Congenital heart defect - ASD; Birth defect heart - ASD; Primum ASD; Secundum ASD
Atrial septal defect (ASD) is a heart defect that is present at birth (congenital).
As a baby develops in the womb, a wall (septum) forms that divides the upper chamber into a left and right atrium. When this wall does not form correctly, it can result in a defect that remains after birth. This is called an atrial septal defect, or ASD.
Normally, blood cannot flow between the two upper heart chambers. However, an ASD allows this to happen.
When blood flows between the two heart chambers, this is called a shunt. Blood most often flows from the left to the right side. When this happens the right side of the heart enlarges. Over time pressure in the lungs may build up. When this happens, the blood flowing through the defect will then go from right to left. If this occurs, there will be less oxygen in the blood that goes to the body.
The health care provider will check how large and severe an ASD is based on the symptoms, physical exam, and the results of heart tests.
The provider may hear abnormal heart sounds when listening to the chest with a stethoscope. A murmur may be heard only in certain body positions. Sometimes, a murmur may not be heard at all. A murmur means that blood is not flowing through the heart smoothly.
Abnormal heart sounds
A heart murmur is a blowing, whooshing, or rasping sound heard during a heartbeat. The sound is caused by turbulent (rough) blood flow through the h...
An echocardiogram is a test that uses sound waves to create a moving picture of the heart. It is often the first test done. A Doppler study done as part of the echocardiogram allows the health care provider to assess the amount of shunting of blood between the heart chambers.
An echocardiogram is a test that uses sound waves to create pictures of the heart. The picture and information it produces is more detailed than a s...
ASD may not need treatment if there are few or no symptoms, or if the defect is small and is not associated with other abnormalities. Surgery to close the defect is recommended if the defect causes a large amount of shunting, the heart is swollen, or symptoms occur.
A procedure has been developed to close the defect (if no other abnormalities are present) without open heart surgery.
The procedure involves placing an ASD closure device into the heart through tubes called catheters.
The health care provider makes a tiny cut in the groin, then inserts the catheters into a blood vessel and up into the heart.
The closure device is then placed across the ASD and the defect is closed.
Sometimes, open-heart surgery may be needed to repair the defect. The type of surgery is more likely needed when other heart defects are present.
Congenital heart defect corrective surgery fixes or treats a heart defect that a child is born with. A baby born with one or more heart defects has ...
Silvestry FE, Cohen MS, Armsby LB, et al. Guidelines for the echocardiographic assessment of atrial septal defect and patent foramen ovale: from the American Society of Echocardiography and Society for Cardiac Angiography and Interventions. J Am Soc Echocardiogr. 2015;28(8):910-958. PMID: 26239900 pubmed.ncbi.nlm.nih.gov/26239900/.
Sodhi N, Zajarias A, Balzer DT, Lasala JM. Percutaneous closure of patent formen ovale and atrial septal defect. In: Topol EJ, Teirstein PS, eds. Textbook of Interventional Cardiology. 8th ed. Philadelphia, PA: Elsevier; 2020:chap 49.
Webb GD, Smallhorn JF, Therrien J, Redington AN. Congenital heart disease in the adult and pediatric patient. In: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier; 2019:chap 75.
Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.