Atrial Septal Defect

Atrial Septal Defect:  (ASD)  this congenital defect, an opening between the left and right atria allows shunting of blood between the chambers.  The left atrial pressure normally is slightly higher than right atrial pressure, blood shunts from left to right.  The pressure difference forces large amounts of blood through the defect and leads to right heart volume overload, therefore, affecting the right atrium, right ventricle, and pulmonary arteries.  Eventually, the right atrium enlarges, and the right ventricle dilates to accommodate the increased blood volume.

ASD is usually a benign defect during infancy and childhood, delayed development of symptoms and complications makes it one of the most common congenital heart defects diagnosed in adults.  Asymptomatic patients have an excellent chance of recovery; the outlook is less hopeful for individuals with cyanosis caused by large, untreated defects.

Cause: Unknown

Symptoms:

May often be asymptomatic, especially if the patient are young preschooler.  He may only complain of feeling tired after extreme exertion.  If large amounts of shunting occur, his growth may become retarded.

Upon auscultation at the second or third left intercostal space may reveal a superfical early to midsytolic murmur.  The doctor may hear a fixed, widely split S2 and a systolic click or late systolic murmur at the apex.  In patients with large shunts, auscultation at the lower left sternal border may reveal a low pitched diastolic murmur that becomes more pronounced on inspiration.

Older Patients with ASD may develop pronounced fatigability clubbing, and cyanosis. Dyspnea on exertion may severely limit the patient's activity, especially after age 40.  Syncope (faint, temporary loss of consciousness) or hemoptysis (spitting up blood) may occur in adults with severe pulmonary vascular disease.

Treatment:

ASD seldom  produces complications in infants and toddlers, the doctor may delay surgery until the patient reaches preschool or early school age.  For large defect:  the patient may require immediate surgical closure with sutures or a patch graft.

Latest Article: Atrial Septal Defect

Atrial Septal Defect:   (ASD)   this congenital defect, an opening between the left and right atria allows shunting of blood between the chambers.  The left atrial pressure normally is slightly higher than right atrial pressure, blood shunts from left to right.  The pressure difference forces large amounts of blood through the defect and leads to right heart...

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