Atrial septal defect overview
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editors-In-Chief: Priyamvada Singh, MBBS [[2]]; Cafer Zorkun, M.D., Ph.D. [3]; Assistant Editor-In-Chief: Kristin Feeney, B.S. [[4]]
Overview
(ASD) are a group of congenital heart diseases that involve the inter-atrial septum. The inter-atrial septum is the tissue that separates the right and left atria from each other. This tissue prevents arterial and venous blood from mixing with each other. If there is a defect in this septum, a direct communication between the atria can occur, which allows shunting, resulting in mixing of arterial and venous blood. It is possible for blood to travel from the left side of the heart to the right side of the heart, or vice versa.
Epidemiology and demographics
Atrial septal defect are common heart defects and comprises approximately 7% of all the congenital heart disorders. [1]. Unlike other conditions ASD has a slight female preponderance of 2:1.
Natural History, Complications and Prognosis
The natural history of atrial septal defect depends on the location, size, amount of shunting of blood and the associated anomalies seen. A small atrial septal defect may remain asymptomatic throughout the life and closes spontaneously in infants. Patients with atrial septal defects are able to survive to adulthood. It can also present in adulthood with insidious development of symptoms. Complications like pulmonary hypertension, atrial fibrillation, right heart failure and stroke can occur if large sized defects are left uncorrected. The mortality rate for surgical intervention repair is less than 1% for atrial septal defect patients under the age of 45, with no history failure or pulmonary artery pressure issues.
Causes
Secundum type of ASDs is the commonest type of atrial septal defects. They occur sporadically. The causes behind ASDs are still not certain. However, they have been found to occur with increased incidences in some genetic disorders like, the Holt-Oram (heart-hand) syndrome, down’s syndrome, Noonan syndrome, Treacher Collins syndrome, and the thrombocytopenia-absent radii (TAR) syndrome.
Diagnosis
Physical Examination
ECG
Echocardiography
Treatment
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