Do infant atrial septal defects heal by themselves?

Written by Tang Li
Cardiology
Updated on September 18, 2024
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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.

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Written by Tang Li
Cardiology
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Can medication be taken for atrial septal defect?

Patients with small atrial septal defects and no related symptoms, pulmonary hypertension, or ventricular enlargement generally do not need specific medication. If symptoms do occur, interventional or surgical treatment should be chosen. Medication is necessary only if there is accompanying heart failure, pulmonary infection, or arrhythmias such as atrial fibrillation. In the case of infections like pneumonia or infective endocarditis, appropriate antibiotics or antiviral medications should be actively used. When heart failure occurs, medications to control arrhythmias, such as vasodilators, diuretics, and agents to control ventricular rate, are required.

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Written by Li Hai Wen
Cardiology
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Can a ventricular septal defect have a vaginal delivery?

Atrial septal defect is a relatively common congenital heart disease in adults. Therefore, when women are diagnosed with this condition, they often ask their doctor one question: "Can I give birth naturally?" This question requires a case-by-case analysis. If the atrial septal defect is not severe, does not cause changes in the heart structure, or lead to heart failure, then natural childbirth is definitely possible. However, if the atrial septal defect is severe and causes changes in heart structure, such as pulmonary hypertension or heart failure, then natural childbirth is generally not advisable. It is best to opt for a cesarean section under the guidance of a doctor to alleviate the burden on the pregnant woman and reduce the occurrence of serious incidents.

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Written by Tang Li
Cardiology
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How does septal defect shunt?

Atrial septal defect is the most common congenital heart disease in adults, accounting for 20%-30% of all adult congenital heart conditions. The impact of an atrial septal defect on hemodynamics primarily depends on the amount of shunting. Due to higher pressure in the left atrium compared to the right atrium, a left-to-right shunt is formed. The amount of shunting depends on the size of the defect, as well as the compliance of the left and right ventricles and the relative resistance in the systemic and pulmonary circulations. Diseases that affect the compliance of the left ventricle, such as hypertension and coronary artery disease, can increase the extent of the left-to-right shunt. A continuous increase in pulmonary blood flow leads to pulmonary congestion, increasing the load on the right heart. Pulmonary vascular compliance decreases, progressing from functional pulmonary arterial hypertension to organic pulmonary arterial hypertension. As right heart system pressure continuously increases and eventually exceeds the pressure in the left heart system, the original left-to-right shunt reverses to become a right-to-left shunt, resulting in cyanosis.

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Written by Zhang Zhi Gong
Cardiothoracic Surgery
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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.

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Written by Di Zhi Yong
Cardiology
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Does ventricular septal defect affect growth and development?

Because atrial septal defect is a type of congenital heart disease, if the patient's congenital heart disease is very severe, surgical treatment is needed. Atrial septal defect does have some impact on growth and development, as congenital heart disease can cause infections or pulmonary inflammation in patients, which can lead to developmental delays in children. Personally, I recommend that if it is a type of congenital heart disease, especially atrial septal defect, it is better to have surgery early, as this can avoid impacting growth and development. After the surgery, there are no sequelae, and it does not affect growth and development. However, not undergoing surgery can impact growth and development.