Atrial septal defect (ASD)
Atrial septal defect (ASD)
An atrial septal defect (ASD) is a hole in the wall between the two upper chambers of your heart. The condition is present from birth (congenital). Smaller atrial septal defects may close on their own during infancy or early childhood.
Large and long-standing atrial septal defects can damage your heart and lungs. An adult who has had an undetected atrial septal defect for decades may have a shortened life span from heart failure or high blood pressure in the lungs. Surgery is usually necessary to repair atrial septal defects to prevent complications.
Many babies born with atrial septal defects don't have signs or symptoms. In adults, signs or symptoms usually begin by age 30, but in some cases signs and symptoms may not occur until decades later.
Signs and symptoms of large or long-standing atrial septal defects may include:
When to see a doctor
These could be symptoms of heart failure or another complication of an atrial septal defect.
Doctors know that heart defects present at birth (congenital) arise from errors early in the heart's development, but there's often no clear cause. Genetics and environmental factors may play a role.
An atrial septal defect allows freshly oxygenated blood to flow from the left upper chamber of the heart (left atrium) into the right upper chamber of the heart (right atrium). There it mixes with deoxygenated blood and is pumped to the lungs, even though it's already refreshed with oxygen. If the atrial septal defect is large, this extra blood volume can overfill the lungs and overwork the heart. If not treated, the right side of the heart eventually enlarges and weakens. In some cases, the blood pressure in your lungs increases as well, leading to pulmonary hypertension.
Comparing ASD with patent foramen ovale
Patent foramen ovale occurs when part of the normal fetal heart circulation fails to close properly at birth. During fetal heart development, a channel (the foramen ovale) is present between the atria to allow blood to bypass the lungs. At birth, once the lungs take over breathing, the hole normally closes. In about 1 in 3 people, this opening doesn't close completely.
Chambers and the valves of the heart
A normal heart has two upper and two lower chambers. The upper chambers, the right and left atria, receive incoming blood. The lower chambers, the more muscular right and left ventricles, pump blood ...
Atrial septal defect
An atrial septal defect is an abnormal opening between the heart's upper chambers. It's a common congenital heart defect. ...
Scientists don't know why atrial septal defects occurs, but they do know that this and other congenital heart defects appear to run in families and sometimes occur with other genetic problems, such as Down syndrome. If you have a heart defect, or you have a child with a heart defect, a genetic counselor can estimate the odds that any future children will have one.
When the following conditions occur during pregnancy, they can increase your risk of having a baby with a heart defect:
A small atrial septal defect may never cause any problems. Small atrial septal defects often close during infancy.
Larger defects can cause mild to life-threatening problems:
Treatment can prevent or help manage many of these complications.
Atrial septal defect and pregnancy
The risk of congenital heart disease is higher for children of parents with congenital heart disease, whether in the father or the mother. Experts recommend that anyone with a congenital heart defect, repaired or not, who is considering starting a family carefully discuss it beforehand with his or her doctor. Some medications may need to be stopped or adjusted before you become pregnant because they can cause serious problems for a developing fetus.
Preparing for your appointment
An atrial septal defect may first be detected when a suspicious heart murmur is heard during a routine examination. A heart murmur is an abnormal whooshing sound caused by turbulent blood flow. If your doctor suspects an atrial septal defect, you or your child will likely be referred to a doctor who specializes in disorders of the heart (cardiologist).
Because appointments can be brief, and there's often a lot of ground to cover, it's a good idea to arrive well prepared. Here's some information to help you get ready for your appointment, and what to expect from your doctor.
What you can do
Your time with your doctor is limited, so preparing a list of questions can help you make the most of your time together. List your questions from most important to least important in case time runs out. For atrial septal defect, some basic questions to ask your doctor include:
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment at any time that you don't understand something.
What to expect from your doctor
Tests and diagnosis
Your doctor may first suspect an atrial septal defect during a regular checkup if he or she hears a heart murmur while listening to your heart using a stethoscope. Or, an atrial septal defect may be found when an ultrasound exam of the heart (echocardiogram) is done for another reason.
If your doctor hears a heart murmur or finds other signs or symptoms of a heart defect, he or she may request one or more of the following tests:
Treatments and drugs
If your child has an atrial septal defect, your doctor may recommend monitoring it for a period of time to see if it closes on its own, while treating any symptoms with medications. Many atrial septal defects close on their own during childhood. For those that don't close, some small atrial septal defects don't cause any problems and may not require any intervention. But, many atrial septal defects eventually require surgery to be corrected.
If your child needs treatment, the timing of it depends on your child's condition and whether your child has any other congenital heart defects.
Follow-up care depends on the type of defect and whether other defects are present. For simple atrial septal defects closed during childhood, only occasional follow-up care is needed. For adults, follow-up care may depend on any resulting complications.
Lifestyle and home remedies
If you find out you have a congenital heart defect, or you've had surgery to correct one, you may wonder about limitations on activities and other issues.
In most cases, atrial septal defects can't be prevented. If you have a family history of heart defects or other genetic disorders, consider talking with a genetic counselor to assess what the risk might be before getting pregnant.
Last Updated: 2009-12-17
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