shortly after a child is born. But the smaller ones can not be found until later in life.

If an atrial septal defect, a health care provider may hear a "whooping" sound called a heart murmur when listening to the heart with a device called a stethoscope.

Tests

Tests that help to diagnose an atrial septal defect (asd) include:

  • The echocardiogram. This is the main test used to diagnose an atrial septal defect. Use sound waves to create images of the beating heart. An echocardiogram shows the structure of the heart chambers and heart valves. It also shows how well the blood moves through the heart and the heart valves.
  • X-ray of the chest. An x-ray of the chest shows the condition of the heart and the lungs.
  • Electrocardiogram (ECG or EKG). This quick and painless test records the electrical activity of the heart. You can show the rapidity or slowness with which the heart is beating. An ECG can help you find irregular heartbeats, called arrhythmias.
  • Cardiac magnetic resonance imaging (MRI). This imaging test that uses magnetic fields and radio waves to produce detailed images of the heart. This may be done if other tests do not provide a certain diagnosis.
  • Computed tomography (CT scan). This test uses a series of X-rays to create detailed pictures of the heart. It can be used if other tests do not provide enough information to make a diagnosis.

Treatment

The treatment for atrial septal defect (asd) depends on:

  • The size of the hole in the heart.
  • If there are other problems with the heart present at birth.

An atrial septal defect can be closed by itself during childhood. For the small holes that do not close, regular health checkups may be the only care you need.

Some of the defects of the atrial septum that do not close the need for a procedure to close the hole. But the closure of the atrial septal defect is not recommended in those with severe pulmonary hypertension.

Drugs

Medications are not the repair of an atrial septal defect (ASD). But they can help reduce the symptoms. Medications for atrial septal defect may include:

  • Beta-blockers to control the heartbeat.
  • Thinning of the blood, called blood thinners to reduce the risk of blood clots.
  • Diuretics to reduce fluid buildup in the lungs and other parts of the body.

Surgery or other procedures

A suggested procedure often to repair medium to large atrial septal defect (asd) in order to avoid complications in the future.

Atrial septal defect repair involves closing the hole in the heart. This can be done in one of two ways:

  • Catheter-based repair. This is done to fix the secundum type of atrial septal defects. A thin, flexible tube called a catheter is inserted into a blood vessel, usually in the groin area. The tube is guided into the heart. A mesh patch or plug, or passed through the catheter. The patch is used to close the hole. The heart tissue that grows around the hotfix, close the hole for life. However, some of the large secundum atrial septal defects might need open heart surgery.
  • Open-heart surgery. This type of ASD repair surgery involves making a cut through the chest wall to the heart. Surgeons use patches to close the hole. Open-heart repair surgery is the only way to fix primum, sinus venosus and coronary sinus atrial defects.

Sometimes, atrial septal defect can be repaired using smaller incisions than traditional surgery. This method is called minimally invasive surgery. If the repair is done with the help of a robot called robot-assisted heart surgery.

Any person who has had surgery for atrial septal defect needs regular imaging tests and health screenings. These appointments are to monitor potential heart and lung complications.

People with large atrial septal defects who do not have surgery to close the hole, often have worse long-term outcomes. They may have more trouble performing everyday activities. This is called reduction of the functional capacity. They are also at higher risk of irregular heartbeat, and pulmonary hypertension.

Lifestyle and home remedies

After a heart-healthy lifestyle is important. This includes eating healthy, not smoking, controlling weight, and getting enough sleep. If you or your child has an atrial septal defect, talk with your health care team about the following:

  • Exercise. The exercise is usually OK for people with an atrial septal defect. But if ASD repair is required, you might have to stop certain activities until the hole in the heart that is fixed. Ask a health care professional what type and amount of exercise is the most secure.
  • Extreme changes in altitude. Extreme changes in the location above or below sea level can cause complications in people with an unrepaired atrial septal defects. For example, there is less oxygen at high altitudes. The lower amount of oxygen that the changes of blood flow through the pulmonary arteries. This can cause shortness of breath and tension in the heart.
  • The Dental work. If you or your child has recently had a TEA fixed, and the need of dental work, speak with a health care professional. You or your child may need to take antibiotics for about six months after the repair of the surgery to prevent infection.

Preparing for your appointment

A medical doctor trained in heart problems that are present at birth usually provides care for people with an atrial septal defect. This type of health care provider that is called a congenital cardiologist.

Here's some information to help you prepare for your appointment.

What you can do

Make a list of:

  • Your or your child's symptoms , and when you noticed his presence.
  • Important personal information, including major stresses, recent life changes, and a family history of heart problems present from birth.
  • All the medications, vitamins, or other supplements being taken. Include the dose.
  • Questions during your appointment.

For atrial septal defect, questions could include:

  • What is the most likely cause of these symptoms?
  • There are other possible causes?
  • What tests are needed?
  • It is the atrial septal defect, likely to close on its own?
  • What are the treatment options?
  • What are the risks of the surgery repair?
  • Are there any activity restrictions?
  • Are there brochures or other printed material I can have? What sites do you recommend?

What to expect from your doctor

Your healthcare provider is likely to ask questions, including:

  • Do you or your child develop symptoms or come and go?
  • Do the symptoms get worse with exercise?
  • Nothing else seems to make the symptoms worse?
  • There is something that seems to make the symptoms better?
  • There is a family history of congenital heart defects?
Symptoms and treatment of Atrial septal defect (asd)