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KEY POINTS
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An atrial septal defect (ASD) 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 ASDs. They can be in different places on the atrial wall, and they can be different sizes:
Other holes in the atrial wall may happen because the baby's heart does not form properly.
ASDs may be inherited, which means 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 ASD is mild, there may be no symptoms. Many people live their entire lives with a small ASD and do not know they have it. It may be found only when they are being tested for something else. Many ASDs cause a whooshing sound, called a murmur, as blood moves through the heart. Healthcare providers can hear the murmur with a stethoscope.
Large ASDs 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 ASD.
A small ASD 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 ASDs at a younger age before the heart or lungs are damaged.
Two types of surgery may be done to close the ASD:
If your child has an ASD and no symptoms, your child 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 antibiotic medicine 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.