Can a ventricular septal defect have a vaginal delivery?

Written by Li Hai Wen

Cardiology

Updated on September 01, 2024

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Atrial septal defect is a relatively common congenital heart disease in adults. Therefore, when women are diagnosed with this condition, they often ask their doctor one question: "Can I give birth naturally?" This question requires a case-by-case analysis. If the atrial septal defect is not severe, does not cause changes in the heart structure, or lead to heart failure, then natural childbirth is definitely possible. However, if the atrial septal defect is severe and causes changes in heart structure, such as pulmonary hypertension or heart failure, then natural childbirth is generally not advisable. It is best to opt for a cesarean section under the guidance of a doctor to alleviate the burden on the pregnant woman and reduce the occurrence of serious incidents.

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Written by Tang Li

Cardiology

1min 38sec

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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 Zhang Zhi Gong

Cardiothoracic Surgery

1min 12sec

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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

1min 3sec

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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

56sec

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Imaging manifestations of atrial septal defect

The imaging characteristics of ventricular septal defects are as follows: 1. Small defects: Normal cardiac silhouette, or left ventricular hypertrophy, with mild pulmonary congestion. 2. Medium defects: Left ventricular hypertrophy or biventricular hypertrophy, enlarged pulmonary artery segment, smaller aortic knob. 3. Large defects: Both ventricles enlarged, left atrium enlarged, prominent pulmonary artery segment, significant pulmonary congestion. When pulmonary hypertension with right-to-left shunting occurs, the pulmonary artery segment is markedly prominent, but the lung fields are clear, and the heart shadow is smaller than before.

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Written by Tang Li

Cardiology

1min 26sec

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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.