Atrial septal defect

Diagnosis

There are cases that ASD could be diagnosed before or shortly after a child is born. Smaller atrial septal defects, however, might not be found until much later in life.

The patient with ASD will have heart murmur (whooshing sound) during the physical assessment of the healthcare professional.

The following tests are used to identify an atrial septal defect:

• Echocardiogram: Sound waves can be utilized to visualize the beating heart in action. How well blood is flowing through the heart and heart valves can be seen on an echocardiography.
• Electrocardiogram (ECG or EKG). Used to monitor the heart’s electrical activity. It can detect if you have heart arrhythmia.
• Chest X-ray: Heart and lung condition can be seen on a chest X-ray.
• Cardiac magnetic resonance imaging (MRI) scan: If echocardiography failed to make a clear diagnosis, a doctor might order this kind of MRI. During this imaging procedure, the heart is captured in fine detail using magnetic fields and radio waves.
• Computed tomography (CT) scan: This produces finely detailed images of your heart using a sequence of X-rays. It can be utilized to identify one as well as associated congenital heart defects.

Treatment

The size of the hole at the heart or other congenital heart defects will determine by the healthcare professional on how the ASD will be treated.

Even though most of atrial septal defects close during childhood on their own, this is not always the case. No additional need for treatment for small atrial septal defects. The medical expert can advise routine checkups to track the progression of the condition.

Surgery is necessary for many atrial septal defects that remain unclosed. Closure is not advised in cases of severe pulmonary hypertension. When the child requires medical attention, the healthcare practitioner will discuss the necessary treatment.

Medications

Medications to regulate the heartbeat (beta blockers) or to lower the risk of blood clots (anticoagulants) may be prescribed for atrial septal defects. The signs and symptoms of an atrial septal defect can be lessened with medication, but the defect cannot be corrected.

Surgery

When a child or adult is identified with a medium to large-sized atrial septal defect, many cardiologists advise surgery to fix it in order to avoid further complications.

Atrial septal defect repair surgery involves patching up the heart hole in both adults and children. There are two ways to do this:

• Open-heart surgery: is used for primum, sinus venosus, and coronary sinus atrial defects. An incision through the chest wall is made in order to directly reach the heart. To close the hole, the surgeons apply patches.

Atrial septal defect correction can occasionally be carried out using a robot-assisted heart surgery and minimally invasive surgery.

• Catheter-based repair: Using imaging methods, a thin, flexible tube (catheter) is placed into a blood vessel, typically in the groin, and directed to the heart. To plug the hole, a mesh patch or plug is inserted through the catheter. The hole is permanently sealed as heart tissue develops around the seal.

Only the secundum kind of atrial septal defects are repaired using a catheter. However, open heart surgery may be necessary for some large secundum atrial septal defects.

Regular checkup and echocardiogram are needed for people who had undergone surgery, to further assess for any complications after the surgery. Heart valve problems, arrhythmias, pulmonary hypertension and heart failure are some of the complications.

Long-term outcomes are often worse for people with large atrial septal defects who do not have surgery to repair the hole. They may have lower functional capacity making it harder to carry out daily tasks. They also run a higher risk of developing pulmonary hypertension and arrhythmias.