Atrial Septal Defect (ASD)

Basic Facts

ASD is a hole in the wall (septum) between the 2 upper chambers of the heart (atria), due to the failure of tissue completely forming between the atria as a fetus.
It is the most common congenital heart lesion in adults and is often asymptomatic until adulthood.

An ASD is different than a PFO, which is a normal hole in the heart of a fetus that does not close properly at birth. ASD’s are typically larger, in a slightly different location, and more likely to cause problems, especially larger ones.

Symptoms will vary depending on the size of the ASD:

Large- or medium-sized ASD left untreated can cause symptoms later in life, usually by age 40. These symptoms may be palpitations, decreased exercise tolerance, shortness of breath, or skin that looks blue (cyanosis).

It is congenital, meaning a person is born with it.

Chest x-ray
Echocardiogram – This test uses sound waves to create a moving picture of the heart, showing its size and shape, as well as how the heart chambers and valves are working.

Closed most often via Cardiac catheterization: a small tube (catheter) is inserted up a blood vessel into the heart chambers to close the hole.
- Small ASD’s can be closed using a special thread made of a polymer material
- Large or medium-sized ASDs are closed with a patch that is made of synthetic fabric, the patient’s own pericardium, or pericardium from a cow or other animal.
Patients with ASD’s are at increased risk of atrial fibrillation and atrial flutter, particularly if defect closure occurs after age 25.

Patients with an ASD that is not repaired will need to see their cardiology team regularly. How often depends on the patient’s situation, more often if there are symptoms or other heart problems.

Patients with an ASD do not need antibiotics for dental visits, unless it was due to prior endocarditis (infection in the heart).

Once the ASD is repaired, antibiotics prior to dental visits are recommended for at least six months afterwards.