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Atrial Septal Defect in Children


What is an atrial septal defect (ASD)?

An ASD is a hole in the septum (wall) between the upper chambers (atria) of your child's heart. The hole may be small or large. An ASD causes a problem with the way blood moves through your child's heart. This makes his heart work harder to pump blood.

What causes an ASD?

The cause of an ASD is not known. An ASD happens during your child's development before birth. Your child has a higher risk for an ASD if his mother had rubella early in her pregnancy. His risk is also higher if he was born too early or has a family history of ASD.

What are the signs and symptoms of an ASD?

Your child may not have any symptoms, even if the ASD is large. Instead, your child may start having symptoms when he gets older. He may have any of the following:

  • Feeling his heartbeat skip or flutter in his chest
  • Frequent colds or lung infections
  • Chest pain
  • Lips and fingernails that turn blue with long periods of crying
  • Shortness of breath that is worse during activity
  • Slow growth or problems gaining weight
  • Tiring easily, especially during feedings

How is an ASD diagnosed?

Your child's healthcare provider will listen to his heartbeat and check for a murmur. A murmur is an abnormal heart sound. Your child may need any of the following:

  • An EKG test records your child's heart rhythm and how fast his heart beats. It is used to check for abnormal heartbeats and other heart problems.
  • X-ray, CT, or MRI pictures will show the size and location of your child's ASD. It may also show problems in his heart or lungs, such as enlarged heart. Do not let your child enter the MRI room with anything metal. Metal can cause serious injury. Tell the healthcare provider if he has any metal in or on his body.
  • An echocardiogram is a type of ultrasound. Sound waves are used to show the size of the ASD and how blood flows through your child's heart. It can also show how well his heart is pumping. Your child may need a transthoracic or transesophageal echocardiogram. Ask his healthcare provider about these types of echocardiogram.
  • A cardiac catheterization is a test used to show how well your child's heart is working or to measure pressure. A tube is guided into his heart through a blood vessel in his leg or arm. He may be given contrast liquid to help his heart show up better in pictures. Tell his healthcare provider if he has ever had an allergic reaction to contrast liquid.

How is an ASD treated?

Your child may not need treatment if the ASD is small and he does not have any symptoms. A small ASD may close on its own within the first year of life. Your child may need any of the following:

  • Medicine may be given to strengthen your child's heart or control his heartbeat. Medicine may also be given to lower pressure in your child's lungs, prevent blood clots, or remove extra fluid.
  • Open heart surgery may be needed to close the ASD with stitches or a patch.
  • Cardiac catheterization is a procedure that is used to close the ASD through a catheter (thin tube). The catheter is placed into an artery in your child's groin and guided up to his heart. A small stitch or patch is used to close the hole.

What can I do to care for my child?

  • Do not smoke near your child. Do not let your older child smoke. Nicotine and other chemicals in cigarettes and cigars can cause lung and heart damage. Ask your healthcare provider for information if you or your older child currently smoke and need help to quit. E-cigarettes or smokeless tobacco still contain nicotine. Talk to your healthcare provider before you or your older child use these products.
  • Feed your child heart-healthy foods. Feed your child more fresh fruits and vegetables. Feed him fewer canned and processed foods. Replace butter and margarine with heart-healthy oils such as olive oil and canola oil. Other heart-healthy foods include walnuts, whole-grain breads, low-fat dairy products, beans, and lean meats. Fatty fish such as salmon and tuna are also heart healthy.
  • Ask your child's healthcare provider if you need to limit his activity. Your child may need to avoid strenuous activities to decrease his symptoms. Examples include running, lifting, and swimming. Your child may also need to avoid scuba diving or hiking in high altitudes. These activities may put too much stress on his heart.
  • Get your child vaccinated. Vaccines help decrease your child's risk for infections. Infections can make your child's condition worse. Ask your child's healthcare provider for a vaccine schedule.

Call 911 for any of the following:

  • Your child has severe chest pain.
  • Your child has trouble breathing or sudden shortness of breath.
  • Your child coughs up blood.
  • Your child loses consciousness or stops breathing.
  • Your child has any of the following signs of a stroke:
    • Part of his face droops or is numb
    • Weakness in an arm or leg
    • Confusion or difficulty speaking
    • Dizziness, a severe headache, or vision loss

When should I seek immediate care?

  • Your child is more short of breath than usual.
  • Your child's heart is beating faster than usual.
  • Your child has swelling in his legs or ankles.
  • Your child has severe abdominal pain or his abdomen is larger than usual.

When should I contact my child's cardiologist?

  • Your child has a fever.
  • Your child has chills, a cough, or feels weak and achy.
  • Your child is not gaining weight as he should.
  • You have questions or concerns about your child's condition or care.

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 healthcare providers to decide what care you want for your child. 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.

© Copyright IBM Corporation 2020 Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or IBM Watson Health

Further information

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