Atrial septal defect (ASD), a congenital birth defect, is an abnormality in the atria (the upper chambers of the heart).
In ASD, the wall between the left and right chambers is not completely closed.
In a developing fetus, there is an opening between the left and right atrium that allows the blood to bypass the lungs. By the time the baby is born, that opening is normally closed, and blood will flow to the lungs. In babies born with ASD, blood passes from the left atrium to the right atrium, and eventually can cause problems in the lungs.
ASD occurs in approximately four out of every 100,000 babies. Those born with minor-to-moderate defects may not suffer any complications or symptoms. Very small ASDs will close on their own about 90% of the time. Those with a more severe defect may have disabilities later in life.
ASD is a congenital defect, meaning it occurs during development of the fetus and is present at birth. Some ASD cases may be caused by a genetic defect or abnormality inherited from a parent, and others can be caused by illnesses suffered by the mother during pregnancy.
Most of the time, the cause of ASD is unknown.
A risk factor is something that increases your chance of getting a disease or condition. Because the cause of ASD is largely unknown, there are no known risk factors for the condition.
Symptoms include:
- Fatigue and tiring easily during activity
- Sweating
- Rapid breathing, difficulty breathing or shortness of breath
- Persistent respiratory infections
- Poor growth
- Heart palpitations
- Poor appetite
- Heart murmur
People with small or moderately-sized defects may show no symptoms, or may not begin to show symptoms until later in life.
Your doctor will ask about your symptoms and medical history, and perform a physical exam. Tests may include the following:
- Chest x-ray
- Echocardiogram
—a test that uses high-frequency sound waves (ultrasound) to examine the size, shape, and motion of the heart
- Doppler image of the heart
- Cardiac Catheterization
—a tube-like instrument inserted into the heart through a vein or artery (usually in the arm or leg) to detect problems with the heart and its blood supply
- Coronary Angiography
(patients over age 35 only)—x-rays taken after a dye is injected into the arteries, allows the doctor to look for abnormalities in the arteries
- MRI of the Chest
—a test that uses magnetic waves to make pictures of structures inside the chest
- Electrocardiogram (ECG, EKG)
—a test that records the heart’s activity by measuring electrical currents through the heart muscle
Small defects that produce few or no symptoms may not require treatment, and many defects may close on their own without any treatment. Talk with your doctor about the best treatment plan for you. Treatment options include:
For patients with large defects and who experience significant symptoms, surgery may be required to close the opening between the atria.
A new procedure may also be performed, which closes the opening without surgery. A closure device is inserted through a heart catheter, which is inserted in the patient’s groin.
After children have undergone open heart surgery to repair the defect, antibiotics will be prescribed prior to any dental work or procedures to reduce the risk of developing
bacterial endocarditis.
Since the condition is a congenital defect and the causes are unknown, there are no known preventive measures that can prevent atrial septal defect. Early diagnosis of the problem and early treatment can help prevent complications from the condition.
