Atrial septal defect (ASD), is a heart condition that can affect kids.
Normal Heart Function
To understand an ASD, it helps to know how the heart works. The heart has four chambers. The lower chambers of the heart are called the ventricles: a left ventricle and a right ventricle. The upper chambers are the atria and there are two— a left atrium and a right atrium.
You may already know that your heart is a muscle that pumps blood throughout your body. In a person without a heart defect, blue blood that's low in oxygen flows first to the right atrium, then to the right ventricle, and is then pumped to the lungs to receive oxygen.
The red oxygen-rich blood then returns to the left atrium, flows from there into the left ventricle, and heads out to the body through the aorta, a large blood vessel that carries blood from the heart to the smaller blood vessels in the body.
Between the right and left atria is a wall called the septum that normally separates the blue and red blood.
Atrial Septal Defect
In a person with an atrial septal defect, there's an opening in that wall that separates the blue and red blood. This hole in the wall lets oxygen-rich blood from the left atrium mix with oxygen-poor blood on the other side. The extra blood that ends up crossing through the hole and flowing through the heart and out to the lungs changes the normal "lub-dub" sounds the heart makes and causes an extra swishing sound, which is called a heart murmur. These sounds may be the only clue that a kid has an ASD.
Symptoms
Many kids with an ASD don't have any problems or symptoms because of it. Occasionally, a kid with a very large ASD might have a poor appetite, may tire easily, may grow slowly, can experience shortness of breath, or have lung problems, like pneumonia. In our case, baby girl has always been very active, appetite was good but her weight gain started to stagnate at some point but thankfully we had already detected the reason at 5 months.
ASD Is One of the More Common Heart Defects
About 1 in every 100 babies is born with some type of heart defect. Atrial septal defects are one of the more common types of these heart defects. Out of the different heart defects, we were told it’s the best type of hole in the heart..but for us a hole is a hole right? A person could be diagnosed with an ASD in infancy, childhood, during their teen years, or even as an adult. Samara’s was discovered at 5months by a God sent doctor who detected the murmur when she had a throat infection. We had taken her coz of the throat infection but the doctor thought we already knew baby girl had a murmur. When she mentioned it, we were shocked as she had not presented any symptoms.
Risks of ASD
In some kids with small-sized atrial septal defects (small-size holes), the hole can close up on its own. Most kids with a medium-sized or large-sized ASD will need some kind of procedure to close the hole.Samara's hole was quite big and we knew that it needed some form of closure at age two. If the hole is left open, later in life that person may develop other kinds of heart problems, such as an abnormal heartbeat. The person also could develop serious damage to the lung blood vessels. The risk of having a stroke, a problem where a clot or air bubble clogs up a blood vessel in the brain, is also increased in someone with an ASD. To prevent these problems, doctors often recommend closing the hole while the kid is still young, ideally before school going age, as you know the flus, colds, coughs are quite a number once they start school.
What Causes an Atrial Septal Defect?
Atrial septal defects develop when a baby is still growing inside its mother. Before birth, the heart begins as a large tube that folds and divides into sections that will eventually become the walls and chambers of the baby's heart. If a problem occurs during this process, a hole may develop in the wall between the left atrium and right atrium.
In some cases, the tendency to develop an ASD may be inherited, or genetic. In other cases, an ASD might happen if the pregnant woman was exposed to chemicals or drugs while the baby was growing in her uterus. For most kids with ASDs, no one knows why they developed this problem.
For baby girl’s case, we suspect that I was exposed to some strong drugs in the first few days of our pregnancy. As most first time pregnancies, I was having some discomfort on my side but wasn’t aware we were pregnant. We were sent by a gynecologist for an ultrasound and they misdiagnosed me. The csan showed I had lots of fluids and the radiologist assumed that it was something else, yet it was our baby growing inside. So when I went to the gyna, he did not agree with the results but to be on safe side diagnosed a very strong drug which I took once then continued with another for 1 week. The side effects were abit worrying and I asked Alex we buy a pregnancy kit and it showed we were pregnant. We told the doctor who said congratulations and stop taking the drugs of which I had stopped even before then, but guess it was too late. Of course as baby grew, we mentioned to a different gyna..about the strong meds but he said all was well and the pregnancy wasn’t complicated at all. When we later discovered about the murmur, the cardiologist said it could be that but the truth is that no one really knows the cause of ASDs.
What Do Doctors Do?
Kids who have ASDs may first find out that they have a heart murmur when examined by their regular doctor. The next stop is usually to a pediatric cardiologist ,a doctor who specializes in diagnosing and treating heart disease in kids and teens.
The pediatric cardiologist will ask about the kid's medical history (the mother's health during pregnancy and illnesses the kid has had). The cardiologist also will do an exam and listen to the kid's heart. If a doctor thinks a kid may have an ASD, these tests (which don't hurt) might be done:
- chest X-ray, which produces a picture of the outline of the heart and surrounding organs in the chest
- electrocardiogram (EKG), which records the electrical activity of the heart
- echocardiogram (echo), which uses sound waves to create a picture of the inside of the heart( ultrasound of the heart)
In some kids, the doctor may recommend regular follow-up visits to see if a small defect will close on its own. A kid with aASD usually can participate in sports and other regular activities without restrictions.For us we did have 6months reviews with the cardiologist which were always tense but the doctor handled us so well. Samara had no restrictions and has always had the energy of two babies.
What If The Hole Doesn't Close on Its Own?
If the hole needs to be closed, the doctor will decide whether the kid needs surgery or a cardiac catheterization. With either one, the kid will get special medicine called anesthesia that causes sleepiness and prevents pain during the operation.
Open Heart Surgery
In ASD surgery, the doctor repairs the hole with stitches or a patch made out of either surgical material or the body's own tissue. A kid may have to spend a few days in the hospital after surgery. We spent about 10days in hospitals.Within about 6 months, the tissue of the heart heals over the patch or stitches.Our surgeon said it would take 8 weeks to completely heal, he said it is more like a fracture.
Cardiac Catheterization
Another way to fix the hole is cardiac catheterization. This method uses a thin, flexible tube called a catheter. The cardiologist inserts the catheter into a blood vessel in the leg that leads to the heart. The cardiologist then guides the tube into the heart and inserts a device that covers the hole in the heart. The device is made out of metal mesh and is springy and flexible. The kid usually will spend a night at the hospital after the procedure. As with surgery, over time the heart's natural tissue will grow to completely cover the device.
Good News
Kids who have had surgery or cardiac catheterization will need to follow their doctors' instructions about taking it easy for a while. But after just a few weeks, kids can return to their normal activities.
Kids with ASDs rarely have any further heart problems. Our doctor said that heart issues are a thing of the past for baby girl and she will lead her life as normal. So we agree that ASD now can stand for : awesome, super, and dazzling!
Reviewed by: Steven B. Ritz, MD
Comments
Nancy
Thanks babe too for opening your heart...i know someone will get to find the same to be quite helpful.