Atrial septal defect history and symptoms
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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 development of symptoms associated with atrial septal defect relates to the size and severity of intracardiac shunting of blood across the defect. A large atrial septal defect will result in the presentation of symptoms at a younger age. However, smaller, less severe defects may be asymptomatic until adulthood. Smaller defects cause less hemodynamic disruptions. As a person ages, the potential for the development of symptoms increases. Adults, especially those over the age of 40, will become symptomatic. Nearly all adults with an atrial septal defect will present with symptom onset by the age of 60.
Symptoms
Atrial septal defects can be asymptomatic for the beginning of a patient's life. Less severe defects can be undetected during examination and present subtle symptoms, if at all. Symptom onset can occur gradually as patients age and the defect becomes more influential on the heart's functioning.
Common symptoms
- Shortness of breath, especially when exercising
- Fatigue, tires easily, especially with exertion/exercise
- Poor growth/failure to thrive
- Swelling of feet and ankle or abdomen (suggesting right sided heart failure)
- Heart palpitations or skipped beats (racing heart, awareness of heart beats)
- Recurrent respiratory infections
Less common symptoms include
- Weakness of different parts of body (stroke) due to paradoxical embolization
- Migraine
- Bluish skin color
Rapidity of Symptom Onset
Atrial septal defect patients are often asymptomatic until later in life. The majority of people with atrial septal defects may not experience any symptoms until after the age of 40. Nearly all atrial septal defect patients will manifest symptoms by the age of 60. Symptoms may become more rapid in onset as patients get progressively older.
ACC / AHA Guidelines- Evaluation of the Unoperated Patient (DO NOT EDIT)[1]
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Class I1. Atrial septal defect (ASD) should be diagnosed by imaging techniques with demonstration of shunting across the defect and evidence of right ventricular (RV) volume overload and any associated anomalies. (Level of Evidence: C) 2. Patients with unexplained RV volume overload should be referred to an adult congenital heart disease (ACHD) center for further diagnostic studies to rule out obscure ASD, partial anomalous venous connection, or coronary sinoseptal defect.(Level of Evidence: C) |
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References
- ↑ Warnes CA, Williams RG, Bashore TM, Child JS, Connolly HM, Dearani JA; et al. (2008). "ACC/AHA 2008 guidelines for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines on the Management of Adults With Congenital Heart Disease). Developed in Collaboration With the American Society of Echocardiography, Heart Rhythm Society, International Society for Adult Congenital Heart Disease, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons". J Am Coll Cardiol. 52 (23): e1–121. doi:10.1016/j.jacc.2008.10.001. PMID 19038677.