Atrial Septal Defect
An atrial septal defect (ASD) is a hole in the wall that divides the upper chambers of the heart that is present from birth. It may close on its own, but may also need treatment.
What is an atrial septal defect?
An atrial septal defect (ASD) is a hole in the wall that divides the upper chambers of the heart (the atria), and is present from birth (congenital). The hole can vary in size, and may close on its own, or may need to be treated with surgery.
ASD is one of the most common congenital heart defects and occurs in about 2% of children, often with no symptoms. Our cardiologists see patients with ASD in our dedicated Heart Health centre where they offer the most advanced diagnostics and treatment options.
More information
Whilst ASD is present from birth, many patients do not have any signs or symptoms until later in life, or it may be entirely asymptomatic (symptomless), and only picked up by routine echocardiography.
Signs and symptoms may include:
frequent respiratory or lung infections
difficulty breathing
shortness of breath with exercise
tiredness
being underweight
heart murmurs
swelling of the legs, feet or stomach
stroke
It’s not fully known why some babies are born with this heart defect, although some studies have identified possible risk factors, including:
genetic predisposition
German measles (rubella) during early pregnancy
maternal diabetes
maternal lupus
alcohol or tobacco use during pregnancy
cocaine use during pregnancy
use of some medicines during pregnancy, including those to treat seizures and mood conditions
An ASD is often detected in foetal ultrasounds or during checks made at birth. ASD is often diagnosed in adults when they have an ECG or echocardiogram as part of their routine healthcare, if they have not experienced any symptoms.
If you’re experiencing symptoms of ASD, our cardiologists will talk to you about your symptoms at an initial consultation in our dedicated Heart Health centre. They’ll carry out further tests to fully diagnose your ASD and the extent of the defect.
Diagnosis of an ASD may include:
an ECG to check the heart’s electrical signals
a transoesophageal echocardiogram (TOE) – an ultrasound of the heart
CT or MRI scans of the heart
ASD is a congenital heart condition that usually can't be prevented. However, good prenatal care – like managing health conditions such as diabetes, lupus, and rubella, avoiding alcohol and harmful medications, and not smoking – can help lower the risk of congenital heart defects overall.
Often, ASD is asymptomatic, especially in children. However, if the hole is large and untreated complications may involve:
right-sided heart failure
irregular heartbeats (arrhythmias)
stroke
high blood pressure in the lung arteries (pulmonary hypertension), which can cause permanent lung damage (Eisenmenger syndrome)
early death
Treatment options for ASD will vary depending on your age, symptoms, size of your defect and any other conditions you may have. Your cardiologist will discuss the best next steps for you.
Medication may be offered to treat the symptoms of the defect, such as blood thinners or blood pressure medication, but there are no medications that can close the hole.
In both children and adults, surgery may be needed to close the hole. There are 2 main types of surgery for this:
Open heart surgery
Open heart surgery to repair ASD can usually be done using minimal access techniques, under general anaesthetic, and will mean a few days in hospital.
Device closure
An umbrella device can be used to close the hole under general anaesthesia, using transoesophageal echocardiography (TOE) and X-ray control. This can be done as a day-case procedure or may require an overnight stay, with only a small puncture in the groin.
At Welbeck, our cardiologists are experts in their field and are dedicated to providing world-class care to every patient.
With access to colleagues across other specialties, our consultants are also able to refer within the Welbeck ecosystem if required to ensure you receive the treatment you need as quickly as possible, all under one roof.
All appointments, testing, treatment, and follow-up appointments take place within our state-of-the-art facilities, enabling us to deliver accurate diagnostics and advanced treatments.
Your health is important to us, so we strive to offer same-day appointments whenever possible.
Our consultants are recognised by the major health insurance companies. If you have private health insurance, your treatment at Welbeck can begin once you have obtained authorisation. We also provide care to self-paying patients. Learn more about the different payment options at Welbeck.
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Frequently asked questions
It’s extremely rare for an atrial septal defect to close on its own in adulthood. Typically, if they are going to close on their own, this happens before the age of 2.
Pregnancy increases blood volume and puts extra pressure on the heart. This can often make existing heart conditions worse. If you have an atrial septal defect, it’s recommended to talk to your cardiologist before becoming pregnant so they can monitor you during pregnancy and make sure you receive specialised care.
If you had an atrial septal defect as a child, there’s a slightly increased risk of your child being born with one. However, most ASDs do not have a clear inherited cause. If you have a family history of ASDs, genetic screening before becoming pregnant can help to assess the risk. A foetal heart ultrasound can be used to detect any issues early.
Many people with an atrial septal defect can still exercise, especially if the defect is small or has been repaired, but it's important to check with your cardiologist that your exercise routine is appropriate for your heart health.