Atrial Septal Defects: Surgical and Transcatheter Management
Atrial Septal Defects: Surgical and Transcatheter Management
What is 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.
Symptoms of Atrial Septal Defect (ASD)
Many babies born with atrial septal defects don't have signs or symptoms. In adults, signs or symptoms may not develop until age 30 or later.
Your doctor may first uncover an atrial septal defect during a regular checkup while listening to your heart using a stethoscope. Hearing a heart murmur may signal a hole in your heart. Atrial septal defects are often found when an ultrasound exam of the heart (echocardiogram) is done for another reason.
Signs and symptoms of atrial septal defects develop once damage occurs to the heart and lungs. Infants with larger atrial septal defects may have poor appetites and not grow as they should. Adults and infants may have signs of heart failure or arrhythmias.
Signs and symptoms of large or long-standing atrial septal defects may include : -
* Shortness of breath
* Fatigue
* Swelling of legs, feet or abdomen
* Heart palpitations or skipped beats
Causes of Atrial Septal Defect (ASD)
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
The term "atrial septal defect" usually refers to holes in the atria resulting from a lack of atrial septal tissue, rather than those related to a condition called patent foramen ovale (PFO).
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 one in three people, this opening doesn't close.
Risk factors of Atrial Septal Defect (ASD)
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 predict the approximate odds that any future children will have one.
Experiencing any the following conditions during pregnancy can increase your risk of having a baby with a heart defect : -
* Rubella infection. Becoming infected with rubella (German measles) while pregnant can increase the risk of fetal heart defects. The rubella virus crosses the placenta and spreads through the fetus's circulatory system damaging blood vessels and organs, including the heart.
* Poorly controlled diabetes. Uncontrolled diabetes in the mother in turn affects the fetus's blood sugar causing various damaging effects to the developing fetus.
* Drug or alcohol use or exposure to certain substances. Use of certain medications, alcohol or drugs, or exposure to chemicals or radiation during pregnancy can harm the developing fetus
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