Atrial Septal Defect (ASD)

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Atrial septal defect (ASD), a hole in the wall (septum) separating the two upper chambers of the heart, is a common congenital heart birth defect. ASDs result in recirculation of blood from the heart to the lungs, causing enlargement of the right side of the heart.

While many ASDs are identified and repaired during childhood, many adults with unrepaired ASDs may not have symptoms but can go on to develop complications. Conditions resulting from unrepaired ASD may include pulmonary hypertension , heart rhythm abnormalities (such as atrial fibrillation), stroke, and long-term damage to the heart and lungs causing heart failure.

ASDs may also be associated with other congenital heart defects, and management will depend on these additional conditions.

Symptoms of ASD
Adults with unrepaired ASD may develop one or more of the following symptoms:  


  • Shortness of breath 
  • Fatigue 
  • Heart palpitations 
  • Lung infections 
  • Swelling of the legs, feet or abdomen


Treatment of ASD
If an ASD is suspected, your doctor my evaluate you using one or more of the following:

  • Chest X-ray
  • Echocardiogram
  • Electrocardiogram (EKG)
  • Cardiac catheterization
  • Magnetic resonance imaging (MRI)
  • Pulse oximetry


Adults often require surgery to repair septal defects to prevent further complications, which may be performed using surgery or catheter-based techniques:

  • Cardiac catheterization uses a thin catheter (tube) to insert a device to close the defect.
  • Open-heart surgery allows surgeons to use patches or stitches to close the hole through an incision in the chest.


After repair, adults with ASDs will need continued regular evaluation to ensure that additional complications do not develop.