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Atrial septal defect (ASD) is a hole in the wall (the septum) between the heart's two uppermost chambers, the right and left atrium. This hole allows blood to flow in either direction between the left and right atrium.
ASDs may cause several problems. First, the right side of the heart now contains extra blood, and extra blood also now flows to the lungs. These problems with blood flow put strain on the heart because it has to pump this extra blood to the lungs. In addition, the strain put on this right side of the heart causes it to become weak or enlarged. This can lead to heart failure if left untreated.
An enlarged heart may also cause arrhythmias (irregular heart rhythms) to develop. This extra blood flow to the lungs may damage the arteries to the lungs over time, leading to high blood pressure in these vessels. Also, ASDs can sometimes allow blood clots from the body to enter the brain and cause a stroke.
Most patients do not have any symptoms in childhood. However, symptoms that might develop over time, depending on the severity of the ASD and other factors, include:
An ASD is congenital, meaning it is a defect that is inborn or exists at birth. Stated another way, the defect is an abnormality, not a disease. The septum between the two atrium of the heart did not develop normally before birth. What is known is that about 20 percent of ASDs that occur in infants close on their own in the first few years of life.
Heart defects in general. In about 95% of the cases, no cause can be identified. Sometimes a viral infection can cause heart defects to develop. Other known causes include genetic factors, certain other medical conditions (Down's syndrome, for example), and some prescription and nonprescription drugs.
During a routine examination, your doctor may hear a murmur when listening to the heart. A heart murmur is an additional sound, a swishing sound heard in the heart. If a murmur is identified, your doctor will order other tests that can include:
Additional tests may be ordered as necessary.
If you or your child is diagnosed with an ASD, your primary care doctor will recommend that you meet with a congenital heart specialist (a doctor who has the training and equipment to determine the heart problem) who will arrange for the necessary special tests, medical care, heart procedures, and follow-up checkups. The best treatment approach will depend on the patient's symptoms as well as the size of the ASD. The ASD may need to be closed surgically through open-heart surgery or may be repaired through an outpatient catheter-based procedure.
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This information is provided by Cleveland Clinic Abu Dhabi, part of Mubadala Healthcare, and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition.