Medical knowledge, Patient Education
Atrial Septal Defect, Adult
An atrial septal defect (ASD) is a hole in the heart. This hole is located in the septum, which is the thin tissue that separates the two upper chambers of the heart (right atrium and left atrium). The hole is present at birth (congenital). However, an ASD may not be diagnosed until symptoms are noted in adulthood. The two most common types of ASD are ostium primum and ostium secundum. A less common form of ASD is called sinus venosus.
-
Blood from the right side of the heart is pumped to the lungs, where oxygen is added to it (oxygenated) and carbon dioxide is removed.
-
The oxygenated blood from the lungs is pumped to the left side of the heart.
-
From the left side of the heart, blood is pumped out to the rest of the body.
-
The hole in the septum allows some blood from the left atrium to mix with blood in the right atrium.
-
The blood flows to the lungs and the left side of the heart. This means that some of the blood makes the trip twice.
-
From the left side of the heart, blood is pumped out to the rest of the body.
An ASD makes the heart work harder by increasing the amount of blood in the right side of the heart. This causes heart overload and eventually weakens the heart’s ability to pump.
What are the causes?
-
Changes in genes or chromosomes during fetal development.
-
Factors that affect the mother, such as environment, medicines, or dietary choices.
What are the signs or symptoms?
-
Tiredness or fatigue.
-
Trouble breathing or shortness of breath.
-
Irregular heartbeats (arrhythmias).
-
An extra “swishing” or “whooshing” sound (heart murmur) that is heard when listening to the heart.
How is this diagnosed?
-
Electrocardiogram (ECG). This records the electrical activity of your heart and traces the patterns of your heartbeat onto paper.
-
Chest X-ray.
-
Echocardiogram. One of these two types may be done:
-
Transthoracic echocardiogram (TTE). This type of echocardiogram is done by moving a wand-like tool (transducer) over your chest. This device uses sound waves to produce an image of the heart.
-
Transesophageal echocardiogram (TEE). In this test, a flexible tube with a camera is passed down the part of the body that connects the mouth and the stomach (esophagus). This device uses sound waves to take more detailed images of your heart and blood vessels.
-
-
MRI or CT scan.
-
Cardiac catheterization. In this test:
-
A small, thin tube (catheter) is passed through a large vein in your neck, groin, or arm.
-
Your heart specialist (cardiologist) looks at the heart defect, checks how well the heart is pumping, and checks the function of the heart valves.
-
How is this treated?
-
Small ASD. Treatment may not be needed if you have a small ASD. In this case, only a small amount of blood is moving back and forth (shunting) from the left to right atrium. You may not have any symptoms.
-
Large ASD. Larger ASDs cause symptoms. Treatment is required. Depending on the type and location of the defect, one of the following procedures will be used to close the ASD:
-
A cardiac catheterization procedure. The hole is repaired by placing an implantable closure device that is inserted using a catheter. In this procedure, the catheter is passed to the heart through a vein in the groin or wrist.
-
Surgery. The hole is repaired with a patch or stitches (sutures). This may be done with a minimally invasive approach that involves small incisions or through open heart surgery with one large incision.
-
Follow these instructions at home:
-
Learn as much as you can about your condition.
-
Keep all follow-up visits. This is important.
Where to find more information
-
American Heart Association: www.heart.org
-
Centers for Disease Control and Prevention: www.cdc.gov
Contact a health care provider if:
-
You are short of breath.
-
You are weak or tired when you are active.
-
You become pregnant or you are thinking about becoming pregnant.
Get help right away if:
-
You have chest pain.
-
You notice your fingertips or lips turning pale or blue.
These symptoms may represent a serious problem that is an emergency. Do not wait to see if the symptoms will go away. Get medical help right away. Call your local emergency services (911 in the U.S.). Do not drive yourself to the hospital.
Summary
-
An atrial septal defect (ASD) is a hole in the heart. This hole is located in the septum, which is the thin tissue that separates the upper chambers of the heart.
-
The cause of this condition is usually not known. Symptoms include fatigue, trouble breathing, shortness of breath, and a heart murmur.
-
This condition is diagnosed based on the results of an electrocardiogram (ECG), echocardiogram, chest X-ray, MRI, CT scan, or cardiac catheterization.
-
Get help right away if you have chest pain or notice blue or pale lips or fingertips.
This information is not intended to replace advice given to you by your health care provider. Make sure you discuss any questions you have with your health care provider.
