Can a ventricular septal defect heal itself?

Written by Tang Li
Cardiology
Updated on September 04, 2024
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Traditional views suggest that the best age to close atrial septal defects (ASDs) is between four and five years old, during preschool. The possibility of spontaneous closure of atrial septal defects larger than 8 millimeters in diameter is very low. If the defect is less than 4 millimeters, there is a possibility of healing. Currently, it is advocated that if an atrial septal defect still exists after the age of one year, and there is evident systolic murmur and fixed splitting of the second heart sound, or if heart catheterization and echocardiography show left-to-right shunting greater than 1.5:1, indicating a defect diameter of five to six millimeters or more, early surgery should be pursued to stop the left-to-right shunt to avoid causing pulmonary hypertension and endocarditis.

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Written by Li Hai Wen
Cardiology
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What does atrial septal defect mean?

Atrial septal defect is a relatively common type of congenital heart disease encountered clinically. In simple terms, the human heart has four chambers: the left atrium, right atrium, left ventricle, and right ventricle. Between the left and right atria, there is a structure called the atrial septum, which separates the two atria. If there is a hole in this septum, this condition is referred to as an atrial septal defect. Atrial septal defects are common congenital heart conditions, and when the defect is severe, it often accompanies heart failure and other complications. Under such circumstances, it is crucial to visit a cardiologist for a formal assessment to determine the necessity and approach to treatment.

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Written by Di Zhi Yong
Cardiology
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What should I do if a ventricular septal defect causes feeding difficulties?

If the patient has a ventricular septal defect, it is still recommended that the patient seek hospital treatment. A murmur can be heard in the precordial area, and it is also advisable for the patient to undergo an echocardiogram to check if the defect is too large. If there is difficulty feeding during breastfeeding, it is personally advised not to breastfeed. Formula can be used instead, because if heart failure is not handled in a timely manner, it may sometimes worsen the symptoms. Since this is a congenital heart disease, the current treatment is primarily surgical. Medical treatment in internal medicine is not very effective and is prone to recurrence. During this period, it is also important to monitor changes in the patient's heart rate, blood pressure, and pulse. If there is an accelerated heart rate or increased blood pressure, these need to be addressed.

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Written by Tang Li
Cardiology
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Atrial septal defect should be consulted with the Department of Cardiology.

Atrial septal defect is a common congenital heart disease in childhood, and it is also the most common congenital heart disease in adulthood. The incidence rate of atrial septal defects is about 1/1500 live births, accounting for 5%-10% of all congenital heart diseases, and it is more common in females. Most children with atrial septal defect, in addition to being prone to respiratory infections such as colds, may have no obvious symptoms and their activities are not limited. It is generally not until adolescence that symptoms like shortness of breath, palpitations, and fatigue appear. Patients with atrial septal defects should seek treatment in departments such as cardiology, cardiovascular surgery, thoracic surgery, or pediatric cardiology.

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Written by Cai Li E
Cardiology
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Atrial septal defect can cause which complications?

Small atrial septal defects generally are asymptomatic, whereas medium to large atrial septal defects may result in pulmonary hypertension and right heart failure. The impact of an atrial septal defect on hemodynamics mainly depends on the amount of shunting, which in turn is determined by the size of the defect. It also relates to the compliance of the left and right ventricles and the relative resistance of the systemic and pulmonary circulation. Continued increase in pulmonary blood flow leads to pulmonary congestion, increasing right heart volume load. Pulmonary vascular compliance decreases, evolving from functional to organic pulmonary hypertension. This in turn continuously increases right heart system pressure until it surpasses the pressure of the left heart system, causing the original left-to-right shunt to reverse to a right-to-left shunt, leading to cyanosis. Atrial septal defects are generally asymptomatic but with the progression of the condition, symptoms such as exertional dyspnea, arrhythmias, and right heart failure may occur. In the advanced stages, about 15% of patients with severe pulmonary hypertension exhibit a right-to-left shunt and cyanosis, leading to the formation of Eisenmenger syndrome.

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Written by Tang Li
Cardiology
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How does septal defect shunt?

Atrial septal defect is the most common congenital heart disease in adults, accounting for 20%-30% of all adult congenital heart conditions. The impact of an atrial septal defect on hemodynamics primarily depends on the amount of shunting. Due to higher pressure in the left atrium compared to the right atrium, a left-to-right shunt is formed. The amount of shunting depends on the size of the defect, as well as the compliance of the left and right ventricles and the relative resistance in the systemic and pulmonary circulations. Diseases that affect the compliance of the left ventricle, such as hypertension and coronary artery disease, can increase the extent of the left-to-right shunt. A continuous increase in pulmonary blood flow leads to pulmonary congestion, increasing the load on the right heart. Pulmonary vascular compliance decreases, progressing from functional pulmonary arterial hypertension to organic pulmonary arterial hypertension. As right heart system pressure continuously increases and eventually exceeds the pressure in the left heart system, the original left-to-right shunt reverses to become a right-to-left shunt, resulting in cyanosis.