Atrial Septal Defect In Children

What is an atrial septal defect?

An atrial 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 to the right ventricle (lower chamber of the heart). Blood in the left side of the heart stays in the left atrium and is pumped to the left ventricle. With ASD, blood in the left atrium may flow back to the right atrium. Over time, increased 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. Treatment is often needed so that your child may go on with his activities and live a normal life.

What causes atrial septal defect?

Caregivers do not exactly know what causes ASD. It is thought that problems during the development of your baby's heart causes ASD. Problems with the information in genes are also thought to cause ASD. A gene is a little piece of information that tells your body what to do or what to make. Premature babies (babies born too early) may also have a greater chance of having ASD.

What are the signs and symptoms of atrial septal defect?

The most common sign of ASD is a heart murmur. Heart murmurs are changes in the heart sounds when caregivers listen to your child's heartbeat. Most children do not have any symptoms, even if the ASD is large. Many children start having symptoms when they get older. The signs and symptoms of ASD may include any of the following:

• Lips and fingernails turning blue with prolonged crying.
  
  
• Shortness of breath.
  
  
• Slow growth or problems gaining weight.
  
  
• Tires easily or feels tired more than the usual.

How is atrial septal defect diagnosed?

Your child may need one or more of the following tests:

• 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. A chest x-ray may be used to check your child's heart, lungs, and chest wall. It can help caregivers diagnose your child's symptoms, or suggest or monitor treatment for medical conditions.
  
  
• 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 heartbeat. This test takes about five to ten minutes. Your child must lie very still during the test.

How is atrial septal defect treated?

Your child may have the following treatments:

• Watchful waiting: Caregivers may want your child to have regular checkups to see if his ASD may close on its own.
  
  
• Medicines: Your child may need 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.
  
  
• Closure of ASD: 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 ASD. 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.

Where can I find support and more information?

Accepting that your child has ASD may be hard. You, your child, and those close to you may feel scared, depressed, or angry. These are normal feelings. Talk to your child's caregivers, family, or friends about your and your child's feelings. You may also want to join a support group. This is a group of people who also have ASD. Contact the following for more information:

• American Heart Association
  7272 Greenville Avenue
  Dallas , TX 75231-4596
  Phone: 1- 800 - 242-8721
  Web Address: http://www.heart.org
  

• National Heart, Lung and Blood Institute
  Health Information Center
  P.O. Box 30105
  Bethesda , MD 20824-0105
  Phone: 1- 301 - 592-8573
  Web Address: http://www.nhlbi.nih.gov/health/infoctr/index.htm
  

Care Agreement

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child.

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