The heart is made up of four chambers, two atria and two ventricles. The upper chambers are left and right atria and two lower chambers are left and right ventricles. The two atria are separated by a wall like structure called septum.
When there is a hole in the septum which divides the two atria, the condition is known as atrial septal defect. It is a congenital defect, meaning the defect is present since birth. Atrial septal defect is very common, particularly in girls.
In atrial septal defect (ASD), blood flows through the hole from left atrium to right atrium, since the pressure in the left atrium is normally higher than that in the right atrium.As a result there is gradual enlargement of the right side of the heart, and the pulmonary artery. If the size of hole is very small, it may close on its own during infancy. However, if the hole is large and if it remains for a long duration it can damage the heart and lungs.
Symptoms Of Atrial Septal Defect
In most children there may be no signs and symptoms if the defect is small or moderate in size. But as time passes, you may find linear growth retardation in these children. The chest may bulge after some period owing to enlargement of right atrium and ventricle.
If it is a large defect, then more amount of blood flows to the right atrium and in the lungs, giving rise to symptoms such as breathlessness, tiredness, lips and nails turning blue etc.
Often atrial septal defect is detected when the physician is examining the patient. A typical heart sound called ‘murmur’ can be heard during auscultation with the help of stethoscope.
The signs symptoms in adults are usually noted around the age of 30.
- A murmur on auscultation.
- Breathlessness after mild exertion.
- Swelling in feet, abdomen and face.
- Split second heart sound heard by physician during auscultation.
- Lips and nails and tongue turning blue.
- Infection of lungs.
- Feeling of palpitation.
Atrial Septal Defect Diagnosis
With modern day diagnostic aids, it has become convenient to diagnose atrial septal defect very early in life.
Echocardiogram: Sometimes the defect is detected while doing an echocardiogram for another reason. However it can specifically detect size of the hole. It can also measure the flow of blood in the atrium.
X-ray, Electrocardiogram and MRI are other useful tools helpful in detecting atrial septal defect.
Treatment Options For Atrial Septal Defect
Aatrial septal defect may not require any treatment in absence of any symptoms or if the defect is very small. A small defect may close on its own. The physician may treat conservatively in the beginning, when the child is small because there are chances of its closure during this period.
However, if the hole is of large size manifesting symptoms, your doctor may suggest surgical intervention.
- There are two methods for closure. Cardiac catheterization is one method and other is open heart surgery.
- In cardiac catheterization, a thin tube is passed through the blood vessel which reaches the heart. A plug is placed to close the hole with the help of the catheter.
- In open heart surgery, an incision is made on the chest and the hole is sutured, or the hole is closed with a patch.