Atrial Septal Defect


What Is Atrial Septal Defect?

An atrial septal defect (ASD) is a hole in the heart’s atrial septum – the muscular wall that separates the heart’s two upper chambers, or atria. This congenital heart defect makes the heart work harder than it should.

The hole in the atrial septum allows oxygen-rich blood from the left chamber of the heart to mix with oxygen-poor blood from the right chamber. Some oxygen-rich blood is pumped to your lungs – where it just arrived from – instead of to your body.

At Aurora Health Care, our surgeons and cardiologists (heart specialists) are experts in diagnosing and treating all types of heart conditions, including ASDs. We will schedule your appointment quickly, listen to your concerns and help you get the treatment you need to keep your heart working correctly.

The good news is that once an ASD has been repaired, most people don’t need further treatment.


Types of Atrial Septal Defect

An ASD is a congenital heart defect, meaning it develops before birth. Doctors are unsure what causes ASD to occur.

Several types of ASDs can develop:

  • ASDs can be small, medium or large.
  • They can occur in the lower, middle or upper parts of the atrial septum.
  • Holes in the middle part of the septum are the most common, affecting about 80% of those born with this condition.
  • Holes in the lower and upper parts of the atrial septum are very rare.


Symptoms of Atrial Septal Defect

Most infants born with ASD have no symptoms, even when the hole in the heart is large. Often, if the hole is smaller, it closes as the heart grows, so there are no symptoms or complications.

If an ASD does cause symptoms, they usually appear in people aged 30 and older. The most common symptom of an atrial septal defect is a heart murmur, an extra or unusual sound during a heartbeat.

Other ASD symptoms include:

  • Arrhythmia
  • Pulmonary hypertension (high blood pressure in the arteries in your lungs)
  • Right heart failure
  • Stroke


How Do Doctors Diagnose an Atrial Septal Defect?

If we suspect an ASD, we may perform tests or order imaging to understand how your heart works.

Tests and imaging may include:

  • Physical exam: We will listen to your heart with a stethoscope to check for a swishing sound that indicates a heart murmur. We’ll also check for an irregular heartbeat and ask about your symptoms and family history.
  • Chest X-ray: We might order a chest X-ray to examine the internal structures of your chest.
  • Pulse oximetry: Pulse oximetry measures the level of oxygen in your blood.
  • Ultrasound testing: We may use heart ultrasound, which uses sound waves to produce a picture of your heart.
  • Echocardiogram (echo testing), including transesophageal echocardiography: An echo test is a type of ultrasound test that lets your doctor visualize the action of your heart. A transesophageal echocardiogram uses a special probe inserted into the esophagus (throat).
  • Electrocardiogram (EKG), also called electrocardiograph testing: Doctors use an EKG to see the electrical activity of the heart as lines marked on paper, to tell how your heart is working.
  • Diagnostic procedures: If we need to examine the internal structures of your heart, we may order a diagnostic procedure such as cardiac catheterization.

Learn more about heart and vascular diagnosis and testing at Aurora.


Expert Treatment for Atrial Septal Defect

Many people who might have a minor ASD don’t need treatment. This includes children and adults who don’t have symptoms.

Large holes in the heart can make the heart work too hard. These ASDs may require one or more forms of care:

  • Medical monitoring: Doctors may observe a small ASD for a period of time to see if symptoms develop.
  • Medications: Medications cannot repair a congenital heart defect, but they can help make the symptoms more tolerable. We might prescribe medications to reduce the chance of blood clots or to keep your heartbeat regular.
  • Cardiac catheterization: We treat many ASDs with this minimally invasive procedure. First, we thread a thin, flexible tube with a camera on the tip through a blood vessel in your arm or groin. Then, within your heart, we can plug the opening in the atrial septum.
  • Surgery: In some cases, a large ASD requires surgical repair. Our surgeons perform high numbers of many types of heart surgery. This gives us experience that leads to excellent results. Read more about open heart surgery.

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