Atrial septal defect (ASD) and Ventricular Septal Defect (VSD)

Atrial septal defect (ASD) and Ventricular Septal Defect (VSD)

Introduction

Atrial septal defect (ASD) and Ventricular Septal Defect (VSD) are congenital heart defects within the structure of the heart where an abnormal opening is present in the wall that divides the heart called septum. The two defects affects the normal blood flow within the heart by allowing mixing of oxygen-rich blood with oxygen poor blood.

Definitions

Atrial septal defect (ASD) is a heart defect where a hole is present in the septum dividing the two upper chambers (atria) of the heart. Ventricular Septal Defect (VSD) refers to a heart defect where a hole is present septum dividing the two lower chambers (ventricles) of the heart.

Symptoms and assessment findings in children

Atrial septal defect has congestive heart failure symptoms in children that include; fatigue, shortness of breath, easy tiring especially when playing, sweating, breathing rapidly, poor growth and frequent infections in the respiratory system. This defect can be diagnosed by hearing the heart murmur.

Ventricular Septal Defect has a certain characteristic murmur and may not be heard at birth. The symptoms of VSDs depends on the size of the hole opening and maybe classified as small, moderate or large VSD. For babies with small hole, the experience a loud murmur and it my get louder as the VSD closes.

For babies with moderate VSD, they experience excessive sweating, fatigue, lack of adequate growth and respiratory infections may result. For large VSD, babies have symptoms similar to those experienced in moderate VSD but are more severe. The most common symptoms include poor weight gain and infections in respiratory system.

Symptoms and physical examing findings in adults

ASD symptoms in adults include; breathe shortness with activity, swelling of abdomen, legs and feet, breathing difficulty and feeling the heart beat known as palpitations (Warnes, Williams & Bashore, 2008). Auscultatory findings include a delicate systolic murmur around the pulmonary area and a second split heart sound that does not vary.

VSD symptoms in adults include a heart murmur, breath shortness, body weakness, fatigue, irregular and rapid heartbeat etc.

Treatment

Most Atrial Septal Defects closes on their own but have to be checked regularly. Most of the holes that need treatment are performed in infancy or early stages of childhood. However, the treatment procedures can also be performed to adults whenever the complication develops. Such procedures include; catheter or surgical procedure (Prasad, 2003).

In ventricular septal defect, no treatment is needed for small hole defect. However, babies should be monitored closely to ensure it closes properly. Babies and adults with large VSD may be administered with medicine or surgery procedures done to close the hole. Cardiac catheterization may also be performed to avoid surgery. A hybrid procedure can also be used which uses both surgical and catheter techniques.

References

Briggs LE, Kakarla J, Wessels A (2012); The pathogenesis of atrial and atrioventricular septal defects with special emphasis on the role of the dorsal mesenchymal protrusion.

Hoffman JI, Kaplan S (2002); The incidence of congenital heart disease. J Am Coll Cardiol.

Johri AM, Rojas CA, El-Sherief A, et al (2011); Imaging of atrial septal defects: echocardiography and CT correlation.

Prasad S. (2003); Ventricular Septal Defect. In: Diagnosis and Management of Adult Congenital Heart Disease, Gatzoulis MA WG, Daubeney PEF (Eds), Churchill Livingstone, Philadelphia.

Warnes CA, Williams RG, Bashore TM, et al. ACC/AHA (2008) Guidelines for the Management of Adults With Congenital Heart Disease.

Webb GD, Smallhorn JF, Therrien J, Redington AN (2010);  Congenital heart disease. In: Bonow RO, Mann DL, Zipes DP, Libby P, Braunwald E, Eds.

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