Atrial Septal Defect

Diagnosis

In many cases of atrial septal defect (ASD), the physician may have heard a heart murmur during a physical examination and referred the patient to a cardiologist for a diagnosis.

The cardiologist performs a physical examination, listens to the heart and lungs, and makes other observations that help in the diagnosis and provide clues about the nature of the heart problem. However, tests are needed to help with the diagnosis and may include the following:

• Echocardiogram
  A procedure to evaluate the structure and function of the heart by using sound waves that produce a picture of the heart in motion. It can show the pattern of blood flow through the ASD and determine where and how large the opening is, as well as how much blood is passing through it. In addition, the echocardiogram can help determine if other problems are present or if the ASD can be closed with a minimally-invasive catheter device.

• Chest X-ray
  A diagnostic test using invisible electromagnetic energy to produce images of internal tissues, bones, and organs onto film. With an ASD, the heart may be enlarged due to more blood flowing through the lungs than normal. Also, changes can take place in the lungs due to extra blood flow and can be seen on an X-ray.

• Electrocardiogram
  A test that records the electrical activity of the heart, shows abnormal rhythms (arrhythmias or dysrhythmias) and detects heart muscle stress.

• Cardiac catheterization
  A procedure that gives highly detailed information about the structures inside the heart. The main reason that a cardiac catheterization would be done at Mayo would be to close the ASD with a small, umbrella-like device. (See nonsurgical closure.)