ASD

Atrial Septal Defect is an opening in the atrial septum, or dividing wall between the two upper chambers of the heart known as the right and left atria. ASD is a congenital (present at birth) heart defect. As the fetus is growing, something occurs to affect heart development during the first eight weeks of pregnancy, resulting in an ASD. 

Normally, oxygen-poor (blue) blood returns to the right atrium from the body, travels to the right ventricle, then is pumped into the lungs where it receives oxygen. Oxygen-rich (red) blood returns to the left atrium from the lungs, passes into the left ventricle, and then is pumped out to the body through the aorta.
An atrial septal defect allows oxygen-rich (red) blood to pass from the left atrium, through the opening in the septum, and then mix with oxygen-poor (blue) blood in the right atrium.

Arial septal defects occur in 4 percent to 10 percent of all children born with congenital heart disease. For unknown reasons, girls have atrial septal defects twice as often as boys.

What causes an atrial septal defect ?

The heart is forming during the first eight weeks of fetal development. It begins as a hollow tube, then partitions within the tube develop that eventually become the septa (or walls) dividing the right side of the heart from the left. Atrial septal defects occur when the partitioning process does not occur completely, leaving an opening in the atrial septum.

Some congenital heart defects may have a genetic link, either occurring due to a defect in a gene, a chromosome abnormality, or environmental exposure, causing heart problems to occur more often in certain families. Most atrial septal defects occur sporadically (by chance), with no clear reason for their development.

 

What are the types of atrial septal defects ?

There are three major types of atrial septal defects : -

Secundum atrial septal defect

This is the most common atrial septal defect, affecting 80 percent of people with this defect. It is caused when a part of the atrial septum fails to close completely while the heart is developing. This causes an opening to develop between the atria.

Ostium primum atrial septal defect

This defect is part of the AV canal defects, and is often found with a split (cleft) in the leaflet of the mitral valve.

Sinus venosus atrial septal defect

This defect occurs at the superior vena cava and right atrium junction. In this defect, one or more of the pulmonary veins enter the right atrium instead of correctly entering the left atrium.

Why is an atrial septal defect a concern ?

This heart defect can cause lung problems if not repaired. When blood passes through the ASD from the left atrium to the right atrium, a larger volume of blood than normal must be handled by the right side of the heart. Extra blood then passes through the pulmonary artery into the lungs, causing higher pressure than normal in the blood vessels in the lungs...

How is an atrial septal defect diagnosed ?

Your child's physician may have heard a heart murmur during a physical examination, and referred your child to a pediatric cardiologist for a diagnosis. A heart murmur is simply a noise caused by the turbulence of blood flowing through the opening from the left side of the heart to the right.

Treatment for atrial septal defect

Specific treatment for ASD will be determined by your child's physician based on : -

• Your child's age, overall health, and medical history
• Extent of the disease
• Your child's tolerance for specific medications, procedures, or therapies
• Expectations for the course of the disease
• Your opinion or preference

Secundum atrial septal defects may close spontaneously as a child grows. Once an atrial septal defect is diagnosed, your child's cardiologist will evaluate your child periodically to see whether it is closing on its own. Usually, an ASD will be repaired if it has not closed on its own by the time your child starts school ...

Care for your child at home following ASD repair

Most children feel fairly comfortable when they go home, and have a fair tolerance for activity. Your child may become tired quicker than before the repair, but usually will be allowed to play with supervision, while avoiding blows to the chest that might cause injury to the incision or breastbone. Within a few weeks, your child should be fully recovered and able to participate in normal activity...

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