Parents, have you ever heard of atrial septal defect (ASD)? This is a birth defect that affects the heart. Babies can be born with a hole in the wall that divides the upper chambers (atria) of the heart).
ASD can affect both small and large scale. Babies may not need special treatment, but in more serious cases surgery may be necessary.
Definition of Atrial Septal Defect
It is important to note that atrial septal defect is a birth defect of the heart in which there is a hole in the wall (septum) that divides the upper chambers (atria) of the heart. The size of this hole varies, with smaller ones likely to close on their own, while larger ones may require surgery.
ASD is a type of congenital heart defect. It is experienced by babies since they are still in the womb. As the baby’s heart develops during pregnancy, there are usually several holes in the walls that divide the upper chambers of the heart (atria). Normally, these holes close during pregnancy or soon after birth.
If one of these openings doesn’t close, a hole is left, a condition called an atrial septal defect. The hole increases the amount of blood flowing through the lungs and over time, can cause damage to the blood vessels in the lungs.
Damage to the blood vessels in the lungs can cause problems in adulthood, from high blood pressure in the lungs to heart failure. Other problems may include an abnormal heartbeat, and an increased risk of stroke .
Symptoms of Atrial Septal Defect
In many cases, babies born with atrial septal defect do not show any symptoms. Signs of this disorder are usually only felt as they grow up.
However, some children may show symptoms including:
- Underweight
- Late growth
- Recurrent respiratory infections
Although very rare, older children with ASD may have symptoms that include:
- Arrhythmia
- Easily tired when exercising
- Difficulty breathing
- Hard to breathe
- Fatigue
- Swelling of the legs or abdomen
- Irregular heartbeat ( arrhythmia )
- Sensation of a fast, pounding heartbeat (palpitations) or skipped beats
- A whooshing sound that can be heard through a stethoscope (heart murmur)
- Tired while breastfeeding
Tell your child’s doctor right away if you notice one or more of these symptoms in your little one. The healthcare provider may run tests to check the structure and function of your child’s heart.
Causes of Atrial Septal Defect
The exact cause of ASD is not fully understood. However, congenital heart defects are often caused by genetic changes that occur before birth. Some genetic mutations associated with ASD affect the NKX2.5/CSX and TBX5 genes.
Here are some factors that can increase the risk of parents having a baby with congenital heart disease. These factors include:
- Alcohol consumption
- Smoking and tobacco use
- Taking certain prescription medications
- Certain medical conditions
- Consumption of unhealthy foods and drinks
Frequency of Occurrence
Compared to other congenital heart defects, ASD is the most common in children, occurring in about 1 to 2 cases per 1,000 live births.
Citing data from the Cleveland Clinic, in the United States there are 1 in 1859 babies born with ASD. This adds up to about 2118 babies born with ASD each year.
Risk Factors
Atrial septal defect occurs as a baby’s heart develops during pregnancy. Several conditions can increase a baby’s risk of having an atrial septal defect or other congenital heart defects.
Medical conditions or the use of certain medications by the mother during pregnancy can be one of the factors that increase the risk. Other things that can potentially cause a baby to be born with ASD are parents who have:
- German measles ( rubella ) infection during the first few months of pregnancy
- Diabetes
- Lupus
- Alcohol or tobacco use
- Use of illegal drugs, such as cocaine
- Use of certain medications, including some anti-seizure medications and medications to treat mood disorders
Some types of congenital heart defects run in families (are inherited). If you or someone in your family has a congenital heart disease, including ASD, screening by a genetic counselor can help determine the risk of certain heart defects in your child in the future.
Diagnosis
To diagnose ASD can be done during pregnancy or after the baby is born. In some cases, the diagnosis can only be made in adulthood. Here are some tests that are done to confirm your child’s condition:
In Content
During pregnancy, there are screening tests (prenatal tests) that can be done to check for birth defects and other conditions in the fetus. An ASD may be seen during an ultrasound (which produces images of the body), but it depends on the size of the hole and its location. If a heart defect is suspected, a specialist will be needed to confirm the diagnosis.
After the Baby is Born
Atrial septal defect is present at birth, but many babies do not show any symptoms. It is possible that ASD may not be diagnosed until adulthood.
One of the most common ways to find this condition is by detecting a murmur when listening to a person’s heart with a stethoscope. If a murmur is heard or other signs or symptoms are present, a healthcare provider may order one or more tests to confirm the diagnosis. The most common test is an echocardiogram, which is an ultrasound of the heart.
Other Tests in Adulthood
Some tests that can be done to confirm an ASD diagnosis for adults include:
- Electrocardiography (ECG/EKG) . An EKG shows the electrical activity of your heart. It can indicate arrhythmias or other problems related to the heart’s electrical system.
- Chest X-ray . This test will show whether the right atrium and right ventricle are enlarged. It will also show whether the blood vessels in the lungs are affected.
- Transthoracic echocardiography (TTE) . This test shows how the left-to-right shunting of blood (caused by the ASD) is affecting the heart. It can also show details related to pulmonary hypertension.
- Transesophageal echocardiography (TEE) . TEE is an ultrasound taken through the esophagus. It can show the size, shape, and location of the ASD as well as examine the heart valves.
- Intracardiac echocardiography (ICE) . This is an ultrasound taken inside the heart. A small camera (echo probe) is sent into the heart through a peripheral vein. This test shows the size and shape of the ASD and the direction of blood flow through it. It is often used during percutaneous (non-surgical) ASD repair.
- Cardiac CT scan or Cardiac MRI . In some cases, these tests may be used. This is especially helpful for people with associated defects or less common forms of ASD.
Handling
Providing appropriate treatment for children with ASD depends on the age of diagnosis, the number or seriousness of symptoms, the size of the hole and whether or not the child has other conditions.
In some cases, surgery is needed to repair the hole. Sometimes, medications will also be prescribed by doctors to help treat the symptoms felt. However, there is no specific medicine that can repair the hole.
If your child is diagnosed with ASD, your healthcare provider may want to monitor them for a while to see if the hole closes on its own. During this time, they may treat symptoms with medications.
Your child’s doctor may also recommend that the hole be closed for a child with a large ASD, even if there are few symptoms, to prevent future problems.
Closing the hole may also be recommended for adults who have many or severe symptoms. This can be done during cardiac catheterization or open-heart surgery. After this procedure, follow-up care will depend on the size of the defect, age, and whether the patient has other birth defects.
Possible Complications
Children born with large or complex ASDs are at higher risk for complications. Some conditions that may occur include:
- Abnormal heart rhythms, especially atrial fibrillation
- Heart failure
- Heart infection (endocarditis)
- High blood pressure in the pulmonary arteries
- Stroke
Atrial Septal Defect Prevention
Actually, there is no specific way to prevent someone from ASD. Moreover, this condition develops when the fetus is still in the womb. However, prenatal care can affect the possibility of a baby suffering from this congenital heart disease.
If you are pregnant or planning a pregnancy, it is important to do the following:
- Quit smoking and using tobacco products
- Avoid drinking alcohol
- Avoid cigarette smoke
- Avoid drug use, including cocaine
- Talk to your doctor about any prescription medications you are taking and whether they might affect your pregnancy.
- Implement a healthy lifestyle
- Get genetic testing, if you or another biological family member has congenital heart disease.
Although there is no specific method to prevent your child from having an atrial septal defect, living a healthy lifestyle can be a preventive measure that can be done. May you and your child always be healthy.
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Republished with permission from theAsianparent Indonesia
