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The atrial septum is the wall between the 2 upper chambers of the heart (right and left atria). An atrial septal defect (ASD) is an abnormal hole in this wall. ASD is a heart problem that is present at birth (congenital).
The heart forms during the first 8 weeks of pregnancy. It starts as a hollow tube and divides into 4 chambers. These chambers are separated by walls (septa). It's normal for the walls to have openings as the fetus grows. The openings usually close shortly before or just after birth. If they don't all close, the atrial septum will have a hole in it. This is called an ASD.
Some congenital heart defects may be passed down in certain families. Most atrial septal defects occur by chance. Doctors can find no clear reason why they occurred.
Many children have no symptoms and seem healthy. If the ASD is large, your child may have symptoms. Your child may:
Older children and adults with ASDs may have migraine headaches. But, it is unclear if the ASD is the cause. A small blood clot that forms in the blood stream that causes a stroke are also association with ASD in older children and adults. However, it does not currently appear that closing the defect or taking anticoagulants (blood thinners) decreases risk. The symptoms of ASD can be like other health conditions. Make sure your child sees his or her healthcare provider for a diagnosis.
Your child's healthcare provider may have heard a heart murmur when listening to your child's heart with a stethoscope. The heart murmur is from the abnormal flow of blood through the heart.
Your child may need to see a pediatric cardiologist for a diagnosis. This is a doctor with special training to treat heart problems in children. The doctor will examine your child and listen to your child's heart and lungs. The doctor will find out where the murmur is best heard and how loud it is. Your child may have some tests, such as:
Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is. The most common type of ASD may close on its own as your child grows.
Once an atrial septal defect is diagnosed, your child's cardiologist will check your child to see if the defect is closing on its own. An ASD will usually be fixed if it has not closed by the time a child starts school. The decision to close the ASD may also depend on the size of the defect.
Treatment may include:
All children with an ASD need to be cared for by a pediatric cardiologist. Most children who have had an ASD repair will live healthy lives. After the repair, your child's doctor may want your child to take antibiotics. This will prevent an infection of the heart lining (bacterial endocarditis).
With early diagnosis and repair of an ASD, children usually do very well. They don't need much follow-up care. Children are more likely to have problems if an ASD is diagnosed later in life and never repaired. Or they may have problems if complications occur after closing the defect.
Some children develop high blood pressure in the lungs (pulmonary hypertension). These children should have follow-up care at a center that specializes in congenital heart disease.
Talk with your child's healthcare provider about the outlook for your child.
Call your child's healthcare provider if your child has new symptoms or symptoms that get worse. Symptoms may include:
Tips to help you get the most from a visit to your child’s healthcare provider:
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