Last updated on January 5, 2022
Content By: Dr. Nikita Toshi BDS, Assistant Manager (Medical Review), Dr. Ritu Budania MBBS, MD (Pharmacology) Head, Medical Affairs &
Last updated on January 5, 2022
A normal heart of a human being is responsible for pumping and receiving blood efficiently. Proper flow of blood is important for a healthy body, it carries nutrients and oxygen and eliminates waste products such as carbon dioxide. However, sometimes, some abnormalities or defects can interfere with the normal functioning of the heart. An atrial septal defect is one such abnormality.
An atrial septal defect (ASD) is a hole in the septum, the wall separating the two upper chambers of the heart. It is a birth defect and happens when the septum has not formed properly. The ASD heart defect is more commonly known as a hole in the heart. Few atrial septal defect symptoms include shortness of breath, swelling of legs, feet or abdomen, fatigue after mild activity and irregular heart rhythm. There are several atrial septal defect treatment options available in India, which can help reduce the symptoms and improve the outlook.
This article covers treatment for atrial septal defect, atrial septal defect symptoms, atrial septal defect types, atrial septal defect causes and many more.
A normal heart of a human being is responsible for pumping and receiving blood efficiently. Proper flow of blood is important for a healthy body, it carries nutrients and oxygen and eliminates waste products such as carbon dioxide. However, sometimes, some abnormalities or defects can interfere with the normal functioning of the heart. An atrial septal defect is one such abnormality.
An atrial septal defect (ASD) is a hole in the septum, the wall separating the two upper chambers of the heart. It is a birth defect and happens when the septum has not formed properly. The ASD heart defect is more commonly known as a hole in the heart. Few atrial septal defect symptoms include shortness of breath, swelling of legs, feet or abdomen, fatigue after mild activity and irregular heart rhythm. There are several atrial septal defect treatment options available in India, which can help reduce the symptoms and improve the outlook.
This article covers treatment for atrial septal defect, atrial septal defect symptoms, atrial septal defect types, atrial septal defect causes and many more.
Written by
BDS, Assistant Manager (Medical Review)
Reviewed by
MBBS, MD (Pharmacology) Head, Medical Affairs
An ASD heart defect is a defect from birth in a newborn’s heart. It refers to a hole in the wall (called the septum) that divides the upper chambers of the heart. It can vary in size and sometimes can close by itself. In some situations, a patient might need to undergo an atrial septal defect surgery.
Approximately 10% of the Indian infant mortality is attributed to congenital heart disease alone. An atrial septal defect is a type of congenital heart disease that interrupts the flow of blood patterns between the two chambers. The statistical data shows that the most common type of ASD is the Ostium Secundum. The condition is more common in females than males.
Types of Atrial Septal Defect
Ostium Secundum (ASD 2 or ASD II): A common atrial septal defect type that occurs there is a hole in the centre of the septum.
Ostium Primum (ASD 1 or ASD I): This condition occurs in the atria and the patient might have other congenital heart issues.
Sinus Venosus (Sinus Venus): Sinus Venosus is a rare defect in the upper part of the atria. It is associated with other congenital heart issues.
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To find out if you have an atrial septal defect or not, it is important to check for the signs and symptoms. Many people might not encounter any problem, but the signs and symptoms will indicate a hole in the heart. They are:
Heart murmurs: These are abnormal sounds made by the turbulent blood flow of blood around the heart. If you hear this sound frequently, it indicates you have to opt for a check-up from a paediatric cardiologist and treatment for atrial septal defect is advised.
Shortness of breath: While taking a rest or lying down, you might encounter shortness of breath. It is a sign of atrial septal defect in babies.
Fainting: Fainting, medically known as syncope, is a sudden loss of posture and consciousness causing the decreased flow of blood to the brain. It is a septal defect symptom.
Fatigue: Working for a short time will lead to tiredness, and you are bound to sleep excessively at that time. If you experience this more frequently, it is one of the atrial septal defect signs and symptoms.
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Understanding how a condition is caused is crucial for an early diagnosis and may even help us avoid the condition. However, there are no known causes for ASD. Here are a few of the assumed causes and risk factors of atrial septal defect that you should be aware of:
Certain genetic defects: Sometimes, autosomal dominant inheritance, which is a pattern of inheriting some genetic diseases, can cause atrial septal defects. This can also lead to skeletal abnormalities such as Holt-Oram syndrome.
Substance abuse during pregnancy: Using alcohol, tobacco, drugs or certain medications during pregnancy can harm the baby. It may also lead to an atrial septal defect.
Maternal UTI: Mothers can also detect urinary tract infection if their offsprings have an atrial septal defect.
Diabetes or lupus in the mother during pregnancy: Having lupus and diabetes during pregnancy increases the chances of an ASD in the fetus.
Viral infections like Rubella: During the first few months of pregnancy, mothers can get measles known as rubella. This infection can increase the risk of developing fetal heart defects.
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It is important to consult your doctor if you experience any of the symptoms of an atrial septal defect and opt for the appropriate treatment options. If ASD is left undiagnosed or untreated, it can lead to other health conditions. Here are a few of the complications of atrial septal defect that you should know about:
Right heart enlargement: If treatment for atrial septal defect in babies is not done right, it causes extra blood to fill the lungs, which in turn, causes the right side of the heart to overwork. If the treatment is not successful, the heart will enlarge and become weak, leading to pulmonary hypertension, a condition where the blood pressure from the heart to the lungs is too high.
Abnormal heart rhythms: In some cases, ASD can lead to irregular and abnormal heart rhythms. Because of this, their lungs start filling with fluids, which affects the organ. It leads to the fluttering of the heart or heart failure.
Stroke: If you do not opt for an atrial septal defect treatment, there is an increased risk of stroke. If you detect signs of ASD defect, you must consult your doctor for medications or a treatment plan.
Leaky tricuspid and mitral valves: Over time, when ASD causes dilation, it leads to the leaky mitral valve (valves that allow blood to pass through in one direction within the heart when opened) and tricuspid valve (a valve that prevents backflow of blood within the heart). Because of that, you might also experience irregular heartbeats.
Eisenmenger syndrome: Any heart defects like atrial septal defect symptoms leading to the PAH development can cause Eisenmenger syndrome (an abnormal blood flow in the heart and lungs leading to permanent damage to a portion of the lungs). So, patients should opt for an atrial septal defect treatment at the earliest.
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An early diagnosis can pave the way for effective management of the condition and also improve the outlook. Given below are a few of the medical tests that your doctor might recommend you to take for ASD diagnosis.
ECG / EKG: It is a graphical representation of the heartbeat done to examine the heart’s electrical activity. This test will help the doctor decide if a hole in heart surgery is required.
Chest X-ray: The chest x-ray gives details of the blood vessels and the size of the heart supplying blood to the lungs. It is an important test to opt for before an atrial septal defect treatment.
2-D Echo – Two-dimensional echocardiography is a non-invasive test used to observe the real-time motion and functioning of the structures of the heart. This helps the doctor to detect an ASD and determine its size.
Transesophageal echocardiography (TEE): It is an ultrasound test carried out through the oesophagus to get a better image of the atria and the shapes and sizes of large ASD. Doppler examination shows the direction of the blood flow and the status of the defect.
Transthoracic echocardiography: This is an ultrasound test that takes place inside the heart. A small camera is put inside via the peripheral vein and the test will give details of the shape and size of the atrial defect. Also, it helps to check the valves of the heart.
Intracardiac echocardiography (ICE): The study is conducted during non-surgical treatment for the atrial septal defect. Doctors will use this report to provide the treatment.
CT Scan: Doctors use a series of X-rays to prepare detailed images of the heart. These images can greatly help in detecting the defect and in getting a closer examination of the same. This test is carried out if echocardiography has not diagnosed the defect.
MRI: This test uses radio waves and a magnetic field to create 3D images of the heart and other bodily tissues and organs. If echocardiography cannot detect an atrial defect, a specialist will recommend you to go for an MRI.
Right heart catheterization: In this test, a thin and small tube is inserted into the heart via a peripheral vein. A specialist might also use a tiny balloon at the catheter end. It helps in measuring the amount of oxygen and blood pressure in every chamber of the heart. It determines the oxygen levels to find out the blood flow across the large ASD.
Left heart catheterization: A special dye is injected into the blood vessels via a catheter in this procedure. After that, the test results will give details of the defect or other heart disease.
During pregnancy, screening tests, such as ultrasound, are conducted to learn more about the atrial septal defect of the heart. With these tests, the doctor and patient will have a better understanding of ASD and where it is located. Mothers are advised to seek constant guidance from their doctors to avoid any further complications.
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Eliminating the defect can be done through non-surgical or surgical treatments depending on the condition of the patients. A cardiologist will analyze the condition of a patient’s heart and then suggest the appropriate treatment option accordingly. A few of the treatment options for atrial septal defect are given below:
Surgical Repair: Many cardiologists recommend an atrial septal defect treatment during adulthood or childhood to eliminate further complications. They opt for surgery when the condition is worse and other procedures have failed miserably. A few of the surgical procedures carried out for atrial septal defect treatment are:
Open-heart surgery: It is a surgery for ASD repair and requires using a heart-lung machine. It is done under general anaesthesia. A surgeon will conduct an atrial septal defect repair by making an incision and using patches to close it. For small atrial septal defects, small incisions are made by the surgeon or a robot. They will focus on repairing the defects present in the heart.
Cardiac catheterization: In this procedure, doctors will insert a flexible and thin tube into the blood vessels and guide the heart through imaging techniques. With the help of a catheter, specialists will plug or place a mesh patch (a flat sheet made of prosthetic material) to close a hole in heart surgery. Around the mesh, the heart tissue starts growing and seals the hole permanently. If there is a large ASD, you might need to go for open-heart surgery.
Based on atrial septal defect complications, the follow-up care procedure will vary. Doctors will prescribe you to go for echocardiograms periodically after you get discharged from the hospital. If it is a small ASD during childhood, occasional follow-ups would be required.
Adults with this defect need to monitor their health throughout their life to avoid further complications. Otherwise, there are chances to develop arrhythmias, pulmonary hypertension, valve problems, and heart failure.
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Seeking support from friends and family members: A congenital atrial septal defect is often detected early. But to be in the best of health, it is essential to be with friends and family members. They can provide the right support needed at this point. Also, if you are undergoing treatment for a small atrial septal defect, taking rest is important. With that, there are high chances that you will recover soon and can lead a healthy life.
Increasing awareness of the condition: It is impossible to prevent complications due to atrial septal defect signs and symptoms at any stage in most situations. But, it would be helpful if you always keep your child’s medical health on track. It is also advisable to be thoroughly aware of the child’s health conditions and the medications they are consuming. Keeping track of all these things will help you have an idea of their health status. You must also have a family medical history to show to the specialist. A suitable way to avoid the complications of ASD is to be under the doctor’s guidance.
Recording/journaling your baby’s health at every stage: After your child is detected with an ASD, it is important to monitor their health at every stage. It helps to avoid emergencies and heart failure, or other related complications. Also, you must ensure that they follow a healthy diet and exercise regularly.
Joining a parenting support group where you can talk about your concerns: Many parenting support groups are available that you can join to talk about your problems. Sharing your concerns with experts will help them understand what you are going through and provide the right guidance. This can greatly help you to lead a healthy life and get rid of stress.
What do you need to ask the doctor?
Firstly, note the problems your child is encountering so you can ask the doctor about them. You may also ask the doctor questions relating to the child’s diet and physical activities.
Do you have to opt for surgery?
Depending on the health condition’s seriousness, a doctor determines if there is a need to go for surgery or not. To avoid complications, it is always better to speak to a doctor and check if all other related health parameters are in check.
What are the do’s and do’s in managing ASD?
An atrial septal defect is a problem that happens before you take birth. In some situations, the hole can disappear on its own, while in others, you might need to visit a doctor. While visiting for medication, it is always better not to delay; otherwise, your heart can enlarge and lead to other health issues. Being under the guidance of a cardiologist is the best thing that you can do to maintain a healthy heart.
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Severe cases of an ASD hole in the heart can be life-threatening if not treated on time. Complications like irregular heartbeats, chest pain, enlargement of the heart, damage to lungs and even heart failure can occur if ASD is neglected.
If atrial septal defect blood flow is not treated at the right time, the right side of the heart might weaken. It might also lead to a stroke, abnormal heart rhythms, congested lungs which causes shortness of breath and irreversible damage to the blood vessels found in the lungs which may cause early death.
Studies show that an atrial septal defect might worsen over the years. That’s why it is better to get treated without getting late. Symptoms may begin to appear between the ages of 6 months to 3 years. However with age, for example, if the disorder is diagnosed after 40 years, symptoms may appear frequently.
Yes, you can exercise even with an atrial septal defect after it has been repaired. However, it is important to consult your doctor to find out which exercises you must avoid.
The most common atrial septal defect closes by itself as the child grows.
For a child, it takes around six weeks to recover from an ASD repair surgery.
After an ASD repair heart surgery, you can return to your normal activities if you no longer have any problems.
If the ASD defect is still present in adulthood, you must get it treated at the earliest, so you can lead a healthy life and eliminate other health problems. Adults can opt for treatments, depending on the severity of the condition. Make sure to speak to your doctor or healthcare providers regarding your options.
Yes, you can get pregnant with a septal defect of the heart that has been repaired. However, pregnant women who suffer from larger atrial septal defects or with complications such as heart failure and pulmonary hypertension can experience complications during pregnancy. It is advised to speak to your doctor before planning your pregnancy.
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