Facts about Atrial Septal Defect (ASD)

The Atrial Septal Defect (ASD) is a congenital heart defect that disrupts the pattern of blood flow between the left and the right auricle, the upper two compartments of the heart. Atrial septal defects are not rare. In fact, in India, around 10% of infants suffer from different types of atrial septal defects. According to a recent  case report made in India, the prevalence of heart defects was around 26.4% for every 1000 patients. Out of which 18.9% cases were that of atrial septal defect. With this heart defect becoming so common among newborn babies, it is very important to educate the population about the atrial septal defect. In this article, let us talk about what is the atrial septal defect, what are the types of this defect, and how these defects can be treated.

What is an Atrial Septal Defect?

Atrial Septal Defects refer to a condition wherein holes are present in the walls (septa) of the heart between the upper chambers. The upper chambers of the heart receive blood from the whole body. These defects might be very small to cause any symptoms. Small holes can get treated without any medical intervention. The turbulent flow of blood through the narrow or leaking heart valves produces a sound known as a “Heart Murmur”. These atrial septal defects murmurs are used for the diagnosis of the atrial septal defect. These defects close on their own within 3 years of life. However, if they persist in adulthood, it might require surgery.

What are Atrial Septal Defect types?

Atrial septal defects in adults can be of various types. These include:

Ostium Secundum Atrial Septal Defect

• This is the most common type of atrial septal defect.
• In this condition, the hole is located in the centre of the atrial septum, that is, in the middle of the wall between the upper chambers of the heart.

Ostium Primum Atrial Septal Defect

• It is the second most common type of atrial septal defect.
• In this condition, the hole is located near the lower end of the atrial septal.
• It can be linked with the defects related to the mitral and tricuspid valve.

Sinus Venosus Atrial Septal Defect

• It is the least common type of defect
• In this condition, the hole is located in the upper part of the atrial septal.
• It is often linked with the abnormal connection of the right pulmonary vein to the right auricle.

Coronary Sinus Atrial Septal Defect

• It is a very rare type of atrial septal defect.
• In this condition, a part of the wall between the coronary sinus (part of the vein system of the heart) and the left auricle is missing.

What are the symptoms of Atrial Septal Defect?

An atrial septal defect is a congenital disorder that occurs in newborn babies. Most often, there are no symptoms depicted by newborn babies. However, if left untreated, atrial septal defects can show certain symptoms during adulthood. The atrial septal defect symptoms include:

• Fatigue
• Shortness of breath especially while performing some physical activity
• Irregular heartbeats known as arrhythmias
• Swelling in the abdomen, legs, and feet.
• Heart murmur or a whooshing sound heard through a stethoscope
• Palpitations, that is a sensation of pounding, rapid or skipped heartbeats.

How is Atrial Septal Defect treated?

In most cases, atrial septal defect gets treated by itself till the child reaches 3 years of age. However, in certain cases when these defects are not treated by themselves, they can be treated during adulthood through medical interventions. Following are the major atrial septal defects treatment options available.

• Medical Therapy

Certain medicines like diuretics and antiarrhythmic medicines can be prescribed by a cardiologist. These medicines will help treat the symptoms of ASD only. The complete treatment required the hole to be closed through an atrial septal defect surgery.

• Atrial Septal Defect Closure

The hole causing the atrial septal defect needs to be closed through surgery. This surgery can be conducted by the cardiologist through two different approaches.

-Open heart surgery

• Open heart surgery is generally done in case of ostium primum and sinus venosus atrial septal defects.
• This surgery is usually recommended during childhood.
• Sutures are used if there are smaller defects in the heart.
• The large defects in the heart are treated through patches. These patches are either made up of synthetic material or the lining of the heart (pericardium).

-Catheter-based closure

• Catheter-based ASD closure is generally recommended in patients with ostium secundum atrial septal defect.
• In this method, a septal occluder is passed into the atrial septal region through the femoral artery or the vein access. 
• The size of the occluder device is chosen based on the size of the hole in the atrial septum.
• The occluder device used during this process is made up of nickel and titanium (nitinol).
• The success of catheter-based closure surgery is determined through echocardiography.

How can atrial septal defects be prevented?

The main cause of the atrial septal defect is still not very clear, therefore, the prevention of these defects is not possible. However, you can take certain measures to ensure that your baby is healthy.

• Get good prenatal care. Make yourself your priority during pregnancy.
• If you yourself have an atrial septal defect, then speak to your doctor about the chances of your baby getting the defect as well.
• Monitor your health condition religiously during pregnancy.
• Take note of the congenital heart defect and other genetic conditions running in your family.
• The rubella virus is often linked to the development of congenital heart defects in the baby, so make sure to get yourself tested for immunity to German measles (rubella).

Takeaway

Atrial septal defects are a set of congenital defects for infants. Though these defects involve the heart, it is often not a situation of great concern. This is because, in most cases, the hole in the atrium septum gets treated on its own during the early years of childhood. However, if the hole is too big or the condition is too severe, to get treated on its own, then an atrial septal defect surgery can be performed to close the hole manually. Your cardiologist might also recommend some medicines to reduce the symptoms of the atrial septal defect. Now that you know the symptoms of ASD, its types, and the treatment options available, make sure that you act wisely if ever you encounter such a situation.

Frequently Asked Questions (FAQs)

• What is the most common cause of atrial septal defect?

The main cause of the atrial septal defect is still unclear. The most possible causes of ASD are genetics, underlying medical conditions, medicines, and lifestyle factors.

• Can you live a normal life with an atrial septal defect?

Yes, you can lead a normal life with ASD. The patients can tolerate untreated defects for more than 80 years. However, assumptions are made that ASD reduces your life expectancy.

• How long can a person with a hole in the heart live?

It is assumed that the average age of death in people with ASD does not exceed 50 years. However, in some cases, you can live with untreated ASD for more than 80 years as well.