Atrial septal defect can cause which complications?

Written by Cai Li E
Cardiology
Updated on November 21, 2024
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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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What are the symptoms of an atrial septal defect?

Atrial septal defect is the most common congenital heart disease in adults, accounting for 20%-30% of adult congenital heart diseases, with a higher incidence in females than males, with a male to female ratio of about 1:1.5-3. There is also a familial tendency. Apart from larger defects, children with atrial septal defects generally show no symptoms. As they age, symptoms gradually appear, with exertional dyspnea being the main symptom, followed by supraventricular arrhythmias, especially atrial flutter and fibrillation, which exacerbate the symptoms. Some patients may develop right heart failure due to excessive right ventricular volume load. In the late stages, about 15% of patients develop severe pulmonary hypertension, resulting in a right-to-left shunt and cyanosis.

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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 Tang Li
Cardiology
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Can a ventricular septal defect heal itself?

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 Li Hai Wen
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Postoperative complications of atrial septal defect intervention surgery

Atrial septal defect is a relatively common congenital heart disease in clinical practice. Minimally invasive interventional treatment can effectively address atrial septal defects and generally leaves no surgical scars. The complications of atrial septal defects can be analyzed from the following aspects: First, puncture complications. Atrial septal defects require the puncture of the femoral vein. A small number of patients may experience complications such as arteriovenous fistula, pseudoaneurysm, or hematoma at the puncture site. Generally, these complications are not serious and do not endanger the patient's life. Second, complications from dislodged occlusion devices. If the occlusion device becomes dislodged, it can lead to serious complications, including obstruction of the relevant blood vessels. Third, hemolytic reactions. A small number of patients may develop hemolytic reactions to the occlusion device. Such complications are also quite serious; however, they are very rare in clinical practice and do not require excessive concern.