Do infant atrial septal defects heal by themselves?

Written by Tang Li
Cardiology
Updated on September 18, 2024
00:00
00:00

Atrial septal defect is a common congenital heart disease, accounting for about 1/1500 of newborns, and is most commonly found in infants and children. The impact of atrial septal defects on hemodynamics mainly depends on the amount of shunting. Some studies confirm that atrial septal defects smaller than six millimeters can close on their own without external intervention. Therefore, when an atrial septal defect is discovered, it is necessary to regularly recheck the cardiac echocardiography to determine the size of the defect. If the atrial septal defect decreases in size as the patient ages, there is a possibility of self-healing. If the area of the patient's atrial septal defect does not change or gradually increases, regular echocardiography rechecks are needed, and cardiac catheterization may be performed if necessary.

Other Voices

doctor image
home-news-image
Written by Tang Li
Cardiology
1min 8sec home-news-image

Is atrial septal defect common?

Atrial septal defect accounts for about 20%-30% of all congenital heart diseases and is more common in females. Many cases are mild in children and are not discovered until adulthood. Atrial septal defects can be classified based on anatomical abnormalities into patent foramen ovale, primary atrial septal defect, and secondary atrial septal defect. A patent foramen ovale generally does not cause shunting between the two atria. A primary atrial septal defect is located at the lower part of the atrial septum, is semicircular in shape, and is often larger, frequently associated with malformation of the mitral or tricuspid valves resulting in regurgitation. A secondary atrial septal defect is situated in the middle of the atrial septum at the fossa ovalis or near the superior and inferior vena cava. The symptoms of an atrial septal defect vary with the size of the defect; minor cases may be asymptomatic, while severe cases can result in heart failure.

doctor image
home-news-image
Written by Tang Li
Cardiology
51sec home-news-image

Can a ventricular septal defect heal itself?

Traditional views suggest that the best age to close atrial septal defects (ASDs) is between four and five years old, during preschool. The possibility of spontaneous closure of atrial septal defects larger than 8 millimeters in diameter is very low. If the defect is less than 4 millimeters, there is a possibility of healing. Currently, it is advocated that if an atrial septal defect still exists after the age of one year, and there is evident systolic murmur and fixed splitting of the second heart sound, or if heart catheterization and echocardiography show left-to-right shunting greater than 1.5:1, indicating a defect diameter of five to six millimeters or more, early surgery should be pursued to stop the left-to-right shunt to avoid causing pulmonary hypertension and endocarditis.

doctor image
home-news-image
Written by Di Zhi Yong
Cardiology
59sec home-news-image

Can babies with ventricular septal defect sleep on their stomachs?

If the child has an atrial septal defect, it is not recommended for them to sleep on their stomach because this position can increase the burden on the heart, leading to an overload of the heart. This is a type of congenital heart disease. Currently, surgical treatment is primarily recommended, as early surgical intervention can alleviate the symptoms in children. Patients with ventricular septal defects typically display signs of ischemia and hypoxia, which can affect a child’s growth and development. It is advised to periodically re-examine the heart through echocardiography. If the defect is relatively large, early surgical treatment is recommended. It is also important to actively prevent upper respiratory infections, which can be beneficial for the child. In terms of sleeping posture, it is not recommended to sleep on the stomach; the best position is lying on the left side, as this can help alleviate the burden on the child’s heart.

doctor image
home-news-image
Written by Cai Li E
Cardiology
1min 38sec home-news-image

Atrial septal defect can cause which complications?

Small atrial septal defects generally are asymptomatic, whereas medium to large atrial septal defects may result in pulmonary hypertension and right heart failure. The impact of an atrial septal defect on hemodynamics mainly depends on the amount of shunting, which in turn is determined by the size of the defect. It also relates to the compliance of the left and right ventricles and the relative resistance of the systemic and pulmonary circulation. Continued increase in pulmonary blood flow leads to pulmonary congestion, increasing right heart volume load. Pulmonary vascular compliance decreases, evolving from functional to organic pulmonary hypertension. This in turn continuously increases right heart system pressure until it surpasses the pressure of the left heart system, causing the original left-to-right shunt to reverse to a right-to-left shunt, leading to cyanosis. Atrial septal defects are generally asymptomatic but with the progression of the condition, symptoms such as exertional dyspnea, arrhythmias, and right heart failure may occur. In the advanced stages, about 15% of patients with severe pulmonary hypertension exhibit a right-to-left shunt and cyanosis, leading to the formation of Eisenmenger syndrome.

doctor image
home-news-image
Written by Zhang Zhi Gong
Cardiothoracic Surgery
1min 12sec home-news-image

The difference between ventricular septal defect and atrial septal defect

The difference between a ventricular septal defect and an atrial septal defect mainly lies in their locations. A normal heart is divided into four chambers, which are the left ventricle, right ventricle, left atrium, and right atrium. Each chamber is separated by a septum, much like walls between rooms in a house. Due to certain reasons, such as congenital heart defects, there may be openings or defects in these walls, known as septal defects. An atrial septal defect refers to a defect between the right atrium and the left atrium, whereas a ventricular septal defect pertains to a defect between the left and right ventricles. The murmur of atrial septal defects is relatively softer, as the pressure difference between the atria is smaller, and the defect is located higher up. In contrast, the murmur of ventricular septal defects is louder due to the greater pressure difference between the ventricles and is located lower down, approximately between the third and fourth ribs. The murmur of atrial septal defects is found between the second and third ribs. Moreover, since the pressure difference in ventricular septal defects is greater, the impact on the heart is relatively more significant.