Atrial septal defect (ASD)

At Aurora Health Care, we do everything we can to protect your heart, including repairing atrial septal defect (ASD). We’ll schedule your appointment quickly, listen to your concerns and help you get the treatment you need to keep your heart healthy. And once we repair the atrial septal defect, the good news is you may not need further treatment.

What is atrial septal defect?

An atrial septal defect is a congenital heart defect, meaning it develops before birth. Doctors are unsure what causes the defect but it makes the heart work harder than it should. There is a hole in the heart’s atrial septum – the muscular wall that separates the heart’s two upper chambers, or atria.

This hole allows oxygen-rich blood from the left chamber of the heart to mix with oxygen-poor blood from the right chamber. Some oxygen-rich blood is pumped back to your lungs – where it just came from – instead of out to your body.

Understanding the types of atrial septal defect

An atrial septal defect develops before birth while you’re in the womb. There are several types that can occur:

• The defect can be small, medium or large.
• They can occur in the lower, middle or upper parts of the atrial septum.
• Holes in the middle part of the septum are the most common, affecting about 80% of those born with this condition.
• Holes in the lower and upper parts of the atrial septum are very rare.

Atrial septal defect symptoms

Most infants born with atrial septal defect have no symptoms, even when the hole in the heart is large. If the hole is smaller, it often closes on its own as the heart grows, so there are no symptoms or complications.

If an atrial septal defect does cause symptoms, they usually appear in your 30s or later. The most common symptom is a heart murmur, an extra or unusual sound during a heartbeat.

Other symptoms include:

• Arrhythmia
• Pulmonary hypertension, high blood pressure in the arteries in your lungs
• Right-sided heart failure
• Stroke

Atrial septal defect diagnosis

If we suspect an atrial septal defect, we’ll start with a thorough examination to check for a swishing sound that indicates a heart murmur. We’ll also check for an irregular heartbeat and ask about your symptoms and family history.

We may also order certain tests to see how your heart is working including:

• Chest X-ray
• Pulse oximetry to measure the level of oxygen in your blood
• Echocardiogram, including a transesophageal echocardiogram that uses a special probe inserted into your esophagus
• Electrocardiogram (EKG)
• Cardiac catheterization

Find out more about our heart and vascular testing and diagnosis.

Atrial septal defect treatment

If you have a minor atrial septal defect, you may not need treatment.

If the hole in the heart is large, it can make your heart work too hard. This may require one or more types of treatment such as:

• Monitoring: You doctor may observe the defect for a period of time to see if symptoms develop.
• Medication: While medications can’t repair a congenital heart defect, they can help make the symptoms more tolerable. We might prescribe medications to reduce the chance of blood clots or to keep your heartbeat regular.
• Cardiac catheterization: In this minimally invasive procedure, we thread a thin, flexible tube with a camera on the tip through a blood vessel in your arm or groin. Then, within your heart, we plug the hole in the atrial septum.
• Surgery: In some cases, a large atrial septal defect requires surgical repair. Our expert surgeons are here to help you regain your active life and a healthy heart.