Atrial septal defect

Atrial septal defect 

Atrial septal defect Overview:

A congenital heart condition, atrial septal defect (ASD), results in a hole between the upper heart chambers, increasing blood flow through the lungs. While some ASDs may remain undetected or resolve early in life, large and persistent defects can lead to heart and lung damage, necessitating surgical intervention to avert complications.

Types

• Secundum: Most common, located in the middle of the atrial septum.
• Primum: Affects the lower portion of the atrial septum, often alongside other congenital heart issues.
• Sinus venosus: Rare, typically found in the upper atrial septum, often with additional structural heart changes.
• Coronary sinus: Uncommon, involving a missing portion of the wall between the coronary sinus and the left upper heart chamber.

Symptoms

Symptoms may not manifest at birth but can emerge in adulthood, including:

• Shortness of breath, especially during exertion.
• Fatigue, particularly after activity.
• Edema in the legs, feet, or abdomen.
• Arrhythmias or palpitations.

When to Seek Medical Attention:

Serious congenital heart defects are typically identified early, but immediate medical assistance is necessary if a child struggles to breathe. Contact a healthcare provider if symptoms such as exertional shortness of breath, fatigue, swelling, or irregular heartbeats occur.

Causes

ASD arises during fetal heart development, resulting in a communication between the atrial chambers. Large defects strain the heart's right side, leading to enlargement and potential complications like pulmonary hypertension.

Risk Factors

Various factors may heighten the risk of ASD, including maternal rubella infection, diabetes, lupus, and prenatal exposure to alcohol, tobacco, or certain medications. Family history can also influence susceptibility.

Complications

While small ASDs may be benign, larger defects can lead to serious issues such as right-sided heart failure, arrhythmias, stroke, or pulmonary hypertension, potentially culminating in early mortality or Eisenmenger syndrome.

Treatment

Early intervention through surgery is crucial to mitigate complications associated with larger ASDs. Pregnant individuals with ASDs should seek preconception counseling to manage risks and ensure optimal prenatal care.

Prevention

Given the unclear etiology of ASDs, prevention strategies are limited. However, comprehensive prenatal care, including genetic counseling and rubella screening, is imperative to manage risk factors and ensure maternal and fetal well-being.