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Atrial Septal Defect by Diana Kohnle

Definition

The atria are the the upper chambers of the heart. An atrial septal defect (ASD) is a hole in the wall between the left and right chambers of the atria. It is present at birth.

Blood passes from the left atrium to the right atrium in babies born with ASD. This eventually can cause problems in the lungs.

ASD occurs in about four out of every 100,000 babies. Those with minor-to-moderate defects may not suffer any complications or symptoms. Very small ASDs close on their own about 90% of the time. Those with more severe defects may have disabilities later in life.

Heart Chambers and Valves

Causes

ASD is a congenital defect. This means that it occurs during fetal development. It is present at birth. Some cases may be caused by a genetic defect or abnormality inherited from a parent. Others can be caused by illnesses suffered by the mother during pregnancy.

Most of the time, the cause is unknown.

Risk Factors

There are no known risk factors for this condition because the cause is largely unknown.

Symptoms

Symptoms include:

Tiring easily during activity
Sweating
Rapid breathing, difficulty breathing, or shortness of breath
Ongoing respiratory infections
Poor growth
Irregular, rapid beating of the heart
Poor appetite

People with minor-to-moderate defects may show no symptoms. They may not begin to show symptoms until later in life.

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done.

Your doctor may need pictures of your heart. This can be done with:
Your doctor may need information about how your heart functions. This can be done with:
Your doctor may need to check the health of your arteries. This can be done with Coronary angiography.

Treatment

Small defects that produce few or no symptoms may not require treatment. Many defects may close on their own without treatment. Talk with your doctor about the best treatment plan for you. Treatment options include:

Surgery

Surgery may be needed in patients with large defects if they cause significant symptoms.

A new procedure may also be performed. It closes the opening without surgery. A heart catheter is inserted in the inner part of the thigh. A closure device is inserted through this catheter.

Antibiotics

Antibiotics may be prescribed for six months after some surgeries. You will need to take an antibiotic before you have dental work or other procedures. In most cases, patients do not need to take antibiotics before procedures. There are some exceptions.

Prevention

The condition is a congenital defect with unknown causes. There are no preventive measures. Early diagnosis and treatment can help prevent complications

RESOURCES:

American Heart Association http://www.heart.org/
National Heart, Lung, and Blood Diseases Institute http://www.nhlbi.nih.gov/health/dci/index.html

CANADIAN RESOURCES:

Canadian Cardiovascular Society http://www.ccs.ca
Heart and Stroke Foundation of Canada http://www.heartandstroke.com/

References:

Antibiotic prophylaxis. American Dental Association website. Available at: http://www.ada.org/2157.aspx . Accessed November 10, 2012.
Atrial septal defects (ASD). EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed . Updated June 6, 2012. Accessed November 10, 2012.
Atrial septal defect. KidsHealth.org website. Available at: http://www.kidshealth.org/parent/medical/heart/asd.html . Updated August 2010. Accessed November 10, 2012.

Last reviewed November 2012 by Michael J. Fucci, DO

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