You might have heard about someone being born with a defect in their heart and wondered exactly what that meant. In this article, we are going to look at one of the most common heart defects called an atrial septal defect. In the United States, between 4 and 8 out of every 1,000 babies will be born with this heart condition. Read on to find out more about it!
What is an Atrial Septal Defect?
Before talking about an atrial septal defect, let’s talk a minute about the basic structure of the heart. In a nutshell, your heart has four chambers and is kind of like a two-story house with two rooms on each floor. The two upper rooms or chambers are called atria. The two lower chambers are called ventricles. They are separated from each other by the septum, or wall, of the heart.
An atrial septal defect (ASD) is the term doctors use to describe a hole in the wall between the upper two chambers of the heart. This means that blood with oxygen in it and blood that has been de-oxygenated (in other words, has no oxygen) gets mixed together – and more blood flows into your lungs than is supposed to, putting stress on both the lungs and the heart. If this is not corrected, it can cause some serious long-term problems, such as the heart getting weak and/or enlarged over time.
How Do You Know if You Have an ASD?
Some people who are born with an ASD are asymptomatic, meaning that they don’t show any symptoms which doctors typically look for. This usually happens if the ASD is small (under 5mm). Sometimes, with those who do not have symptoms, they are not diagnosed until their 30’s or even later on in life!
For those who do have symptoms, they can often include the following:
- In babies, poor appetite and poor growth
- Difficulty breathing, especially when active or getting short of breath easily
- Feeling tired all the time, even with enough sleep
- Swelling in the legs or belly
- Feeling like the heart is racing or skipping beats
- Heart murmur (this is a sort of whooshing sound that doctors can hear if they listen to the heart with a stethoscope)
- Frequent infections in the lungs (like bronchitis or pneumonia)
What Causes an ASD?
Doctors still aren’t sure just what causes an ASD, but they do know that it happens early in pregnancy when a baby’s heart is beginning to develop. Because this problem can run in families, many doctors think that there is a genetic cause, or something that a baby inherits from its mother or father. Other suspect that environmental causes – such as a mother getting exposed to a virus or toxic chemical while pregnant – might also be the problem. Studies have shown that babies whose moms have lupus, diabetes, are obese or use alcohol or tobacco while pregnant have a greater chance of being born with an ASD.
Are there Different Types of ASD’S?
There are actually four different types of ASD’s. They are:
- This is the most common form of ASD and occurs in the middle of the wall between the two upper chambers of the heart
- This occurs in the lower part of the septum and is often congenital, which means a person is born with it.
- Sinus venosus. This rare form of ASD happens in the upper part of the septum.
- Coronary sinus. This is also rare and happens between the left atrium and the coronary sinus, which is part of the vein system of the heart.
Who is at Risk?
There are several factors which increase the risk that a baby will be born with an ASD. These include:
- Babies with a family history of the disorder
- Babies born with other genetic defects such as Down syndrome
- Babies whose moms had a rubella infection or are diabetic or have lupus
- Babies whose moms use alcohol or tobacco during pregnancy
Sometimes, however, babies can be born with an ASD even if they have none of the risk factors mentioned above!
What Complications Can You Have with an ASD?
If someone has an ASD and it goes untreated, apart from being tired and short of breath a lot, there are also other long-term problems this heart defect can cause. These include:
- Heart failure, due to the heart having to work too hard to get oxygen to the rest of the body
- Arrhythmias, which are irregular heartbeats or heartbeats that are too fast or too slow
- Increased risk of a stroke
- Pulmonary hypertension, which refers to increased blood pressure in the lungs; this is a rare but serious complications
How Does the Doctor Test for this Condition?
Some babies born with an ASD will be diagnosed right away based on their signs and symptoms; at other times, doctors will suspect the presence of an ASD if they hear a murmur, or whooshing sound, while listening to a baby’s heart during a routine check-up. Sometimes, if someone is diagnosed with an ASD as an adult, it is by accident when a doctor is looking at other things!
If a doctor suspects that someone has an ASD, there are several tests they can run to help diagnose this. These include:
- An echocardiogram, which uses sound waves to produce an image of the heart
- A chest x-ray, which also gives the doctor more information about the condition of the heart and chest cavity
- An electrocardiogram, which gives the doctor information about the electric activity of the heart and whether the heart is beating regularly or not
- A CT scan, which uses a series of X-rays to produce images of the heart
- Cardiac catheter,
Can an ASD be Treated?
For some lucky people, an ASD will close on its own and there is no need for treatment, only regular monitoring to make sure that the defect has healed. For others, treatment can include:
- Medication to reduce the side effects of ASD, such as blood thinners to reduce the chances of a stroke or beta blockers to keep the heartbeat regular
- Surgical repair; this can be through a cardiac catheter, in which a thin tube is threaded up to the heart through the larger vessels and a patch or plug is put into the hole or through open heart surgery
For those living with an ASD, a heart-healthy diet, staying away from tobacco products, controlling stress and exercising with the permission of a doctor are all good ways to care for this condition at home.
In short, an atrial septal defect can range from a very mild problem which takes care of itself to a severe one which requires heart surgery to repair. Fortunately, due to many medical advances in recent years, people with this defect have more treatment choices – and a better quality of life – than patients in the past.