An atrial septal defect (ASD) is a hole in the septum separating the left and right atria. The most common type is ostium secundum ASD. Causes are unclear but may include genetic factors or infections during pregnancy. Symptoms often do not appear until adulthood and may include shortness of breath, fatigue, or heart palpitations. Diagnosis is made through echocardiogram, MRI, or CT scan. Small ASDs may be treated with medications but larger defects often require catheter-based or open-heart surgical repair to close the hole in the septum. Complications can include heart failure, arrhythmias, or pulmonary hypertension if left untreated.

1. ARTERIAL SEPTAL DEFECT
PRESENTED BY-SALMAN KHAN
ASSISSTANT PROFESSOR(IINSR)

4. DEFINITION
1.An atrial septal defect
(ASD) is a hole in the
heart between the
upper chambers (atria).
2.A congenital defect
characterized by a hole
in the wall between the
atria, the two upper
chambers of the heart.

5. Incidance
 ASD accounts for about 17 % of all congenital cardiac
defects and occurs more frequently in girls than in boys.

6. TYPES:Types of atrial septal defects include:
Ostium Secundum. This is the most common
type of ASD. It occurs in the middle of the wall
between the upper heart chambers (atrial
septum)

7. Conti…………………….
Primum. This type of ASD affects the lower part
of the atrial septum and might occur with other
congenital heart defects

8. Conti……………………
•Sinus venosus. This rare type of ASD usually occurs in the upper
part of the wall separating the heart chambers. It's also associated
with other heart structure changes present at birth.

9. Conti…………………..
Coronary sinus. In this rare type of ASD, part of the wall between the
coronary sinus — which is part of the vein system of the heart — and
the left upper heart chamber (left atrium) is missing

10. Causes
The cause of atrial septal defect
is unclear.

11. FACTORS
 German measles (rubella) infection during the first few months of
pregnancy
 Diabetes
 Lupus:It is a disease that occurs when your body's immune system
attacks your own tissues and organs (autoimmune disease
 Alcohol or tobacco use
 Illegal drug use, such as cocaine
 Use of certain medications, including some anti-seizure medications and
drugs to treat mood disorders

12. Symptoms & symptoms:Many babies born with
atrial septal defects have no signs or symptoms. Signs or symptoms
can begin in adulthood.
• Shortness of breath, especially when exercising
• Fatigue
• Poor weight gain
• Swelling of legs, feet or belly (abdomen)
• Irregular heartbeats (arrhythmias)
• Sensation of a rapid, pounding heartbeat (palpitations) or skipped beats
• Whooshing sound that can be heard through a stethoscope (heart murmur

13. Diagnostic evaluation
 History collection
 Physical examination
 X-Ray: right atrial and ventricular enlargement and enlargement of pulmonary artery.
 E.C.G. :Right axis deviation and mild RVH
 Auscultation : Soft systolic ejection murmur heard best at the left upper sternal border.
 Echocardiogram:This is the most commonly used test to diagnose an atrial septal defect. Sound waves are
used to create pictures of the heart in motion. An echocardiogram can show how well blood is moving through the
heart and heart valves.

14. Conti…………………………..
•(MRI) scan :This imaging test uses magnetic fields and radio waves to create
detailed images of the heart. A health care provider might request this type
of MRI if echocardiography didn't provide a definitive diagnosis.
•Computed tomography (CT) scan:This uses a series of X-rays to create detailed
images of your heart. It can be used to diagnose an atrial septal defect and related
congenital heart defects if echocardiography hasn't definitely diagnosed an atrial
septal defect.

15. Management (medical management)
 Because the cause of atrial septal defect (ASD) is unclear, prevention may not be
possible.
 Anticongestive therapy (digoxin and Lasix) may be necessary, if signs of CHF are
present.
 Infective endocarditis prophylaxis for 6 months after surgery.

16. SURGICAL MANAGEMENT
 Catheter-based repair. A thin, flexible tube (catheter) is inserted into a blood vessel,
usually in the groin, and guided to the heart using imaging techniques. A mesh patch or
plug is passed through the catheter and used to close the hole. Heart tissue grows around
the seal, permanently closing the hole.
• Open-heart surgery. This type of atrial septal defect repair surgery involves an incision
through the chest wall to access the heart directly. The surgeons use patches to close the
hole. This open-heart repair surgery is the only way to fix primum, sinus venosus and
coronary sinus atrial defects.
• Sometimes, atrial septal defect repair can be done using small incisions (minimally
invasive surgery) and with a robot (robot-assisted heart surgery).

17. Complications
 Right-sided heart failure
 Irregular heartbeats (arrhythmias)
 Stroke
 Early death
 High blood pressure in the lung arteries (pulmonary hypertension)

18. REFRANCES
 Atrial septal defect (ASD) - Diagnosis and treatment - Mayo Clinic
 ASD CONGENITAL HEART DEFECT surgical management - Search (bing.com)
 Shukla Dr. Bhuvanesh, Sharma PankaJ, “A text Book of Pediatric Nursing” 2nd
edition, Lotus Publishers, Page no.151-152.
 Sharma Rimple, “A textbook of Book of” Pediatric Nursing, 3rd edition, Jaypee
Publishers, Page no.238-239.