Atrial Septal Defect

Some people are born with a hole in their heart called an atrial septal defect (ASD). While larger holes can cause symptoms and increase your risk of stroke, treatment at the Center for Structural Heart Disease can help you live a healthy life.

Why choose Henry Ford Health to care for an atrial septal defect?

Our team offers the range of expertise you need for your care, from advanced imaging to minimally invasive ASD treatment. We can often repair your heart without the need for open-heart surgery.

What is an atrial septal defect?

This rare heart defect occurs in the wall (septum) between the heart’s two upper chambers (atria). The septum sometimes does not develop properly when a baby is in the womb. This can leave a hole.

Smaller holes don’t have much impact on blood flow or the heart or lungs. But oxygen-rich blood meant for the body can flow through larger holes and mix with oxygen-depleted blood. The blood goes back into the lungs and forces the heart to work harder to pump. The extra blood flow can also cause fluid buildup in the lungs and damage them over time.

ASD and stroke risk

Larger atrial septal defects can increase your risk for stroke, from tiny blood clots that develop in our veins. Normally, these clots travel through the veins into the heart and lungs. Tiny blood vessels (capillaries) in the lungs then filter out the blood clots.

With ASD, the clots can go through larger holes in the heart. They may then travel through the arteries to the brain and cause a stroke.

Causes of atrial septal defects

ASD is a congenital heart defect, meaning it’s present at birth. Doctors often don’t know why the septum fails to fully develop.

Symptoms of ASD

If you have an atrial septal defect, you may not experience symptoms until adulthood. In fact, some people may not have symptoms if the opening is small. If the hole is larger, the most common symptoms are a heart murmur (an unusual sound during a heartbeat) and mild shortness of breath.

If it’s not repaired, a large ASD can damage the heart and lungs over time. You may eventually experience symptoms of heart failure in adulthood, including:

• Fatigue
• Fluid buildup in the lungs
• Shortness of breath
• Swelling in the abdomen, legs, ankles, feet and veins in the neck
• Tiring quickly during physical activity

Diagnosing atrial septal defects

Some people come to us with an existing ASD diagnosis. Others may experience symptoms and come to us to determine the cause. Either way, we start your care with a thorough evaluation. During this visit, your doctor meets with you to:

• Discuss your symptoms and lifestyle
• Perform a complete physical exam
• Listen for a heart murmur or other abnormal sounds
• Review your medical history
• Review any previous tests or imaging studies
• Possibly recommend more heart tests or scans

Advanced treatment for atrial septal defects

After your evaluation, your interventional cardiologist works with you to develop a customized treatment plan. Your plan may include a minimally invasive procedure or open-heart surgery to close the hole. If you have a large ASD, you could still benefit from having it closed as an adult.

The treatment our team suggests may include the following:

• Observation and medications: You probably don’t need to have the defect closed if you have a small ASD. You can see your doctor for ongoing monitoring to ensure the hole doesn’t pose a risk to your health. We can also prescribe medications to relieve any symptoms and reduce your risk of stroke.
• Minimally invasive heart procedures: If you have heart failure symptoms or a large ASD that was not closed in childhood, we often perform minimally invasive repair. Doctors insert a small tube (catheter) into a blood vessel to close the hole. These techniques allow us to repair an ASD without open-heart surgery, for fewer complications and a faster recovery. Learn more about our cardiac hole closure.
• Surgery: While we typically suggest minimally invasive techniques, some people still need open-heart surgery. Examples include people with holes in unusual positions or who have additional heart defects. Our team includes experienced Henry Ford heart surgeons to treat these cases.