Know About Atrial Septal Defect in Children

 

An atrial septal defect is also known as a hole in a person’s heart and is a common kind of congenital heart defect where there is an abnormal opening inside the dividing wall between the upper chambers of the heart. In case of an atrial septal defect, there is an opening in the wall that is present between the atria. This leads to the flowing of oxygenated blood from the left atrium through the hole in the septum into the right atrium wherein it mixes with the oxygen-poor blood while increasing the overall amount of blood flowing towards the lungs (Reece, A.S. and Hulse, G.K., 2020. Contemporary epidemiology of rising atrial septal defect trends across USA 1991–2016: A combined ecological geospatiotemporal and causal inferential study. BMC pediatrics, 20(1), pp.1-12). On the other hand, this increased blood flow creates a swishing sound or a heart murmur which is commonly identified as one of the first signs that a child suffers from an atrial septal defect.

Causes of an atrial septal defect

Children suffering from an atrial septal defect are born with it. It happens during the fetal development of the heart. During fetal development, the heart starts as a large tube and gradually forms into distinct sections, which will eventually become its walls and chambers. If any issues arise during this process, it can result in the formation of a hole in the wall that separates the left atrium from the right atrium. While some cases of ASDs may have a genetic component, where the tendency to develop such conditions can be inherited, genetic syndromes can also play a role by causing additional or missing segments of chromosomes that are associated with ASDs. However, the majority of ASDs do not have a clearly identifiable cause. Additionally, the reason why ASDs are more prevalent in girls than in boys remains unclear.

Signs and Symptoms of Atrial Septal Defect

The symptoms experienced as a result of ASD can vary depending on the size and location of the defect (Lau-Jensen, S.H., Asschenfeldt, B., Evald, L. and Hjortdal, V.E., 2021. Hyperactivity and inattention in young patients born with an atrial septal or ventricular septal defect. Frontiers in Pediatrics, 9, p.786638). In many cases, children with ASDs appear healthy and do not exhibit any noticeable symptoms. They typically experience normal growth and weight gain. However, children with larger and more severe ASDs may display some signs or symptoms, including Decreased appetite: These children may have a poor appetite and show a lack of interest in eating.

Poor growth

In some cases, poor growth or failure to thrive may be observed in children with significant ASDs. They may have difficulty gaining weight as compared to other children.

Extreme tiredness

Children with a severe atrial septal defect might experience excessive fatigue or tiredness, which can affect their overall energy levels and daily activities.

Shortness of breath

As a result of the abnormal blood flow caused by ASD, some children may experience difficulty breathing and shortness of breath.

Lung problems and infections

Certain complications can arise due to ASDs, such as increased susceptibility to lung problems and infections like pneumonia.

Complications of Atrial septal defect 

An Atrial Septal Defect that is not treated in childhood may result in diverse health problems in later life. This may include atrial arrhythmia or abnormal heart rhythm as well as problems in how effectively the heart pumps blood. As these children get older, they are also increasingly susceptible to stroke as blood clots may form, pass through the septum hole and travel to their brain. In addition, high blood pressure in the lungs or pulmonary hypertension may also develop over time in the case of older patients if they have larger untreated atrial septal defects. It is because of these complications and problems that doctors recommend closing the atrial septal defect early in childhood.

Diagnosis and Treatment of Atrial Septal Defect

Upon hearing heart murmurs that indicate a hole in the child’s atrial septum, doctors usually refer the patient to a pediatric cardiologist who specializes in the diagnosis and treatment of heart diseases in children and teenagers. Some further tests like chest X-ray, electrocardiogram and echocardiogram may be recommended to diagnose the atrial septal defect.

Treatment of an Atrial Septal Defect

The treatment of an Atrial septal defect depends on the age of the child and the size, severity and location of the defect. Smaller ASDs usually do not need any treatment. However, if the ASD has not closed on its own after a certain point of time, cardiologists recommend fixing the hole through cardiac catheterization or heart surgery (Hansen, J.H., Duong, P., Jivanji, S.G., Jones, M., Kabir, S., Butera, G., Qureshi, S.A. and Rosenthal, E., 2020. Transcatheter correction of superior sinus venosus atrial septal defects as an alternative to surgical treatment. Journal of the American College of Cardiology, 75(11), pp.1266-1278).

 

Is atrial septal defect fatal?

 

   

In most cases, atrial septal defects are not fatal and can be diagnosed and treated successfully with minimal complications. However, severe cases may cause life-threatening complications like chest pain, irregular heartbeats or heart failure.

 

 

Is it possible to prevent atrial septal defect?

 

   

As atrial septal defects are a kind of congenital heart defect and there is no one specific cause, prevention may not be possible. However, getting good prenatal care is crucial to minimize the risks of developing this condition.