Congenital heart disease of atrial septal defect is a condition that can occur in both children and adults. If the hole is small, symptoms may not appear, but as age increases, abnormal symptoms will manifest. If left untreated, it can cause arrhythmia leading to heart failure. Self-monitoring or consulting a cardiologist for a detailed examination is crucial for timely treatment.
What is Atrial Septal Defect?
Congenital heart disease of atrial septal defect (ASD) is caused by abnormal heart development in the fetus, resulting in an incomplete formation of the heart septum with a hole. This causes oxygenated blood to flow from the left atrium to the right atrium, leading to excessive blood flow back to the lungs. If left untreated, complications such as heart enlargement or heart failure may occur. In young children, symptoms may not be apparent, but as they grow older, it may be detected incidentally during a heart health check. Cardiologists can hear abnormal heart sounds. Some patients may experience easy fatigue and palpitations.
Signs That May Indicate Atrial Septal Defect
- Chest pain
- Easy fatigue
- Palpitations
- Hands and feet turning purple or green when the body lacks oxygen
Most patients visit a doctor as adults and often have heart-related symptoms such as easy fatigue and palpitations. In some cases, if the hole is large and pulmonary artery pressure is very high, symptoms include severe fatigue, lips, hands, and feet turning blue or purple which can be life-threatening
Diagnosis
Diagnosis is done by echocardiography or ECHO, which uses high-frequency sound waves safely sent to the chest area. The reflected sound waves are then converted into images displayed on a screen, showing the shape, size, function of the heart muscle, and heart valves. This can detect congenital heart disease that may cause symptoms like easy fatigue or chest tightness, helping cardiologists determine the correct treatment plan.
Treatment Approaches
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- Monitoring symptoms In cases where the patient has a small hole, there is a chance it may close on its own, which is rare. If the hole is small and causes no symptoms or impact on daily life.
- Closing the hole with a catheter For moderate-sized holes from 1-3 centimeters or more, treatment with a catheter technique without surgery (Transcatheter ASD Closure) is necessary. A metal device is inserted to close the hole between the heart chambers through a catheter inserted via a vein in the groin. Once at the defect site, the device is released to close the hole. The body will gradually grow tissue over the device within 3-6 months. The choice of device depends on the characteristics and size of the hole. After treatment, the patient stays in the hospital for about 2 days and undergoes follow-up with echocardiography before discharge, with periodic check-ups at 1 month, 6 months, and 1 year.
Dr. Ongkarn Komsan
Cardiologist
Phyathai Phaholyothin Hospital
