Atrial Septal Defect is characterized by the presence of a hole in the septum, which is a wall separating the upper two chambers of the heart. This hole is present in the septum right from birth. Thus, atrial septal defect is congenital in nature. If the hole is insignificant and small in size, then it heals on its own as the child grows up, however, the significantly large holes tend to cause damage to the lungs and the heart.
Due to the presence of this hole, oxygen-poor blood leaks into the neighboring chamber containing oxygen-rich blood. In case an adult is suffering from an undetected atrial septum, then his chances of survival are quite low as he has huge risks of death due to high blood pressure which may trigger an attack in his heart.
Types of Atrial Septal Defect
Four Main Types Of Atrial Septal Defect Are There, Namely:
- Ostium Primum Atrial Septal Defect: It is a type of atrioventricular canal defect and hence it is linked with the presence of a hole in one of the leaflets present in the mitral valve.
- Ostium Secundum Atrial Septal Defect: This is the most common defect and around seventy percent of the children who are diagnosed with atrial septal defect, suffer from this particular condition. This type of defect arises during the pregnancy period, when the atrial septum is unable to close at the time of development of the heart. It leads to the formation of an opening in the septum.
- Sinus Venosus Atrial Septal Defect: This type of defect arises due to the presence of a hole at the junction of superior vena-cava and the right atria, at the point where the pulmonary veins enters into the heart. As a consequence of which, blood drains out of the pulmonary vein from the right atria towards the left atria.
- Coronary Sinus Atrial Septal Defect: This type of defect arises in the coronary sinus, which is a structure present in the right atria where all the other veins of the heart enter into the right atria. It is one of the rarest forms of atrial septal defect.
Causes of Atrial Septal Defect
Atrial Septal Defect is a congenital condition and is present in the human body right from birth. This condition arises due to the abnormal development of the heart during the pregnancy period. The formation of the heart takes place in the first eight weeks of pregnancy. Heart is initially formed as a small tube, which later generates a septum. The septum divides the heart into two sides. During the partitioning process, it may so happen that the septum is improperly generated, thereby, a hole is formed in it. This is how atrial septal defect generates.
Symptoms of Atrial Septal Defect
Most of the children who suffer from atrial septal defect show no symptoms apart from rugged breath and breathlessness after doing small work. Moreover, these children are small in size as compared to other children of their age. In case, the hole is significantly large, then the blood easily leaks from one chamber to the next. As a result of which the lungs get overworked and the children suffering from this defect exhibit the following symptoms.
- Profuse Sweating
- Tiredness by small activity
- Ruggedness in breath
- Frequent respiratory infections
- Rapid breathing
- Poor growth
However, the symptoms are different for every child. It is also to be noted that these are general symptoms which may characterize many other heart diseases and medical conditions which affect the children. Thus, it is important to consult with a child’s physicians for proper diagnosis of the medical condition.
Popular Facts About Atrial Septal Defect
It is more common among girls as their ratio of suffering from this condition is almost double when compared to boys.
Around six to eight percentages of the children who are born with congenital heart disease suffer from this condition.
Diagnosis of Atrial Septal Defect
Since the symptoms of atrial septal defect are quite similar to other pediatric diseases, hence the diagnosis is quite difficult. If the child’s physician comes across a heart murmur while listening to the heartbeat, then he/she needs to immediately refer the child to a heart specialist who deals with the diagnosis and proper treatment of congenital heart diseases and other related medical problems that arise in childhood. The heart specialist carries out a few physical examinations by listening to the heart and lungs sounds so as to make accurate calculations about the condition. They generally evaluate the heart murmurs based on their loudness, pitch, shrillness, intensity and other such related factors. This is how the cardiologists get a general idea of the disease the child is suffering from. Once the symptoms primarily point towards any particular disease, the cardiologist can proceed to carry out other examinations so as to confirm the syndrome. There are various diagnostic tests present which may confirm the syndrome however they are carried out depending on the age of the child and the primary clinical condition. Some of the diagnostic tests are as follow:
Electrocardiogram: This particular test portrays the electrical activity of the heart and with its help abnormal heart beats can be traced easily. It also helps to detect stress acting on the heart muscles, if any.
Chest X-rays: Chest X-rays help in producing images of the internal tissues, bones and other organs on the X-ray sheet. However, X-rays cannot penetrate through the bones and thus they fail to trace the image of those organs which are protected by the bones of the rib cage. When a child suffers from Atrial Septal Defect, then child’s heart may be larger than the normal size as the right ventricle and auricle need to handle the excess pressure generated in the other two chambers of the heart. Moreover, the lungs also expand larger than their normal size in order to accommodate the excess blood flowing through it and the changes can be easily traced on the X-ray sheet.
Echocardiogram: By this process, sound waves which are firstly recorded on electronic sensors are made to pass through heart so as to produce moving images of the heart and valves of it. Echo traces the pattern in which the blood is flowing through the opening of the atrial septum. It thereby helps to determine the size of the opening and the amount of blood flowing through it.
Cardiac Catheterization: This process is considered as one of the best ways to confirm the presence of atrial septal defect. It is an invasive process which provides the cardiologist with a detailed image of the interior of the heart. The patient is firstly sedated and then a flexible tube is inserted in the blood vessels present in the genitals and is slowly pushed through the other organs to the heart. It provides proper measurement of working of the various blood vessels and chambers present in the heart.
Apart from this, a body tolerant dye is also inserted in the body so that the images produced by the tube on the screen will be perfectly clear. Generally, it is considered that an echocardiogram is sufficient to confirm the presence of atrial septal defect; however, cardiac catheterization gives a detailed image of the heart and its chambers which not only helps to diagnose the syndrome, but also helps to have a general idea about the seriousness of the disease.
Treatments of Atrial Septal Defect
There are several methods of treatment available to treat this medical condition. However, the process employed is entirely dependent on the following criteria:
- The age of the child
- The medical history of the child
- Intolerance towards certain medical drugs, if any
- Opinion of the parents and their preference
The treatment of atrial septal defect is hugely dependent on the size of the hole present in the septum. If it is a small hole, then it may naturally heal as the child grows up. It will naturally close with the time. However, the large holes are the ones that need immediate attention. Once diagnosed with the condition, the child’s physician needs to maintain a tabular record of every medication given to the child and its effect on the child, whether small or big, the holes should be repaired during the childhood itself so as to prevent further problems in adulthood.
Types of Medication that are Generally Prescribed to the Children Suffering from Atrial Septal Defect:
Doctors generally try to repair the hole through medications. They keep surgery as the latter option because performing an open heart surgery on a child can be quite risky. Thus, they prescribe medicines which not only helps to repair the hole, but also help the heart to be tolerant towards the pressure generated on the right side of it due to the flow of excess blood through the hole.
The Below Mentioned Medications Are Prescribed By The Doctors For The Particular Condition:
Digoxin: It increases the strength of the various heart muscles so as to increase their efficiency in pumping blood.
Diuretics: The inaccurate working of the heart affects the water balance of the body. This medication make the kidneys work more efficiently in removing excess water from the patient’s body.
If the doctors decide to perform a surgery of the heart, then it is done strictly under the effect of general anesthesia. Once the surgery is completed, the cut needs to be stitched up immediately. Proper precautions need to be taken while performing a surgery as a child suffering from atrial septal defect has huge risk of infections on the heart’s inner surface known as bacterial endocarditis.