Consumer Information

Atrial Septal Defect In Children

WHAT YOU SHOULD KNOW:

An atrial (AY-tree-al) septal defect or ASD, is a hole in the atrial septum (wall) of your child's heart. The atrial septum separates the two upper chambers of the heart called the atria.

Normally, blood in the right side of the heart stays in the right atrium and is pumped into the right ventricle (lower chamber of the heart). Blood in the left side of the heart stays in the left atrium and is pumped into the left ventricle. With ASD, blood in the left atrium may flow back to the right atrium. Over time, increase in the backflow of blood may cause the right atrium to enlarge. This may lead to other problems such as irregular heartbeats and increased blood pressure to the lungs. These problems may make it difficult for the heart and lungs to provide oxygen to the body.
Problems during the development of the heart are thought to cause ASD. A child with ASD may not have any signs and symptoms except for a heart murmur. A heart murmur is an abnormal change in heart sounds. Cardiac catheterization is used to diagnose ASD. Other tests may include chest x-rays, echocardiogram, doppler, and an electrocardiogram.
If the ASD is mild, watchful waiting may be all that is needed. Surgery or transcatheter device closure may be needed if the ASD did not close on its own. These treatments are often needed so that your child may go on with his activities and live a normal life. Ask your caregivers for more information about tests and treatments for ASD.

CARE AGREEMENT:

You have the right to help plan your child's care. To help with this plan, you must learn about your child's health condition and how it may be treated. You can then discuss treatment options with your child's caregivers. Work with them to decide what care may be used to treat your child.

RISKS:

Atrial septal defect if left untreated may worsen symptoms your child has. Increased lung pressure and irregular heartbeats may cause heart failure, which may be serious and life-threatening. Surgery, and transcatheter device closure of ASD may increase the chances of getting heart infection. Your child may have to take antibiotic medicines for at least six months. Ask your caregivers if you have questions about your child's ASD, medicines, and treatments.

WHILE YOU ARE HERE:

Informed consent: You have the right to understand your child's health condition in words that you know. You should be told what tests, treatments, or procedures may be done to treat your child's condition. Your child's caregiver should also tell you about the risks and benefits of each treatment. You may be asked to sign a consent form that gives your child's caregivers permission to do certain tests, treatments, or procedures. If you are unable to give your consent, someone who has permission can sign this form for you. A consent form is a legal piece of paper that tells exactly what will be done to your child. Before giving your consent, make sure all your questions have been answered so that you understand what may happen to your child.

Emotional support: You may stay with your child for comfort and support. Your child may need to stay in the hospital for more than a day. Ask caregivers if another family member can stay with your child when you cannot be there. Bring in something from home that your child likes. Your child may like to have his favorite blanket, toy, or clothing with him.

Blood gases: These tests are also called arterial blood gases (ABGs). Blood is taken from an artery usually in your child's wrist. ABGs may be done if your child has trouble breathing or other problems caused by his illness.

Heart monitor: This is also called an ECG, electrocardiogram, or telemetry. Three or five sticky pads are placed on your child's chest. Each pad has a wire leading to a TV-type screen or to a small portable box (telemetry unit). This screen or box shows a picture of your child's heartbeat. Caregivers watch this picture to make sure your child's heart is doing OK.

Medicines: Your child may have the following:

Heart medicine: This medicine may be given to make your child's heart beat stronger or more regularly. There are many different kinds of heart medicines. Talk with caregivers to find out what your child's medicine is and why he is taking it.
Diuretics: This medicine may be given to help your child's body and lungs get rid of extra fluid. This can help your child breathe easier. Diuretics may make your child urinate more often.

Tests: Your child may need the following:

Cardiac catheterization: A cardiac catheterization is a test to see how well your child's heart is working. It is also used to see how well the blood vessels connected to the heart are doing. A special tube is threaded into your child's heart through a blood vessel in his arm, leg, or neck. Dye may be given so x-ray pictures of your child's blood vessels show up better on a TV-like screen. Your child's caregiver may also measure the pressure inside your child's heart.
Chest x-ray: This is a picture of your child's lungs and heart. Caregivers use it to see how your child's lungs and heart are doing. Caregivers may use the x-ray to look for signs of infection (such as pneumonia) or other problems.
Doppler: A doppler test is done to check blood flow in the heart. A small metal disc with gel is placed on your child's chest. Caregivers may hear abnormal sounds when an ASD is present.
Echocardiogram: This test is also called an echo. Sound waves are used to show pictures of the size and shape of your child's heart. The echo can also show how well the heart is pumping and how well blood flows through it. Your child will lie down during the test. Caregivers will squirt clear gel onto your child's chest to help the echo probe move easily. The echo pictures are shown on a TV-like screen. The whooshing noise that you may hear is the sound of blood flowing through the heart. Caregivers may ask you to stay in the room with your child during this test. 12 Lead EKG: This test helps caregivers see your child's heart activity. It helps caregivers look for changes or problems in different areas of the heart. Sticky pads are placed on your child's chest, arms, and legs. Each pad has a wire that is hooked to a machine or TV-like screen. This machine shows a tracing of your child's heart beat. This test takes about five to ten minutes. Your child must lie very still during the test.

Treatment options: Your child may have to undergo procedures to close the ASD. This will depend on the location and size of your child's ASD, and his symptoms. Your child may have any of the following:

Surgery: Surgery may be done by making a cut through your child's chest to repair the atrial septal defect. Ask your caregiver for more information about surgery for ASD.
Transcatheter device closure: This is a procedure where a device called a septal occluder is used to close the hole in the atrial septum. A catheter is inserted into your child's blood vessel. This is then threaded up to the heart where the septal occluder device is put in place to plug the ASD. Ask your caregiver for more information on transcatheter device closure for ASD.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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