Atrial Septal Defect (ASD)
- By sahlhealth
- May 18, 2021
- 19 views
An Atrial Septal Defect (ASD) is a hole in the wall between the two upper chambers of your heart (atria). The condition is present at birth (congenital).Small defects may never cause a problem and may be found incidentally. It’s also possible that small 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 that affects the arteries in the lungs (pulmonary hypertension). Surgery may be necessary to repair Atrial Septal Defects to prevent complications.
-Many babies born with Atrial Septal Defects don't have associated signs or symptoms. In adults, signs or symptoms may begin around age 30, but in some cases signs and symptoms may not occur until decades later.
Atrial septal defect signs and symptoms may include:
- Shortness of breath, especially when exercising
- Swelling of legs, feet or abdomen
- Heart palpitations or skipped beats
- Heart murmur, a whooshing sound that can be heard through a stethoscope
-Your or your child's doctor may first suspect an Atrial Septal Defect or other heart defect during a regular checkup if he or she hears a heart murmur while listening to the heart using a stethoscope.
-If your doctor suspects you or your child has a heart defect, the doctor may request one or more of the following tests:
- Echocardiogram. This is the most commonly used test to diagnose an Atrial Septal Defect. Some atrial septal defects can be found during an echocardiogram done for another reason.During an echocardiogram, sound waves are used to produce a video image of the heart. It allows your doctor to see your heart's chambers and measure their pumping strength.This test also checks heart valves and looks for any signs of heart defects. Doctors may use this test to evaluate your condition and determine your treatment plan.
- Chest X-ray. An X-ray image helps your doctor to see the condition of your heart and lungs. An X-ray may identify conditions other than a heart defect that may explain your signs or symptoms.
- Electrocardiogram (ECG). This test records the electrical activity of your heart and helps identify heart rhythm problems.
- Cardiac catheterization. In this test, a thin, flexible tube (catheter) is inserted into a blood vessel at your groin or arm and guided to your heart. Through catheterization, doctors can diagnose congenital heart defects, test how well your heart is pumping and check the function of your heart valves. Using catheterization, the blood pressure in your lungs also can be measured.However, this test usually isn't needed to diagnose an Atrial Septal Defect. Doctors may also use catheterization techniques to repair heart defects.
- Magnetic resonance imaging (MRI). An MRI is a technique that uses a magnetic field and radio waves to create 3-D images of your heart and other organs and tissues within your body. Your doctor may request an MRI if echocardiography can't definitively diagnose an Atrial Septal Defect.
- Computerized tomography (CT) scan. A CT scan uses a series of X-rays to create detailed images of your heart. A CT scan may be used to diagnose an Atrial Septal Defect if echocardiography hasn't definitely diagnosed an Atrial Septal Defect.
-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 treatment. But many persistent Atrial Septal Defects eventually require surgery to be corrected.
- Medical monitoring
-If your child has an Atrial Septal Defect, your child's cardiologist may recommend monitoring it for a period of time to see if it closes on its own. Your child's doctor will decide when your child needs treatment, depending on your child's condition and whether your child has any other congenital heart defects.
-Medications won't repair the hole, but they may be used to reduce some of the signs and symptoms that can accompany an Atrial Septal Defect. Drugs may also be used to reduce the risk of complications after surgery. Medications may include those to keep the heartbeat regular (beta blockers) or to reduce the risk of blood clots (anticoagulants).
-Many doctors recommend repairing an Atrial Septal Defect diagnosed during childhood to prevent complications as an adult. Doctors may recommend surgery to repair medium- to large-sized Atrial Septal Defects. However, surgery isn't recommended if you have severe pulmonary hypertension because it might make the condition worse.For adults and children, surgery involves sewing closed or patching the abnormal opening between the atria. Doctors will evaluate your condition and determine which procedure is most appropriate. Atrial Septal Defects can be repaired using two methods:
-Cardiac catheterization. In this procedure, doctors insert a thin tube (catheter) into a blood vessel in the groin and guide it to the heart using imaging techniques. Through the catheter, doctors set a mesh patch or plug into place to close the hole. The heart tissue grows around the mesh, permanently sealing the hole.This type of procedure may be performed to repair only the secundum type of atrial septal defects. Some large secundum Atrial Septal Defects may not be able to be repaired through cardiac catheterization, and may require open-heart surgery.
-Open-heart surgery. This type of surgery is done under general anesthesia and requires the use of a heart-lung machine. Through an incision in the chest, surgeons use patches to close the hole. This procedure is the preferred treatment for certain types of Atrial Septal Defects (primum, sinus venosus and coronary sinus), and these types of Atrial defects can only be repaired through open-heart surgery.This procedure may also be conducted using small incisions (minimally invasive surgery) for some types of Atrial Septal Defects.Doctors use imaging techniques after the defect has been repaired to check the repaired area.
-Follow-up care depends on the type of defect and whether other defects are present. Repeated echocardiograms are done after hospital discharge, one year later and then as requested by your or your child's doctor. For simple Atrial Septal Defects closed during childhood, only occasional follow-up care is generally needed.Adults who've had Atrial Septal Defect repair need to be monitored throughout life to check for complications, such as pulmonary hypertension, arrhythmias, heart failure or valve problems. Follow-up exams are typically done on a yearly basis.