Atrial Septal Defect

By Joseph Rodney de Leon

An atrial septal defect (ASD) is a hole between the two upper chambers of the heart. The condition is present from birth. Smaller atrial septal defects may close on their own during infancy or early childhood. The health effects of holes That remain open often dont Show up until adulthood.

Many babies born with ASD dont have signs and symptoms. In adults signs and symptoms typically develop between the ages of 30 to 40. It may be heard byStethoscope hearing aMurmur may signify ASDIt is commonly found when an USDExam is done.

SIGNS

&

SYMPTOMS

Signs and Symptoms of ASD

Shortness of BreathFatigueSwelling of Legs, FeetOr skipped beatsHeart Palpitations or skipped beats

SIGNS

&

SYMPTOMS

. An ASD is an abnormal opening between the heart’s upper chambers. Commonly a congenital heart defect.. Often no clear cause. Genetics and environmental factors may playA role.

CAUSES

Congenital heart defects appear to run in families and sometimes occur with other genetic problems, such as down syndrome. If you have a heart defect, or you have a child with a heart defect, a genetic counselor can predict the approximateOdds that any future childWill have one.

RISK

FACTORS

ASD may be detected by a physician via stethoscope. Hearing murmurs that indicate a hole in the heart’s chambers.Chest X-ray: helps determine the condition of your heart and lungs that may show the doctor the cause of your S&SECG or EKG: identifies heartRythm via electrical activity.Cardiac Catheterization: using a small flexible tube doctors can diagnose CHD test how well your heart is pumping and check the functioning of the heart valves.

SCREENING

&

DIANOSIS

Pulse Oximetry: painless test that measures how well oxygenated your tissues are. It helps detect whether oxygenatedblood is mixing with deoxygenated blood, which canhelp diagnose the type of heart defect present.

SCREENING

&

DIANOSIS

A small atrial septal defect may never cause any problems. Small holes often close during infancy, perhaps even undetected.

Larger defects can cause mild to life threatening problems.

Right-sided heart failureHeart rhythm abnormalitiesShortened life expectancyIncreased risk for stroke

COMPLICATIONS

If a large ASD goes untreated increase blood flow to your lungs increases the blood pressure in the lung arteries. In rare cases, this can cause permanent lung damage, and pulmonary hypertension becomes irreversable. This is called EISENMENGER’S SYNDROME.

COMPLICATIONS

Medications: wont cure an ASD but may be used to alleviate some of the S&S-Keep the beat regular (lopressor, Lanoxin)-Increase the strength of the heart’s contractions (Lanoxin)-Decrease the amount if fluid in circulation (Lasix)-Reduce the risk of blood clots (Coumadin)

TREATMENT

Surgery: many doctors recommend repairing an ASD diagnosed during childhood to prevent complications as an adult.-Open Heart Surgery: done under general anaesthesia and requires the use of heart-lung machine. Through an incision in the chest, surgeons use patches or stitches to close the hole.-Cardiac Catheterization: a thin tube is inserted then guided to the heart a small mesh patch or plug is put into place to close the hole the heart tissue grows around the mesh permanently sealing the hole.

TREATMENT

In most cases ASD cant be prevented. If you have a family history of heart defects or other genetic, consider talking with a genetic counselor before getting pregnant.

Self – care: if you find out you have a congenital heart defect you may need to know that there are some limitations on ADL’s and other issues such as -Exercise -Employment-Prevention of Infections -Pregnancy-

PREVENTION

Ventricular Septal Defect

Ventricular septal defect describes one or more holes in the wall that separates the

right and left ventricles of the heart. Ventricular septal defect is one of the most

common congenital (present from birth) heart defects.

It may occur by itself or with other congenital diseases.

Before a baby is born, the right and left ventricles of its heart are not separate. As the fetus grows, a wall forms to separate these two ventricles. If the wall does not completely form, a hole remains. This hole is known as a ventricular septal defect, or a VSD.

Causes, incidence, and risk factors

Ventricular septal defect is one of the most common congenital heart defects. The baby may have no symptoms, and the hole can eventually close as the wall continues to grow after birth. If the hole is large, too much blood will be pumped to the lungs, leading to heart failure.

Causes, incidence, and risk factors

The cause of VSD is not yet known. This defect often occurs along with other

congenital heart defects.In adults, ventricular septal defects are a rare

but serious complication of heart attacks. These holes are related to heart attacks and

do not result from a birth defect.

Causes, incidence, and risk factors

Patients with ventricular septal defects may not have symptoms. However, if the hole is large, the baby often has symptoms related to heart failure.Shortness of breathFast breathingHard breathingPalenessFailure to gain weightFast heart rateSweating while feedingFrequent respiratory infections

SYMPTOMS

Listening with a stethoscope usually reveals a heart murmur (the sound of the blood crossing the hole). The loudness of the murmur is related to the size of the defect and amount of blood crossing the defectChest x-ray -- looks to see if there is a large heart with fluid in the lungsECG -- shows signs of an enlarged left ventricleEchocardiogram -- used to make a definite diagnosisCardiac catheterization (rarely needed, unless there are concerns of high blood pressure in the lungs)MRI of the heart -- used to find out how much blood is getting to the lungs

DIAGNOSTIC

PROCEDURE

If the defect is small, no treatment is usually needed. However, the baby should be closely monitored by a health care provider to make sure that the hole eventually closes properly

and signs of heart failure do not occur.Babies with a large VSD who have symptoms related to heart failure may need medicine to

control the symptoms and surgery to close the hole. Medications may include digitalis

(digoxin) and diuretics.

TREATMENT

If symptoms continue despite medication, surgery to close the defect with a Gore-tex patch is needed. Some VSDs can be closed

with a special device during a cardiac catheterization, although this is

infrequently done.Surgery for a VSD with no symptoms is controversial. This should be carefully

discussed with your health care provider.

TREATMENT

Many small defects will close on their own. For those defects that do not spontaneously close, the outcome is good with surgical repair. Complications may result if a large defect is not treated.

PROGNOSIS

Heart failureInfective endocarditis (bacterial infection of the heart)Aortic insufficiency (leaking of the valve that separates the left ventricle from the aorta)Damage to the electrical conduction system of the heart during surgery (causing arrhythmias)Delayed growth and development (failure to thrive in infancy)Pulmonary hypertension (high blood pressure in the lungs) leading to failure of the right side of the heart

COMPLICATIONS

Except for the case of heart-attack-associated VSD, this condition is always present at birth.

Drinking alcohol and using the antiseizure medicines depakote and dilantin during pregnancy have been associated with

increased incidence of VSDs. Other than avoiding these things during pregnancy, there

is no known way to prevent a VSD.

PREVENTION

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