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 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.

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Written by Zhang Zhi Gong
Cardiothoracic Surgery
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The difference between ventricular septal defect and atrial septal defect

The difference between a ventricular septal defect and an atrial septal defect mainly lies in their locations. A normal heart is divided into four chambers, which are the left ventricle, right ventricle, left atrium, and right atrium. Each chamber is separated by a septum, much like walls between rooms in a house. Due to certain reasons, such as congenital heart defects, there may be openings or defects in these walls, known as septal defects. An atrial septal defect refers to a defect between the right atrium and the left atrium, whereas a ventricular septal defect pertains to a defect between the left and right ventricles. The murmur of atrial septal defects is relatively softer, as the pressure difference between the atria is smaller, and the defect is located higher up. In contrast, the murmur of ventricular septal defects is louder due to the greater pressure difference between the ventricles and is located lower down, approximately between the third and fourth ribs. The murmur of atrial septal defects is found between the second and third ribs. Moreover, since the pressure difference in ventricular septal defects is greater, the impact on the heart is relatively more significant.

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Written by Li Hai Wen
Cardiology
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Can someone with an atrial septal defect go swimming?

Atrial septal defect is not uncommon in our daily lives. Many patients with atrial septal defects often ask their doctor if they can swim. This has to be analyzed based on specific circumstances. If the atrial septal defect is not severe, and it's just a minor atrial septal defect, generally it does not affect the patient's daily activities, such as swimming or running. However, if the atrial septal defect is severe, especially if it has led to heart failure and heart enlargement, in this situation, one should definitely not engage in strenuous activities such as swimming or running.

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Written by Li Hai Wen
Cardiology
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Is a 12mm atrial septal defect serious?

Atrial septal defect (ASD) is a fairly common congenital heart disease in pediatric cardiology. For infants and young children, atrial septal defects can be categorized based on their size into three types: A large atrial septal defect typically refers to a defect larger than 10 millimeters. A medium atrial septal defect generally refers to a defect that ranges from 5 to 10 millimeters. A small atrial septal defect usually refers to a defect that is less than 5 millimeters. Therefore, for an infant or young child, an atrial septal defect measuring 12 millimeters would indeed be considered quite severe.

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Written by Tang Li
Cardiology
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How to treat atrial septal defect

Typical cardiac murmur ECG and X-ray findings may suggest the presence of an atrial septal defect. An echocardiogram can confirm the diagnosis, and it should be differentiated from conditions such as anomalous pulmonary venous return, pulmonary valve stenosis, and small ventricular septal defects. For the treatment of atrial septal defects, in adult patients, if echocardiographic evidence of increased right ventricular volume load is present, the defect should be closed as soon as possible. Treatment options include interventional and open-heart surgical procedures. Before the implementation of interventional surgeries, all cases of simple atrial septal defects that have caused hemodynamic changes, with signs of increased pulmonary blood flow, enlargement of the atria and ventricles, and corresponding ECG findings, should undergo surgical treatment. In older patients with severe pulmonary hypertension, surgical treatment should be approached with caution.