Categories: Paediatric Cardiology

Atrial Septal Defect (ASD) – Causes, Symptoms and Treatment

Atrial Septal Defect (ASD)- A treatable defect!

ASD or Atrial Septal Defect or hole in the heart is a congenital (inborn) heart defect. In ASD, a hole is there in the septum.  A septum is a muscular wall that separates the two atria (upper chambers of the heart). An ASD happens when this muscular wall or septum does not develop properly. Through this hole, some oxygenated blood from the left atrium flows into the right atrium and gets mixed with oxygen-poor blood. It increases the amount of blood that flows through the lungs. While small-sized defects might be diagnosed accidentally and may never cause a problem, a large and long-standing ASD can cause serious damage to the heart as well as lungs.

What are the most common causes of Atrial Septal Defect (ASD)?

An opening between the upper heart chambers (atria) is there at the time of birth in every child. This opening allows blood to pass through it during the development of a fetus. It is no longer needed after birth and usually closes on its own within several weeks or months.

But sometimes, this opening does not get closed, resulting in the atrial septal defect. The cause of most ASDs is still unknown. Though in some cases, it can be due to genetic issues.

Which are the most common signs and symptoms of Atrial Septal Defect (ASD)?

The signs and symptoms of ASD largely depend on the size of the opening. Children with small-sized defects may not have any identifiable signs and symptoms since there is no added workload on the heart and lungs.

The signs and symptoms of large-sized defects may include the following:

  1. Recurring lung or respiratory infections
  2. Difficulty in breathing
  3. Shortness of breath during exertion
  4. A heart murmurs that can be heard by clinicians using a stethoscope
  5. Swelling in feet or stomach area
  6. Stroke

What are the risk factors that can increase the risk of having a baby with an Atrial Heart Defect?

Some conditions during pregnancy can increase the risk of your baby having a heart defect:

  1. Rubella infection during pregnancy
  2. Drug, tobacco, or alcohol use during pregnancy can harm the fetus
  3. Diabetes or lupus during pregnancy

How can clinicians diagnose Atrial Septal Defect (ASD)?

A doctor can find the defect during pregnancy or after the baby is born.

During pregnancy, the atrial septal defect can be detected during an ultrasound.

After birth, a doctor can find ASD by detecting a specific murmur using a stethoscope. To further confirm, doctors may prescribe investigations like 2 D Echo, Chest Xray, and ECG.

Is Atrial Septal Defect (ASD) curable?

Treatment of ASD depends on age and the location size, and severity of the defect.

For very ASDs, a cardiologist may not recommend any medical or surgical intervention and advise follow-up visits for observation.

If an Atrial Septal Defect has not closed on its own by the time child is 4 to 5 years of age, a pediatric cardiologist may recommend procedures like cardiac catheterization or heart surgery.

  • Cardiac catheterization

During cardiac catheterization, the surgeon inserts a catheter into a leg artery that leads to the heart and guides the tube into the heart to measure blood flow, oxygen levels, and pressure in the heart chambers. The surgeon positions an implant into the hole. This implant gets flatten against the septum and permanently seals the opening.

  • Heart Surgery

If the Atrial Septal Defect (ASD) is at an unusual position, or if there are other heart defects along with ASD then the catheter technique is not sufficient to close the defect. In such cases, the surgeon performs heart surgery to close the defect.

How much time does my child take to recover after surgery or cardiac catheterization?

The cardiologist may recommend regular follow-up for few weeks after surgery or cardiac catheterization to check on the child’s progress. Doctors may go for another echocardiogram to make sure that the opening has closed completely.

Most children quickly recover from the treatment. We can even notice an increase in their diet and physical activity within a few weeks after surgery.

However, after surgery or cardiac catheterization, if the child has any of the below-mentioned symptoms, contact your doctor immediately.

  1. Difficulty in breathing
  2. Bluish colour around lips, tongue, or mouth
  3. Weight loss
  4. Decreased activity level
  5. Unexplained recurring fever
  6. Pain, tenderness, or oozing of pus from the incision site

Atrial Septal Defect (ASD) is a serious disease. But if diagnosed and treated early can not prevent your child from living a healthy and active life.

Dr. Dhananjay R S | Consultant – Cardiology – Adult, Cardiology – Paediatric | SS Narayana Heart Centre, Davangere

Narayana Health

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