A hole in the septum between the heart's two upper chambers is called an Atrial Septal Defect (ASD). Holes in the heart are congenital defects that affect the heart’s structure and blood flow from birth. The heart has two sides, separated by an inner wall called the septum. With each heartbeat, the right side of the heart receives oxygen-poor blood from the body and pumps it to the lungs. The left side receives oxygen-rich blood from the lungs and pumps it into the body. The septum prevents mixing of blood between the two sides of the heart. However, studies in India have shown that one out of four infants is born with an ASD condition.

Symptoms:

ASD signs and symptoms in babies include:

Shortness or gasping of breath
Swelling of legs, feet, or abdomen
Heart palpitations or skipped beats
Frequent lung infections
Heart murmurs (most common)

Causes:

Although doctors know that this type of heart defect is present at birth, there is no definite cause. What is known is that congenital heart defects tend to run in families and sometimes occur with genetic conditions such as Down syndrome.

Dr. Devi Shetty, Chairman, Narayana Health, believes that in several cases, infant ASDs are linked to the mother’s health, age, family history of heart disease, and lifestyle. Some factors that may increase the risk of having a baby with a heart defect include:

Rubella infection: German measles during the first few months of pregnancy can increase the risk of fetal heart defects.
Drugs, tobacco, smoking, and alcohol: Use of certain medications, tobacco, alcohol, or drugs such as cocaine during pregnancy can harm the developing fetus.
Obesity: Being extremely overweight may increase the risk of birth defects.
Phenylketonuria (PKU): PKU patients not following the recommended meal plan may have a higher risk of babies with heart defects.

Complications:

A small ASD may never cause any problems and often closes during infancy. However, larger defects can lead to mild to serious complications such as right-sided heart failure, heart rhythm abnormalities (arrhythmias), and an increased risk of stroke later in life.

Treatment:

Dr. Shetty mentions that ASDs are best treated when the child turns 3–4 years old. Until then, regular medical checkups and heart evaluations by a specialized paediatric cardiologist are advised. In most cases, ASDs aren’t harmful to babies, and when treatment is necessary, it can often be managed through non-surgical methods.