Staten Island Heart's Doctors, Board Certified Cardiologists, Specializing in the treatment, care and prevention of Cardiovascular Disease. Located in Staten Island, New York.
Atrial Septal Defect
What is an atrial septal defect?
The atrial septum is a partition that divides the right and left atria, the top two chambers of the heart. The formation of the interatrial septum is a complicated process. In about one baby in 1000, the atrial septum is incompletely developed and a hole exists in the septum. This is known as an atrial septal defect. Its importance is largely determined by the amount of blood that travels across the defect. The shunting of blood across the atrial septal defect leads to an increased workload for the right ventricle, the pumping chamber to the lungs. Over time this may lead to high blood pressure within the lung circuit, failure of the right ventricle and the development of heart rhythm disturbances such as atrial fibrillation.
What are the symptoms of an atrial septal defect?
Unless the defect is very large there may be few symptoms. In fact, many people may live their entire lives with small atrial septal defects and be unaware that any abnormality exists. For those with atrial septal defect, the most common symptom is shortness of breath with activity. In most people, this does not happen until their 20's or 30's. As outlined above, the increased blood flow through the lungs may lead to an increase in the blood pressure in the lungs ad this can ultimately lead to congestive heart failure.
How is atrial septal defect diagnosed?
A physical examination performed by your doctor may suggest the diagnosis. A chest x-ray may be helpful in showing an enlargement of the right heart and an increase in lung blood flow. An electrocardiogram (ECG) is sometimes helpful. An ultrasound of the heart (echocardiogram) is a very helpful test to assess the size of the defect and its effects on the heart. The definitive study is a cardiac catheterization. This is a hospital test that provides a precise measurement of the blood flow through the defect, measures pressure within the heart and helps plan surgical therapy.
How is it treated?
Small atrial defects do not require therapy. Larger defects require surgical closure. Surgical closure involves a patch of pericardium, a dacron patch, or primary closure. More recently a catheter based approach has been developed by which a clam shell like device is used to close the defect.
The decision as to which defects should be closed is often difficult. The amount of blood flow through the defect, the age of the patient, the symptoms produced, the liklihood of complications and the chances of symptom improvement are all important variables.
What are the symptoms of an atrial septal defect?
Unless the defect is very large there may be few symptoms. In fact, many people may live their entire lives with small atrial septal defects and be unaware that any abnormality exists. For those with atrial septal defect, the most common symptom is shortness of breath with activity. In most people, this does not happen until their 20's or 30's. As outlined above, the increased blood flow through the lungs may lead to an increase in the blood pressure in the lungs ad this can ultimately lead to congestive heart failure.
How is atrial septal defect diagnosed?
A physical examination performed by your doctor may suggest the diagnosis. A chest x-ray may be helpful in showing an enlargement of the right heart and an increase in lung blood flow. An electrocardiogram (ECG) is sometimes helpful. An ultrasound of the heart (echocardiogram) is a very helpful test to assess the size of the defect and its effects on the heart. The definitive study is a cardiac catheterization. This is a hospital test that provides a precise measurement of the blood flow through the defect, measures pressure within the heart and helps plan surgical therapy.
How is it treated?
Small atrial defects do not require therapy. Larger defects require surgical closure. Surgical closure involves a patch of pericardium, a dacron patch, or primary closure. More recently a catheter based approach has been developed by which a clam shell like device is used to close the defect.
The decision as to which defects should be closed is often difficult. The amount of blood flow through the defect, the age of the patient, the symptoms produced, the liklihood of complications and the chances of symptom improvement are all important variables.
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