Summary about Disease
Interatrial communication, more commonly known as an Atrial Septal Defect (ASD), is a congenital heart defect where there's an abnormal opening in the septum between the heart's two upper chambers (atria). This allows oxygen-rich blood from the left atrium to flow into the right atrium, mixing with oxygen-poor blood. Over time, this can overwork the right side of the heart and lungs.
Symptoms
Many people with ASDs, especially small ones, have no symptoms, particularly in childhood. When symptoms do occur, they may include:
Shortness of breath, especially during exercise
Fatigue
Heart palpitations or skipped beats
Swelling in the legs, ankles, or feet
Stroke
Heart murmur (detected during a physical exam)
Frequent lung infections
Poor growth (in children)
Causes
ASDs are congenital, meaning they are present at birth. The exact cause is often unknown, but it's believed to be a combination of genetic and environmental factors. Risk factors may include:
Family history of heart defects
Maternal illness during pregnancy (e.g., rubella)
Maternal use of certain medications during pregnancy
Medicine Used
Medications are often used to manage symptoms and prevent complications, but they do not close the defect. Common medications include:
Diuretics: To reduce fluid buildup in the lungs and body.
Beta-blockers or Digoxin: To control heart rate and rhythm.
Anticoagulants (blood thinners): To prevent blood clots, especially if atrial fibrillation develops. Ultimately, definitive treatment usually involves closure of the ASD via surgery or catheter-based intervention.
Is Communicable
No, Atrial Septal Defect is not communicable. It is a structural heart defect present at birth and cannot be spread from person to person.
Precautions
Precautions depend on the size of the ASD and the presence of symptoms. General recommendations may include:
Regular follow-up with a cardiologist
Prophylactic antibiotics before dental procedures (in some cases, to prevent endocarditis – infection of the heart lining)
Avoiding strenuous activity if symptomatic (consult with a doctor)
Maintaining a healthy lifestyle (diet and exercise, as tolerated)
How long does an outbreak last?
There is no "outbreak" associated with ASDs, as it's not an infectious disease. The condition is present from birth and is managed throughout the individual's life.
How is it diagnosed?
Echocardiogram: This is the primary diagnostic tool. It uses sound waves to create an image of the heart and can show the size and location of the ASD, as well as how it's affecting heart function.
Electrocardiogram (ECG or EKG): Measures the electrical activity of the heart and can detect abnormal heart rhythms.
Chest X-ray: Shows the size and shape of the heart and lungs.
Cardiac Catheterization: A more invasive procedure used to measure pressures in the heart and lungs, and to evaluate the size and location of the ASD. It is less commonly used for diagnosis now due to improvements in echocardiography.
MRI: Can provide detailed images of the heart.
Timeline of Symptoms
At birth: Often asymptomatic, especially with small ASDs.
Childhood: Symptoms may develop as the child grows and becomes more active.
Adulthood: Symptoms can appear later in life as the heart becomes more overworked, particularly with larger, untreated ASDs. The progression of symptoms can vary greatly depending on the size of the defect and individual factors.
Important Considerations
Early diagnosis and treatment are crucial to prevent long-term complications.
The decision on whether and when to close the ASD depends on its size, the patient's symptoms, and the overall impact on the heart and lungs.
Even after closure, lifelong follow-up with a cardiologist is recommended.
Pregnancy can pose risks for women with ASDs. Careful planning and management are essential.
Pulmonary hypertension (high blood pressure in the lungs) is a potential complication of long-standing, untreated ASDs and can significantly impact prognosis.