This heart problem that is present at birth causes a hole between the heart's upper chambers. It can be treated.
An atrial septal defect (ASD) is a heart condition that you're born with. That means it's a congenital heart defect. People with an ASD have a hole between the upper heart chambers. The hole increases the amount of blood going through the lungs.
Small atrial septal defects might be found by chance and never cause a concern. Others might close during infancy or early childhood.
A large, long-term atrial septal defect can damage the heart and lungs. Surgery may be needed to repair an atrial septal defect and to prevent complications.
Types of atrial septal defects (ASDs) include:
A baby born with an atrial septal defect (ASD) may not have symptoms. Symptoms may begin in adulthood.
Atrial septal defect symptoms may include:
Serious congenital heart defects are often diagnosed before or soon after a child is born.
Get immediate emergency help if a child has trouble breathing.
Call a healthcare professional if these symptoms occur:
The cause of atrial septal defect is not clear. The problem affects the structure of the heart. It happens as the baby's heart is forming during pregnancy.
The following may play a role in the cause of congenital heart defects such as atrial septal defect:
To understand the cause of atrial septal defect, it may be helpful to know how the heart typically works.
The typical heart is made of four chambers. The two upper chambers are called the atria. The two lower chambers are called the ventricles.
The right side of the heart moves blood to the lungs. In the lungs, blood picks up oxygen and then returns it to the heart's left side. The left side of the heart then pumps the blood through the body's main artery, called the aorta. The blood then goes out to the rest of the body.
A large atrial septal defect can send extra blood to the lungs and cause the right side of the heart to work too hard. Without treatment, the right side of the heart grows larger over time and becomes weak. The blood pressure in the arteries in the lungs also can increase, causing pulmonary hypertension.
A typical 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 out of the heart. The heart valves, which keep blood flowing in the right direction, are gates at the chamber openings.
Atrial septal defect (ASD) occurs as the baby's heart is forming during pregnancy. It is a congenital heart defect. Things that may increase a baby's risk of atrial septal defect or other heart problems present at birth include:
Some types of congenital heart defects occur in families. This means they are inherited. Tell your care team if you or someone in your family had a heart problem present at birth. Screening by a genetic counselor can help show the risk of certain heart defects in future children.
A small atrial septal defect might never cause any concern. Small atrial septal defects often close during infancy.
Larger atrial septal defects can cause serious complications, including:
Pulmonary hypertension can cause permanent lung damage. This complication, called Eisenmenger syndrome, most often occurs over many years. It sometimes happens in people with large atrial septal defects.
Treatment can prevent or help manage many of these complications.
If you have an atrial septal defect and are pregnant or thinking about becoming pregnant, talk to a care professional first. It's important to get proper prenatal care. A healthcare professional may suggest repairing the hole in the heart before getting pregnant. A large atrial septal defect or its complications can lead to a high-risk pregnancy.
Because the cause of atrial septal defect (ASD) is not clear, prevention may not be possible. But getting good prenatal care is important. If you were born with an ASD, make an appointment for a health checkup before becoming pregnant.
During this visit:
Some atrial septal defects (ASDs) are found before or soon after a child is born. But smaller ones may not be found until later in life.
If an ASD is present, a healthcare professional may hear a whooshing sound called a heart murmur when listening to the heart with a device called a stethoscope.
Tests that help diagnose an atrial septal defect (ASD) include:
Treatment for atrial septal defect (ASD) depends on:
An atrial septal defect may close on its own during childhood. For small holes that don't close, regular health checkups may be the only care needed.
Some atrial septal defects that do not close need a procedure to close the hole. But closure of an ASD isn't recommended in those who have severe pulmonary hypertension.
Medicines won't repair an atrial septal defect (ASD). But they can help reduce symptoms. Medicines for atrial septal defect might include:
A procedure is often suggested to repair a medium to large atrial septal defect (ASD) to prevent future complications.
Atrial septal defect repair involves closing the hole in the heart. This can be done two ways:
Sometimes, atrial septal defect repair can be done using smaller cuts than traditional surgery. This method is called minimally invasive surgery. If the repair is done with the help of a robot, it's called robot-assisted heart surgery.
Anyone who has had surgery for atrial septal defect needs regular imaging tests and health checkups. These appointments are to watch for possible heart and lung complications.
People with large atrial septal defects who do not have surgery to close the hole often have worse long-term outcomes. They may have more trouble doing everyday activities. This is called reduced functional capacity. They also are at greater risk for irregular heartbeats and pulmonary hypertension.
Following a heart-healthy lifestyle is important. This includes eating healthy, not smoking, managing weight and getting enough sleep. If you or your child has an atrial septal defect, talk to your healthcare team about the following:
A doctor trained in heart problems present at birth usually provides care for people with an atrial septal defect. This type of healthcare professional is called a congenital cardiologist.
Here's some information to help you get ready for your appointment.
Make a list of:
For atrial septal defect, questions to ask might include:
Your healthcare professional is likely to ask questions, including: