An atrial septal defect is a hole between the upper 2 chambers of the heart. The size of the hole can be very small or it may be more than an inch in diameter. It is a birth defect, also called a congenital heart defect.
The heart has 4 sections, or chambers. The upper chambers are called atria, and the lower chambers are called ventricles. The wall between the right and left atria is called the atrial septum. Normally, blood flows from the right atrium into the right ventricle, and the right ventricle pumps it to the lungs. When there is a hole in the atrial septum, the left atrium pushes blood into the right atrium. The extra blood increases the heart’s workload. It also increases the flow of blood to the lungs.
There are different types of atrial septal defects. They can be in different places on the atrial wall, and they can be different sizes:
Heart defects may be inherited, which means that that they are passed from parents to children through their genes. Genes are inside each cell of your body. They contain the information that tells your body how to develop and work.
If the defect is mild, there may be no symptoms. Many people live their entire lives with a small atrial septal defect and do not know they have it. It may be found only when they are being tested for something else. Many defects cause a whooshing sound, called a murmur, as blood moves through the heart. Healthcare providers can hear the murmur with a stethoscope.
Large defects may cause symptoms. The extra blood flow through the lungs may increase the blood pressure in the lungs. Over time, this may cause heart failure. Symptoms may include:
Sometimes blood clots form inside the blood vessels. Clots can break into pieces and float in the bloodstream and through the hole in the heart. If they block a blood vessel, the result can be a heart attack, stroke, loss of vision, or other problems.
Your healthcare provider will ask about your child's symptoms and medical history and examine your child.
Tests may include:
Your child may have other tests to check for possible causes of the symptoms.
Your healthcare provider will advise treatment based on the symptoms and size of the defect.
A small defect may never cause any symptoms or problems. It may close on its own during the first years of a child’s life. If a very small amount of blood flows through the hole, there may be no benefit to having the hole closed.
In general, it is best to close large defects at a younger age before the heart or lungs are damaged.
Two types of surgery may be done to close the defect:
If your child has an atrial septal defect and no symptoms, he or she should have regular checkups. Your child may need to have regular follow-up visits with a specialist in congenital heart disease.
Ask your healthcare provider if your child should take antibiotics to prevent infection before having dental work or procedures that involve the rectum, bladder, or vagina.
Ask your child’s healthcare provider:
Make sure you know when your child should come back for a checkup. Keep all appointments for provider visits or tests.