Atrial septal defect

Mayo Clinic Healthcare cardiologists have expertise in atrial septal defect (ASD). The inherited condition leaves a hole in the heart, specifically between its upper chambers. Because of this hole, extra blood flows to the lungs.

Some small ASDs are discovered by chance and may never cause problems. Many close on their own during infancy or early childhood.

A large ASD that lasts for many years can strain the heart and lungs. In these cases, surgery may be needed to repair the opening and reduce the risk of complications. This repair is an ASD closure procedure.

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ASD symptoms in adults

People born with an ASD may have no symptoms, though they may appear in adulthood. Symptoms may include:

  • Shortness of breath, especially during activity.
  • Tiredness with physical effort.
  • Swelling in the legs, feet or abdomen.
  • Irregular heartbeats (arrhythmias).
  • Skipped beats or a fast, pounding or fluttering heartbeat (palpitations).

Complications

Small ASDs often cause no problems and may close on their own. Larger ASDs can lead to serious complications, including:

  • Heart failure on the right side.
  • Irregular heart rhythms (arrhythmias).
  • Stroke.
  • High pressure in the lung arteries (pulmonary hypertension).
  • Early death.

Pulmonary hypertension can eventually cause permanent lung damage, known as Eisenmenger syndrome. This usually develops over many years and most often is linked to large ASDs. Treatment can prevent or manage many of these issues.

ASD and pregnancy

Mayo Clinic Healthcare specialists can provide an expert evaluation if you have an ASD and are pregnant or planning a pregnancy, as a large defect or its complications can make pregnancy high risk. Your ASD specialist can advise you on proper prenatal care, including if repairing the ASD before pregnancy is advised.

Diagnosis

Mayo Clinic Healthcare specialists can perform a variety of tests to understand the exact nature of the of ASD. We provide expert assessment and management for adults with secundum ASD. Because we house the necessary tests, you can receive results usually within a few days of visiting the clinic.

  • Echocardiogram. The main test for ASD. It uses sound waves to create images of the beating heart and shows the chambers, valves and blood flow.
  • Chest X-ray. Shows the condition of the heart and lungs.
  • Electrocardiogram (ECG or EKG). Records the heart's electrical activity. It shows heart rate and can detect arrhythmias.
  • Cardiac MRI. Uses magnetic fields and radio waves to produce detailed heart images. It may be used if other tests are unclear.
  • CT scan. Uses X-ray images to give detailed views of the heart when other tests do not provide enough information.

Atrial septal defect management

After testing to understand the exact type and size of your ASD, your specialist will tailor a plan to your unique condition and health goals. For instance, if the opening is small, regular check-ups may be all that is needed.

Mayo Clinic Healthcare may provide medication management to address your ASD. Possible medicines include beta blockers to help control heart rhythm, blood thinners (anticoagulants) to reduce the risk of clots, and diuretics to lower fluid build-up in the lungs or body.

If your ASD is large enough to cause problems, your Mayo Clinic Healthcare consultant may refer you to a trusted provider for advanced procedures, such as: 

  • Catheter-based repair. Used mainly for secundum ASDs. A catheter is placed into a vein — usually in the groin — and guided to the heart. A mesh patch or plug is delivered through the catheter to close the hole. Heart tissue grows over the patch, creating a permanent seal. Large secundum ASDs may still require surgery.
  • Open-heart surgery. Surgeons reach the heart through an incision in the chest wall and use patches to close the opening. This is the only option for primum, sinus venosus and coronary sinus ASDs.

Some repairs can be done with smaller incisions (minimally invasive surgery) or with robotic assistance.

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If you're experiencing symptoms from ASD or want a second opinion, contact us today. Our experienced ASD specialists near you can help by providing expert ASD care.

Request an appointment online or call us at +44 (0) 207 871 2575.