How to treat atrial septal defect

Written by Tang Li
Cardiology
Updated on September 06, 2024
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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.

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Written by Tong Peng
Pediatrics
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Will babies with atrial septal defects develop slowly?

Babies with atrial septal defects do not necessarily develop more slowly. An atrial septal defect is one of the congenital heart diseases. If the diameter of the defect is relatively small, it will not affect the normal blood flow of the heart, the oxygen supply to the body, or significantly impact daily activities like sleeping or exercising for the baby. The growth and development of the baby would be normal, with no abnormalities compared to their peers. However, if the diameter of the atrial septal defect is relatively large, typically exceeding 6-8 millimeters, it can cause the baby to experience a lack of oxygen during physical activities, leading to a compromised quality of life and potentially causing delayed development.

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Written by Tang Li
Cardiology
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Can someone with an atrial septal defect get pregnant?

Whether patients with atrial septal defects can become pregnant depends on the following factors: 1. Whether the patient normally has symptoms. 2. Whether the echocardiography indicates heart enlargement or pulmonary hypertension. 3. The size of the atrial septal defect. 4. Whether there is a combination of arrhythmias such as atrial flutter or atrial fibrillation, and complications such as pulmonary hypertension or heart failure. For those without symptoms, and where the defect does not cause pulmonary hypertension or right heart enlargement, choosing to become pregnant is possible. Complications are not common in pregnant women with isolated atrial septal defects without pulmonary hypertension. Studies have shown that the incidence of complications in pregnant women, whether the defect is repaired or not, is relatively low. If the patient has related arrhythmias and complications, it should be closely monitored, because the cardiovascular system of the mother undergoes changes during pregnancy, leading to increased cardiac workload and a higher burden on the heart, which in turn can increase the incidence of arrhythmias. For women who are already at high risk of atrial flutter or fibrillation, this risk can increase further. Additionally, pregnant women are in an older physiological state, making it easier to form blood clots, and for those with atrial septal defects, the risk of paradoxical thrombosis increases.

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Written by Li Hai Wen
Cardiology
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How severe is an atrial septal defect considered to be?

Atrial septal defect (ASD) is a relatively common congenital heart disease in clinical practice. From a medical perspective, the severity of ASD depends on whether the patient is an adult or a child. For adults with ASD, generally speaking, defects larger than 20 millimeters are considered large atrial septal defects, which are more severe. If the defect size is between 10 and 20 millimeters, it is often classified as a moderate atrial septal defect. Defects smaller than 4 millimeters are considered small atrial septal defects. Generally, small and moderate atrial septal defects are not severe. For children, an atrial septal defect larger than 10 millimeters is considered a large atrial septal defect, which is more severe. Sizes between 5 and 10 millimeters are classified as moderate atrial septal defects. Defects smaller than 5 millimeters are considered small atrial septal defects, which generally are not severe.

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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 Li Hai Wen
Cardiology
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Postoperative precautions for atrial septal defect surgery

Ventricular septal defect surgery is often divided into surgical operations and interventional treatments by the Department of Internal Medicine. For interventional treatments, it is important to rest in bed for 24 hours afterwards. Also, the site of the puncture needs to be immobilized for at least eight hours, so it is important to regularly check the heart with an echocardiogram after the surgery. After surgical operations, it is important to maintain a balanced diet with easily digestible foods. Within a month after surgery, try to avoid strenuous activities, and regularly check the heart with an echocardiogram under the guidance of a doctor.