Atrial Septal Defect

Symptoms

Signs and symptoms of ASD may not occur until adulthood—often age 30 or older—after damage to the heart and lungs has occurred.

Patients with ASD may have some, all, or none of the following symptoms:

• Shortness of breath
• Fatigue
• Swelling in the legs, feet, and/or abdomen (edema)
• Palpitations or irregular beats of the heart
• Poor weight gain in children

An ASD may be discovered by your doctor during a routine checkup. If your doctor detects a heart murmur through a stethoscope or finds other signs of a heart defect, your doctor may suspect ASD and refer you for tests to determine if it’s present.

In infants, even large ASDs are well tolerated for the first few years of life.

Those tests may include the following:

• Echocardiogram – An echocardiogram uses sound waves (ultrasound) to produce a video image of the heart. It provides your doctor a window into the chambers of your heart to look for defects and allows evaluation of the heart’s pumping strength and examination of its valves.
• Electrocardiogram (ECG or EKG) – An ECG traces your heart’s rhythm and electrical activity.
• Chest X-ray – This test provides an image of your heart and lungs.

Progression and possible complications

If a moderate or large ASD isn’t treated, it can lead to the following problems:

• Irreversible damage to the blood vessels of the lungs – Damage results from long-term exposure to abnormally high blood pressure in the lungs (pulmonary hypertension). If allowed to progress, the damage will result in early death (typically in the fourth or fifth decade of life).
• Possible stroke – A stroke can occur if a blood clot passes to the left side of the heart. Under normal circumstances, the lungs would filter the blood clot.
• Abnormal heart rhythms – Abnormal heart rhythms may arise due to the stretching of the wall of the right atrium because of enlargement caused by increased blood flow through it.