Consumer Information

Atrial Septal Defect

WHAT YOU SHOULD KNOW:

An atrial (A-tree-ull) septal (SEP-tull) defect is a hole in a wall inside the heart. This is also called an ASD. ASD is a common heart defect that babies are born with. The heart has 4 chambers or rooms called the atria (A-tree-uh) and the ventricles (VEN-trik-ulls). With an ASD, there is a hole in the wall between the 2 upper chambers, the right and left atria. This hole may be small or large. With an ASD, blood does not flow through the heart in the normal way. Your heart and lungs must work harder because of this.
Usually an ASD is found when a child is young. Sometimes the ASD is very small and is not noticed until the person has grown up. Some of the symptoms of an ASD are shortness of breath and fatigue (tiredness). A baby or child with an ASD may grow too slowly and have trouble gaining weight. Tests will be done to learn more about your heart and the ASD. Some people with an ASD need open heart surgery to have the hole closed. Surgery is usually done as an infant or young child. Sometimes the hole closes on its own so surgery is not needed.

CARE AGREEMENT:

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

RISKS:

There are risks if you do not get treatment for your ASD. You may live a shorter life. You may have more heart symptoms and be unable to do the things you used to do. If not treated, your heart may begin to fail, fluid may fill your lungs, and your liver may get very large. You may not be able to care for yourself. You may have a stroke or even die. You may get a heart infection called bacterial (bak-TEER-e-ull) endocarditis (end-o-kar-DI-tis).

WHILE YOU ARE HERE:

Informed consent: You have the right to understand your health condition in words that you know. You should be told what tests, treatments, or procedures may be done to treat your condition. Your doctor should also tell you about the risks and benefits of each treatment. You may be asked to sign a consent form that gives 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 you. Before giving your consent, make sure all your questions have been answered so that you understand what may happen.

Call button: You may use the call button when you need your caregiver. Pain, trouble breathing, or wanting to get out of bed are good reasons to call. The call button should always be close enough for you to reach it.

Gown: A hospital gown is used so that caregivers can easily check and treat you. Caregivers will show you how to put on your gown. When you feel better you may be able to wear your own gown or pajamas.

Heart monitor: This is also called an ECG, electrocardiogram, or telemetry. Sticky pads are placed on your chest or different parts of your body. Each pad has a wire leading to a small portable box (telemetry unit), or to a TV-type screen. This lets caregivers see a tracing of the electrical activity of your heart. The heart monitor may help caregivers see problems with the way your heart is beating. Do not remove any wires or sticky pads without asking your caregiver first.

IV: An IV is a tube placed in your vein for giving medicine or liquids. This tube is capped or connected to tubing and liquid.

Oxygen: You may need extra oxygen to help you breathe easier. It may be given through a plastic mask over your mouth and nose. It may be given through a nasal cannula, or prongs, instead of a mask. A nasal cannula is a pair of short, thin tubes that rest just inside your nose. Tell your caregiver if your nose gets dry or if the mask or prongs bother you. Ask your caregiver before taking off your oxygen. Never smoke or let anyone else smoke in the same room while your oxygen is on. Doing so may cause a fire.

Pulse oximeter: A pulse oximeter is a machine that tells how much oxygen is in your blood. A cord with a clip or sticky strip is placed on your ear, finger, or toe. The other end of the cord is hooked to a machine. Caregivers use this machine to see if you need more oxygen.

Vital signs: This includes taking your temperature, blood pressure, pulse (counting your heartbeat), and respirations (counting your breaths). To take your blood pressure, a cuff is put on your arm and tightened. The cuff is attached to a machine which gives your blood pressure reading. Caregivers may listen to your heart and lungs by using a stethoscope. Your vital signs are taken so caregivers can see how you are doing.

Tests: Usually an ASD is found early in life. Sometimes the ASD is very small and is not noticed until a person has grown. The following tests may be done to learn if you have an ASD. Some of the test results may be normal if the ASD is small.

Blood gases: This test is also called an arterial blood gas or ABG test. Blood is taken from an artery (blood vessel) in your wrist, arm, or groin. The groin is the area where your abdomen meets your upper leg. Your blood is tested for the amount of "gases" in it, such as oxygen, acids, and carbon dioxide.
Blood tests: You may need blood taken for tests. The blood can be taken from a blood vessel in your hand, arm, or the bend in your elbow. It is tested to see how your body is doing. It can give your caregivers more information about your health condition. You may need to have blood drawn more than once.
Cardiac Catheterization (kath-uh-ter-i-ZA-shun): This is a test used to see how well your heart is working. This test may be done to show how much oxygen is in the blood in the right atrium. With an ASD, there is more oxygen than normal in the blood in the right atrium. A special tube is threaded into your heart through a blood vessel in your leg or arm. Dye may be given so x-ray pictures of your arteries show up better on a TV-like screen. Your caregiver may also measure the pressure inside your heart.
Chest X-ray: This is a picture of your lungs and heart. Caregivers use it to see if the right atrium and ventricle are larger than the left atrium and ventricle. Caregivers may use the x-ray to look for fluid around your heart and lungs.
Echocardiogram (eh-ko-KAR-d-o-gram): An echocardiogram is often called an "echo". Sound waves are used to show pictures of the size and shape of your heart on a TV-like screen. An echo can show caregivers the type and size of an ASD. The echo and color flow Doppler can tell how your heart moves when it is beating and how blood flows through the heart. It can tell if your heart is pumping well. An echo can find problems with the valves of your heart.
12 Lead EKG: This test helps caregivers see if it takes too long for the right ventricle to contract (pump). This is normal for someone with an ASD. Sometimes, the EKG can show signs of other problems that may happen with ASD. Sticky pads (10) are placed on your chest, arms, and legs. Each pad has a wire that is hooked to a machine. This machine prints a paper tracing of your heart working instead of showing it on a TV-type screen. This test is painless and takes about 5 to 10 minutes.

Treatment Options: If you do not have ASD heart problems, you may not need any special medicines for the ASD. One or more of the following treatments may be used to treat your ASD.

Medicines: You may need one or more of these medicines to treat or prevent problems with your ASD.
- Antibiotics: Antibiotics may be given to help treat or prevent an infection caused by germs called bacteria.
- Blood pressure medicine: This medicine may be given to lower your blood pressure. Keeping your blood pressure under control protects your heart, lungs, brain, kidneys, and other organs.
- Blood thinning medicine: You may be given blood-thinning medicine, which keeps clots from forming in the blood. Clots can cause strokes and death. Blood thinners may be taken by mouth or as a shot. Blood thinners may make it easier to bleed or bruise. Ask your caregiver about special care that you need to take when on blood thinners.
- Diuretics (di-u-REH-tiks): You may be given diuretics or "water pills". Diuretics help get rid of extra fluid in your body and lungs. This can help you breathe easier. Diuretics make you urinate more often. This medicine can be given as a pill or in an IV.
- Heart medicine: You may be given heart medicine to make your heart beat better or more regularly. There are many different kinds of heart medicines. Talk with your caregiver to find out what your medicine is and why you are taking it.
Surgery:
- Your doctor’s ASD repair plan may depend upon the type of ASD you have. It also may depend on where the ASD is in the heart wall. Even if you are having no symptoms, closing an ASD early in life may prevent heart problems in later life. If an ASD is repaired early enough in life, you may not need any more surgeries for the ASD.
- Surgery to close the ASD with stitches (thread) is open heart surgery. Sometimes a man made patch or piece of the heart is used to help close the ASD. If a person with ASD has no symptoms, the ASD may be repaired by age 4 or 5. If there are symptoms, the ASD may be repaired by age 1 or 2.
Treatment without surgery: Sometimes a man-made umbrella-like patch or plug may be put in place to close the hole. This is done during cardiac catheterization so the person does not need surgery.

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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