An atrial septal defect is a congenital heart defect in which a hole in the septum divides the heart’s two upper chambers (the atria). This septum is the dividing wall between the two upper heart chambers or atria. Due to the presence of a hole in the septum, oxygenated blood from the left atrium mixes with right atrial blood with less oxygen in it.
While smaller ASDs do not have any symptoms and may even close on their own, larger defects may result in problems like arrhythmias, cardiac failure, and a higher risk of stroke. Although ASD is usually diagnosed in childhood, in less severe cases it may not be identified until maturity.
Symptoms
Some common symptoms of ASD include:
- Shortness of Breath: Individuals suffering from severe ASD experience shortness of breath, particularly during any physical activity. This is because the heart has to pump more oxygenated blood than normal.
- Fatigue: ASD can cause the heart to work harder, leading to fatigue and tiredness, even with minimal exertion.
- Heart Murmur: It is usually the first sign detected from a routine physical check-up. The sound is produced from the abnormal flow of blood through the defect.
- Swelling of the Legs or Abdomen: Over time, ASD may cause fluid accumulation in the legs, abdomen, or lungs because the heart cannot pump blood efficiently. It causes swelling.
- Frequent Lung Infections: Children who have ASD may also suffer from respiratory infections like pneumonia because of increased blood flow to the lungs.
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When to See a Doctor
It is important to see a doctor if you or your child experience any of the symptoms linked with ASD, such as heart murmur, unexplained shortness of breath, or fatigue. While ASDs are usually detected during routine checkups, still some cases may go undiagnosed until adulthood. Early diagnosis and treatment can prevent serious complications, including heart failure or stroke.
At FitwellHub, we provide personalized cardiology care to diagnose and treat congenital heart conditions like ASD. Book an appointment with us today, and let our experts guide you on your wellness journey!
Causes
The causes of ASD are mainly linked to abnormal fetal heart formation:
1- Genetic Factors
Certain genetic mutations or family history of congenital heart defects can make individuals more vulnerable because congenital heart defects can be hereditary.
2- Congenital Heart Defects
ASD is a congenital heart defect, meaning it is present at birth and occurs when the heart does not form properly during fetal development.
3- Environmental Factors
Exposure to some environmental factors, like medicines and infection, during pregnancy, can increase the risk of developing a baby with heart defects.
4- Down Syndrome
Children with Down syndrome are more susceptible to congenital heart defects, including ASD, due to the alterations in the genetic makeup linked to this condition.
5- Maternal Health
Pregnancy-related health issues in mothers, such as uncontrolled diabetes, obesity, or substance abuse, may increase the risk of congenital heart defects, including ASD.
Complications
An atrial septal defect can cause several serious complications if left untreated, including the following:
- Heart Failure: Untreated ASD can lead to heart failure and a weakening of the heart due to the extra workload placed on the heart to pump blood efficiently.
- Pulmonary Hypertension: ASD causes increased blood flow to the lungs, increasing the pressure in the lung arteries (pulmonary hypertension). It may cause respiratory problems.
- Stroke: Blood clots formed in the veins may pass through the ASD and into the left side of the heart. These clots travel to the brain and cause a stroke.
- Arrhythmias: An abnormal heart rhythm (arrhythmia) may occur due to the additional stress exerted by the ASD on the heart. It increases the risk of complications like atrial fibrillation.
- Eisenmenger Syndrome: Rarely, long-term untreated ASD can cause Eisenmenger syndrome, a condition in which elevated lung pressure reverses blood flow, resulting in cyanosis (blue-tinged skin).
Prevention
Though ASD cannot always be prevented, steps can be taken to keep the pregnancy healthy and may decrease the risk.
1- Avoid Alcohol and Smoking During Pregnancy
Avoiding alcohol, smoking, and drug use during pregnancy can reduce the risk of congenital heart defects in the developing fetus.
2- Manage Maternal Health Conditions
Diabetic or blood pressure conditions should be regulated before and during pregnancy to decrease the risk of birth defects, including ASD.
3- Prenatal Care
Regular prenatal care helps track the condition of the mother and the child. It helps detect complications from the early stages and manage them effectively and timely.
4- Genetic Counselling
If you have a family history of genetic conditions or heart defects, go for genetic counseling before or during pregnancy to evaluate the risk of ASD.
5- Healthy Lifestyle Choices
Eating a healthy diet, having regular exercise, and avoiding harmful substances during pregnancy help in the normal growth and development of the fetus, thus decreasing the possibility of congenital defects.
To support a healthy pregnancy, FitwellHub provides prenatal care and services on genetic counseling. Visit our help page for more information.
Diagnosis
Several tests are required for the evaluation of the structure and function of the heart to diagnose an atrial septal defect.
- Echocardiogram: An echocardiogram uses sound waves to create detailed images of the heart, allowing doctors to visualize the atrial septum and detect the presence of an ASD.
- Chest X-ray: Doctors use a chest X-ray to view an enlarged heart or increased blood flow to the lungs, both of which can show an underlying heart defect like ASD.
- Electrocardiogram (ECG): In certain cases, doctors use cardiac catheterization to confirm a diagnosis and measure the pressure within the heart chambers.
- Cardiac MRI: A cardiac MRI provides detailed anatomical pictures of the heart, helping in assessing the size and location of the ASD and determining appropriate treatment.
- Cardiac Catheterization: In certain cases, doctors use cardiac catheterization to confirm a diagnosis and measure the pressure within the heart chambers. This gives additional information related to the defect.
FitwellHub offers advanced diagnostic services for conditions like ASD. Visit our lab today to learn more or book your tests!
Treatment
The treatment of atrial septal defect depends on the size of the defect and the severity of symptoms. The following treatment options are available.
1- Monitoring
For minor ASD with no symptoms, doctors usually recommend observing the condition with repeated echocardiograms and follow-ups without urgent treatment.
2- Medications
Medicines like beta-blockers or anticoagulants are used to manage symptoms like arrhythmias or reduce the risk of blood clots. But they do not close the defect.
3- Cardiac Catheterization
Moderate to large ASDs are closed in the catheterization lab using a special closure device. It prevents the need for open-heart surgery.
4- Surgery
In severe cases, surgery is sometimes required to close the ASD. This is often done by open-heart surgery, where the hole is closed by stitches or a patch.
5- Lifestyle Changes
Maintaining a healthy weight, not smoking, and exercising can help alleviate symptoms and avoid complications.
At FitwellHub, AI in healthcare enables us to offer accurate diagnostics, predictive analytics, and personalized treatment plans for conditions like Atrial Septal Defects (ASD). This innovative approach ensures that patients in Pakistan receive timely, effective care tailored to their specific needs.
Medications
Some of the common medications used in the management of ASDs are:
| Medication | Description |
|---|---|
| Beta Blockers | Used to control heart rate and manage arrhythmias caused by ASD, relieving symptoms like palpitations. |
| Anticoagulants | Medications like warfarin or rivaroxaban are used to prevent blood clots and strokes caused by ASD. |
| Diuretics | Used to decrease fluid retention and lower blood pressure, helping to manage heart failure symptoms caused by ASD. |
| Antiarrhythmic Drugs | Medications like amiodarone are used to maintain normal heart rhythm and avoid arrhythmia attacks linked to ASD. |
| ACE Inhibitors | Prescribed to reduce blood pressure and the workload on the heart, preventing complications in large or untreated ASDs. |
At FitwellHub, our pharmacy offers a wide range of medications for treating atrial septal defects and related symptoms. Visit our pharmacy to explore available options and consult with our experts.
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Frequently Asked Questions (FAQ’s)
An atrial septal defect is a congenital heart defect in which a hole in the septum divides the heart’s two upper chambers (the atria). This septum is the dividing wall between the two upper heart chambers or atria. Due to the presence of a hole in the septum, oxygenated blood from the left atrium mixes with the right atrium blood with less oxygen in it.
Small ASDs can completely close during childhood, but larger defects need proper treatment.
For the diagnosis of ASD, imaging techniques like an echocardiogram, chest X-ray, or cardiac MRI are used. These images will give a detailed view of the inner structure of the heart.
The treatment options include regular monitoring, drugs for the management of symptoms, and procedures like cardiac catheterization or surgery to close the defect.
The condition may become fatal without proper treatment, but an early diagnosis and treatment can avoid life-threatening complications like heart failure and stroke.
