Atrial septal defect (ASD) is a congenital heart defect that is detected most often in adults. In small patients, the defect is usually asymptomatic. Only with the patient's age does it pose a real threat, because it carries the risk of embolism in the brain or lungs. What are the symptoms of ASD? How is this type of defect treated? Is a surgeon's intervention always necessary?

Atrial septal defect(ASD - atrial septal defect) isthe most common congenital heart defectin adults (accounting for approximately 7-12 percent of all abnormalities). It is most often an isolated defect, which means that it usually does not coexist with other heart defects. ASD is twice as common in girls as in boys.

Contents:

  1. Atrial septal defect - what is it?
  2. Atrial septum defect - risk to he alth and life
  3. Atrial septal defect - symptoms
  4. Atrial septum defect - examinations
  5. Atrial septal defect - treatment

Atrial septal defect - what is it?

At the time when the heart develops in utero, initially one atrial cavity is divided into two atria by a septum. Initially, they are connected by a foramen oval that allows the proper functioning of the fetal circulatory system. However, at birth, when the left atrial pressure increases, physiological closure of the atrial septum is made redundant. Otherwise, a cavity is created, which may occur in different parts of the partition. Usually, however, it appears in the place where the foramen ovale should close after delivery, i.e. in the upper part of the septum. In medical terminology, it is defined as a secondary orifice-type defect.

Atrial septum defect - what is the risk for he alth and life?

As a result of a loss between the atria, there is a leak, i.e. mixing of arterial and venous blood (with varying intensity) from the left atrium to the right, which increases venous return to the right ventricle. It should be emphasized that the severity of the flow determines whether the defect cancause symptoms. As a consequence, there is increased pulmonary flow and volume overload of the right ventricle.

The consequence of these processes, which are unfavorable for the heart, is atrial arrhythmias and right ventricular heart failure. The connection between the atria is also a potential source of a cross-embolus, which we are talking about when a thrombus from the venous part of the blood system (large circulation) through the right ventricle and a pathological defect between the atria enters the arterial bed bypassing the lungs, which can cause dangerous blockages, e.g. of the brain or coronary arteries.

Atrial septal defect - symptoms

Symptoms in children

This defect can only be diagnosed in an adult, because earlier the leakage is not large and does not show any clinical symptoms. However, if it occurs in children, it manifests itself as exercise intolerance and breathlessness.

Symptoms in adults

Small cavities do not cause any discomfort. However, with age, as leakage and thus symptoms worsen, congestive heart failure may develop. Larger ones cause recurrent respiratory infections.

Atrial septal defect - what tests are performed to diagnose the defect? ​​

Often the opening is detected only when the doctor hears a soft, soft murmur above the heart (best heard in the 2nd or 3rd intercostal space at the sternum). In this case, the doctor orders an EKG or a chest X-ray. We talk about ASD when the right ventricle is enlarged. However, the final diagnosis is based on echocardiography.

Atrial septal defect - treatment

Closing a larger cavity can be performed using a percutaneous or surgical technique, which is recommended for adult patients over 40 years of age.

In the case of large defects, surgical treatment is necessary, which consists in placing a special patch or suture. It is indicated in the event of a significant shunt, with high pulmonary flow and enlargement of the right ventricle.

An alternative is interventional treatment, which consists in inserting an implant through a special catheter. The semi-invasive procedure prevents cardiac arrhythmias and failure later in the child's life.

Category: