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A hole in the heart: 3 things to know about atrial septal defect

Women outside holding her dog - Atrial septal defect post

Cases of atrial septal defect (ASD) can vary widely in severity.

While having a hole in your heart certainly sounds scary, atrial septal defect (ASD) is a condition that varies widely in severity.

“This defect allows oxygen-rich blood to leak into the oxygen-poor blood chambers in the heart. ASD is a defect in the septum between the heart’s two upper chambers. The septum is a wall that separates the heart’s left and right sides,” according to the American Heart Association.

ASD accounts for about 1 out of every 10 congenital heart defects and about 2,000 babies are born with it each year in the United States, according to the Centers for Disease Control and Prevention.

Why do people get ASD?

ASD is present at birth and the underlying causes for it are not completely understood. There is a genetic component; if parents have ASD their children are more likely to have it as well, said Dr. Guruprasad Naik, a Marshfield Clinic Health System cardiologist. It’s also thought some medications mothers take during pregnancy may contribute to heart defects forming in their babies.

“Most often these defects are identified in infancy and childhood and are treated early in life,” Naik said.

Complications and treatment

If the defect is large in children, they may develop congestive heart failure. With congestive heart failure, the child may experience lung infections and develop pulmonary hypertension, which is high blood pressure in the arteries to the lungs. If a child is experiencing heart failure they will likely need early intervention, which either involves open heart surgery, or more commonly, closure of the defect using trans-catheter techniques.

If the defect is small, there is a very good chance that the hole will close on its own.

“Atrial septal defects are an uncommon diagnosis in adults, as most are detected and treated, or close spontaneously, in childhood. When diagnosed in adults, they will require elective closure unless the defect is small,” Naik said.

In the past the hole was closed via sutures or a synthetic patch placed over the hole. Over the past 30 years or so, a new procedure has been developed where a device is introduced into the heart via catheter, and the device then closes the hole.

Long-term impact

“In the past it was broadly stated that ASD is a simple disease. You take care of it and people go on to live a normal life,” Naik said. “More recent studies show that people with ASD have a higher mortality rate than those who don’t have it.” Therefore, it is important these patients continue long-term follow up care with a cardiologist.

Those with ASD are also more prone to heart rhythm problems. People with small defects or defects that are repaired can live a mostly normal life and do not usually have any limitations placed on them in terms of exercise or activities.

Each case of atrial septal defect is different, and having a discussion with a provider will help determine the best course of action.

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