Atrial septal defect natural history: Difference between revisions
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As many atrial septal defect patients are asymptomatic, it is common to survive into adulthood without any need for intervention. Many atrial septal defects smaller than 8mm in diameter spontaneously close during infancy. Spontaneous closer is uncommon in children and adults. Adulthood, however, can lead to onset of symptoms and altered life expectancy. Beyond 40-50 years of age, survival without intervention is under 50% with an attrition rate of about 6% per year. Complications may onset later in life and include associated conditions such as [[atrial fibrillation]], [[pulmonary hypertension]], and [[stroke]]. | As many atrial septal defect patients are asymptomatic, it is common to survive into adulthood without any need for intervention. Many atrial septal defects smaller than 8mm in diameter spontaneously close during infancy. Spontaneous closer is uncommon in children and adults. Adulthood, however, can lead to onset of symptoms and altered life expectancy. Beyond 40-50 years of age, survival without intervention is under 50% with an attrition rate of about 6% per year. Complications may onset later in life and include associated conditions such as [[atrial fibrillation]], [[pulmonary hypertension]], and [[stroke]]. | ||
In a study done by Craig et al. on a series of 128 adult (age range 18 to 67 years) atrial septal defect patients 75% | In a study done by Craig et al. on a series of 128 adult (age range 18 to 67 years) atrial septal defect patients, 75% were found to be symptomatic with mild to moderate non-progressive symptoms. Less than 25% patients had significant pulmonary artery involvement. The pulmonary artery involvement could be progressive and can lead to shunt reversal [[eisenmenger’s syndrome]] and may be death at later stages. The prognosis after medical and surgical treatment for [[pulmonary hypertension]] could be poor. [[Heart failure]] and [[atrial arrhythmias]] were other complications found associated with atrial septal defects, mostly in elderly patients. | ||
==[[Atrial septal defect complications|Complications]]== | ==[[Atrial septal defect complications|Complications]]== | ||
===[[Atrial septal defect complications comorbidities#Complications involving comorbidity|Complications involving comorbidity]]=== | ===[[Atrial septal defect complications comorbidities#Complications involving comorbidity|Complications involving comorbidity]]=== | ||
Revision as of 14:30, 25 August 2011
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Atrial Septal Defect Microchapters | |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Priyamvada Singh, M.B.B.S. [[2]]; Cafer Zorkun, M.D., Ph.D. [3]; Assistant Editor(s)-In-Chief: Kristin Feeney, B.S. [[4]]
Overview
The majority of atrial septal defect patients are asymptomatic until adulthood. Symptom onset and severity hinges largely on the size of the defect. Without intervention, the mortality rate for symptomatic adults is greater than 50%. Possible complications include atrial fibrillation, pulmonary hypertension and stroke.
Natural history
As many atrial septal defect patients are asymptomatic, it is common to survive into adulthood without any need for intervention. Many atrial septal defects smaller than 8mm in diameter spontaneously close during infancy. Spontaneous closer is uncommon in children and adults. Adulthood, however, can lead to onset of symptoms and altered life expectancy. Beyond 40-50 years of age, survival without intervention is under 50% with an attrition rate of about 6% per year. Complications may onset later in life and include associated conditions such as atrial fibrillation, pulmonary hypertension, and stroke.
In a study done by Craig et al. on a series of 128 adult (age range 18 to 67 years) atrial septal defect patients, 75% were found to be symptomatic with mild to moderate non-progressive symptoms. Less than 25% patients had significant pulmonary artery involvement. The pulmonary artery involvement could be progressive and can lead to shunt reversal eisenmenger’s syndrome and may be death at later stages. The prognosis after medical and surgical treatment for pulmonary hypertension could be poor. Heart failure and atrial arrhythmias were other complications found associated with atrial septal defects, mostly in elderly patients.
Complications
Complications involving comorbidity
Atrial fibrillation | Pulmonary hypertension | Right heart failure | Stroke