Atrial septal defect (ASD) is a common heart defect, where a hole exists between the two upper chambers, the left and right atria. The tissue between the left and right atria is called the septum; an ASD occurs in the septum, allowing an increased amount of blood to flow from the heart to the lungs. All babies are both with this small opening and, in healthy hearts, it closes on its own shortly after birth.
Often, an atrial septal defect is diagnosed before birth (during pregnancy) or soon after birth. However, many adults are unaware they were born with this heart defect because symptoms do not exist, or symptoms do not appear until later in life.
Many ASDs close on their own during childhood, but others persist in adulthood. If an ASD is small, it may not produce symptoms and may not require treatment. Larger holes can strain the heart and cause damage to both the heart and lungs, requiring surgery.
Without treatment, adults with large ASDs may experience complications including:
A hole in the middle of the atrial septum is called a secundum ASD.
A primum ASD is located in the lower section of the atrial septum and often occurs with other congenital heart problems.
A hole in the upper section of the atrial septum is a sinus venosus ASD. This is a rare condition and usually occurs with other congenital heart problems.
The coronary sinus is a blood vessel located between the heart’s left atrium and left ventricle. When a section of the coronary sinus does not develop, and is missing, a coronary sinus ASD exists. This is a rare condition.
The cause of ASD is usually unknown. Experts believe genetics play a role, with ASDs sometimes affecting multiple people in the same family.
Some patients with ASD experience symptoms, while others do not. If symptoms exist, they may appear at any time, from birth to adulthood.
Adults with ASD may suffer from any of these symptoms:
Because the cause of ASD is usually unknown, prevention may not be possible. However, certain conditions may increase the risk of a baby being born with this heart defect. If a pregnant woman has any of the following illnesses or lifestyle habits, the baby may be at an increased risk of developing an ASD:
Even if symptoms do not exist, an ASD may be identified by a health care provider during a routine checkup. Abnormalities like heart murmur can be heard through a stethoscope. If your provider identifies something out of the ordinary, they may recommend testing to identify or rule out an ASD. These tests could include:
If the ASD is small and is not causing symptoms or strain on the heart or lungs, the condition usually does not require treatment. Health care providers may recommend regular checkups to watch for any changes.
Larger ASDs often require a procedure to close the hole. Depending on the size of the hole, and whether or not any other complications exist, health care providers will recommend either a minimally invasive catheter-based procedure or surgery.
Because ASD is a structural condition, medication cannot “fix” the problem. Medication is often used to treat symptoms caused by ASD. Depending on the specific symptoms, the following may be recommended:
A thin, flexible tube (catheter) is inserted through a small incision in the groin. Using high-resolution imaging technology, the heart specialist guides the catheter through the blood vessels until it reaches the ASD. A patch is applied to the hole, providing permanent closure. Most patients are able to resume normal activities within a week.
Large or complex ASDs may require open-heart surgery. This procedure involves a large incision in the chest to access the heart. The heart specialist will apply a patch to the ASD, providing permanent closure of the hole. Recovery can last weeks or months.
Patients who undergo either minimally invasive ASD repair or open-heart surgery will need consistent monitoring throughout their lives. Regular checkups and imaging are necessary to ensure the patch is still providing closure, and to make sure the heart and lungs are functioning properly. Medication to prevent blood clots may be needed.
Patients who are diagnosed with an atrial septal defect as adults need appropriate testing to assess the size of the ASD and to identify any heart damage that may have occurred. The team of esteemed cardiologists affiliated with Memorial Hermann has extensive experience diagnosing and caring for adults with ASD.
Whether adults received treatment as children and need long-term, follow-up care, or are newly diagnosed, it is important to seek treatment to enhance heart health. Memorial Hermann’s heart and vascular specialists utilize the most state-of-the-art imaging technology and minimally invasive therapeutic options to repair ASD and consistently monitor patients throughout their lives.
If you’d like a referral to a heart and vascular specialist or want more information about our services, please fill out the form below or call us at (713) 219-3519. For other inquiries, such as obtaining medical records, imaging reports or test results, please call (713) 222-CARE (2273).