What is Atrial Septal Defect?
An atrial septal defect is a congenital heart defect in which there is a hole in the wall (septum) that separates the upper chambers (atria) of the heart. The hole can vary in size and may close on its own or require surgery. An atrial septal defect is a type of congenital heart defect. Congenital means present at birth.
Because a baby's heart develops during pregnancy, there are usually several holes in the wall that separates the upper chambers of the heart (atria). They usually close during pregnancy or shortly after birth.
If one of these holes does not close, a hole is left and this is called an atrial septal defect. The hole increases the amount of blood entering the lungs and, over time, can damage the blood vessels in the lungs. Damage to the blood vessels in the lungs can cause problems in adulthood, such as high blood pressure in the lungs and heart failure. Other problems may include abnormal heart rhythms and an increased risk of stroke.
Causes and risk factors
The causes of heart defects, such as atrial septal defect, are unknown in most children. Some children develop heart defects due to changes in their genes or chromosomes. It is also believed that these types of heart defects are caused by a combination of genes and other risk factors, such as things the mother comes into contact with in the environment, or what the mother eats or drinks, or medications she uses.
Diagnosis
An atrial septal defect may be diagnosed during pregnancy or after the birth of a child. In many cases, it may not be diagnosed until adulthood.
During pregnancy
During pregnancy, screening tests (prenatal tests) are done to check for birth defects and other conditions. An atrial septal defect can be seen on an ultrasound (which creates images of the body), but it depends on the size of the hole and its location. If an atrial septal defect is suspected, a specialist will need to confirm the diagnosis.
After the birth of a child
An atrial septal defect is present at birth, but many babies have no signs or symptoms. Signs and symptoms of a large or untreated atrial septal defect may include the following:
- Frequent respiratory or lung infections
- Difficulty breathing
- Tiring when feeding (infants)
- Shortness of breath when being active or exercising
- Skipped heartbeats or a sense of feeling the heartbeat
- A heart murmur, or a whooshing sound that can be heard with a stethoscope
- Swelling of legs, feet, or stomach area
- Stroke
Atrial septal defect can only be diagnosed in adulthood. One of the most common ways to detect an atrial septal defect is to detect noise when listening to a person's heart with a stethoscope. If noise is heard or other signs or symptoms are present, the doctor may order one or more tests to confirm the diagnosis. The most common test is an echocardiogram, which is an ultrasound of the heart.
Treatment
Treatment for an atrial septal defect depends on age at diagnosis, the number or severity of symptoms, the size of the hole, and the presence of other conditions. Sometimes surgery is needed to fix the hole. Sometimes medications are prescribed to relieve symptoms. No known medicine can repair the hole.
If a child has been diagnosed with an atrial septal defect, the doctor may want to observe the child for a while to see if the hole closes on its own. During this period, the doctor may treat the symptoms with medicines. A doctor may recommend closing an atrial septal defect for a child with a significant atrial septal defect, even if there are few symptoms, to prevent problems later in life. Closure may also be recommended for an adult who has many or severe symptoms. Closure of the hole may be performed during cardiac catheterization or open heart surgery. After these procedures, aftercare will depend on the size of the defect, the person's age, and whether they have other birth defects.