Diagnosis
Atrioventricular septal defect may be diagnosed in a baby before birth during a pregnancy ultrasound or special heart imaging.
Tests
Tests to diagnose atrioventricular septal defect may include:
- Echocardiogram. Sound waves are used to make pictures of the heart in motion. An echocardiogram can reveal a hole in the heart or heart valve issues. It also shows how blood flows through the heart.
- Electrocardiogram. Also called an ECG or EKG, this noninvasive test records the electrical activity of the heart. Sticky patches with sensors are placed on the chest. Wires connect the patches to a computer, which shows results.
- Chest X-ray. A chest X-ray shows the condition of the heart and lungs. It can show if the heart is enlarged or if the lungs hold extra blood or other fluid. These could be signs of heart failure.
- Cardiac catheterization. A thin, flexible tube called a catheter goes into a blood vessel in the groin and up to the heart. A contrast material injected through the catheter makes the heart structures show up more clearly on X-rays. During the procedure, a healthcare professional can measure pressure in different parts of the heart.
This test also may be done later in life to measure pressure in the heart to guide treatment.
Treatment
Open-heart surgery is needed to treat a complete or partial atrioventricular septal defect. More than one surgery may be needed. Surgery involves using one or two patches to close the hole in the heart wall. The patches become part of the heart's wall as the heart's lining grows over them.
Other parts of the surgery depend on whether the defect is partial or complete and what other heart conditions there are.
For a partial atrioventricular septal defect, surgery is needed to repair the mitral valve so it can close tightly. If the valve can't be fixed, it may need to be replaced.
For a complete atrioventricular septal defect, surgeons separate the large single valve between the upper and lower heart chambers into two valves.
Many people who have surgery to correct an atrioventricular septal defect don't need more surgery. But some complications, such as heart valve leaks, may need treatment. This may include more surgery.
Prognosis
Treatment greatly improves the outlook for children with atrioventricular septal defect. But they may still have challenges later in life, including:
- Irregular heartbeats, also called arrhythmias.
- Leaky heart valves, also called valve regurgitation. Leaky heart valves may need surgery.
- Narrowing of the heart valves, also called valve stenosis.
Follow-up care
After congenital heart defect surgery, you need regular checkups for life with a doctor trained in heart disease. This type of doctor is called a cardiologist. Your cardiologist tells you how often you need an appointment or imaging tests.
If you're an adult with a congenital heart defect treated in childhood, you may need care from an adult congenital cardiologist. You may need special care around the time of future surgeries, even those that do not involve the heart.
Preventive antibiotics
Sometimes, a congenital heart defect can increase the risk of infection in the lining of the heart or heart valves. This infection is called infective endocarditis. You or your child may need to take antibiotics before certain dental procedures. Ask your or your child's healthcare professional whether preventive antibiotics are needed.
Self-care
Many people with successful repair of a congenital heart defect have no activity restrictions. But some people may need to limit exercise or sports activities. Your healthcare professional can tell you which sports and types of exercise are safe for you or your child.
Coping and support
Many children with heart conditions present at birth, called congenital heart defects, grow up to lead active lives.
If you have a congenital heart defect or if you have a child with one, these tips may be helpful.
- Seek support. You may find talking with other people who've been in the same situation helpful. Ask your healthcare team if there are any support groups in your area.
- Record your or your child's health history. Write down medicines. Write down surgeries and other procedures, and the dates they were done. Include the medical report from the surgeon and other important information about your or your child's care.
This information is useful for healthcare professionals who don't know you or your child. It also may help your child move from pediatric to adult care professionals.
Preparing for your appointment
You or your child might be sent to a doctor trained in heart conditions, called a cardiologist.
What you can do
- Write down all symptoms, including any that may seem unrelated to the reason for the appointment.
- Make a list of all your medicines, vitamins and supplements, including doses.
- Write down important medical information, including other health conditions you have or your child has.
- Write down questions to ask your healthcare professional.
- Find out if your family has a history of heart disease.
What to expect from your doctor
Your healthcare professional is likely to ask many questions, such as:
- When did you notice symptoms?
- Do your symptoms come and go, or do you have them all the time?
- What, if anything, makes the symptoms worse or better?
Questions to ask your doctor
For atrioventricular septal defect, some questions might include:
- What's the most likely cause of these symptoms?
- What tests are needed? How do we prepare for them?
- What treatment do you suggest?
- How can we manage other health conditions together with atrioventricular septal defect?
Be sure to ask all the questions you have.
