ASD describes the congenital connection of the right and left heart at an atrial level. The connection can vary in size and location greatly but essentially allows an undesirable left to right “shunting” of blood between the atria. This can lead to right heart stretch and ultimately heart failure.
Symptoms and detection
Adults with atrial septal defects (ASDs) often have minimal symptoms. You may present with mild breathlessness, or more likely, just be picked up by the doctor hearing a sound whilst listening to the heart. In addition it may be spotted when doing a routine electrocardiogram (ECG) or echocardiogram (TTE).
For most ages of patient, further investigation is warranted. A decision needs to be made on the size of the hole, and of the risks and benefits of ASD closure. To assess the size of the hole. Transoesophageal echocardiography (TOE) and cardiac MRI scanning are useful. A coronary angiogram to look for related coronary artery disease and measure heart pressures may be needed. In addition, assessment of your true limitation of exercise tolerance may be made with an MVO2 exercise treadmill test (ETT).
If closure is planned, then the choice is between surgery and an umbrella device placed via a groin puncture (See ASD closure). Umbrella closure is usually preferred.