Doctors know that heart defects present at birth (congenital) arise from errors early in the heart's development, but there's often no clear cause. Genetics and environmental factors may play a role.

An atrial septal defect (ASD) allows freshly oxygenated blood to flow from the left upper chamber of the heart (left atrium) into the right upper chamber of the heart (right atrium). There, it mixes with deoxygenated blood and is pumped to the lungs, even though it's already refreshed with oxygen.

If the atrial septal defect is large, this extra blood volume can overfill the lungs and overwork the heart. If not treated, the right side of the heart eventually enlarges and weakens. If this process continues, the blood pressure in your lungs increases as well, leading to pulmonary hypertension.

Atrial septal defects can be several types, including:

  • Secundum. This is the most common type of ASD, and occurs in the middle of the wall between the atria (atrial septum).
  • Primum. This defect occurs in the lower part of the atrial septum, and may occur with other congenital heart problems.
  • Sinus venosus. This rare defect occurs in the upper part of the atrial septum.
  • Coronary sinus. In this rare defect, part of the wall between the coronary sinus — which is part of the vein system of the heart — and the left atrium is missing.
Dec. 11, 2014

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