Atrial Septal Defect
Defects of the secundum type of atrial septal defect usually go undetected in the first year or two of life because of the lack of symptoms and unimpressive auscultatory findings. A soft systolic murmur is the usual reason for referral. Symptoms become more common in persons in their late teens and twenties, and by age 40 the majority of these individuals are symptomatic, some severely so.
- What Are Holes in the Heart ?
- Types of Holes in the Heart
- How Are Holes in the Heart Diagnosed
- How Are Holes in the Heart Treated?
- Living With Holes in the Heart
- Key Points
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How Are Holes in the Heart Diagnosed?
Holes in the heart are usually diagnosed based on results from a physical exam and special tests. The exam findings for an atrial septal defect often aren't obvious, so the diagnosis is sometimes not made until later childhood or even adulthood. A ventricular septal defect has a very distinct heart murmur, so this diagnosis is usually made in infancy.
Antenatal diagnosis
An increasing number of cases of congenital heart disease are now diagnosed before a baby is born. This can be done by carrying out a foetal echocardiography.
A foetal echocardiography is a type of ultrasound scanner that has been specially designed to build a picture of the insides of the chambers of the heart.
Foetal echocardiography should be carried out during routine antenatal examinations, usually some time between the 18th and 20th week of pregnancy.
However, it is not always possible to detect heart defects (particularly mild ones) using a foetal echocardiography.
Postnatal diagnosis
If a baby is born with cyanotic heart disease, a diagnosis can usually be made quickly and confidently due to the distinctive blue colour of their skin.
If your baby is born with acyanotic heart disease, their symptoms may not become immediately apparent for several months, or possibly years, after birth. In some types of acyanotic heart disease, symptoms are not apparent until a child reaches three years of age.
Possible signs that your child may have acyanotic heart disease include:
- - problems feeding,
- - slow growth,
- - shortness of breath after exercising,
- - tiredness after exercising, and
- - swelling of their hands, feet and ankles.
You should contact your GP if your child has any of the above symptoms. Further testing can confirm or disprove a diagnosis of congenital heart disease.
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Specialists Involved
Doctors who specialize in heart problems are called cardiologists. Pediatric cardiologists take care of babies and children who have heart problems. Other specialists who treat heart defects include cardiac surgeons.
Physical Exam
During a physical exam, the doctor:
- - Listens to your child's heart and lungs with a stethoscope
- - Looks for signs of a heart defect, such as a heart murmur or signs of heart failure
Diagnostic Tests and Procedures
The doctor will order several tests to diagnose an ASD or VSD. These tests also will help the doctor determine the location and size of the defect.
This test, which is harmless and painless, uses sound waves to create a moving picture of the heart. During echocardiography, ultrasound waves bounce off the structures of the heart, and then a computer converts them into pictures on a video screen. The test allows the doctor to clearly see any problem with the way the heart is formed or the way it's working.
Echocardiography is an important test for diagnosing a hole in the heart and for following the problem over time. This test shows problems with the heart's structure and how the heart is reacting to these problems. Echocardiography helps the cardiologist decide whether and when treatment is needed.
EKG
An EKG (electrocardiogram) detects and records the electrical activity of the heart. This simple and painless test is used to assess the heart rhythm. An EKG shows how fast the heart is beating and whether the heart's rhythm is steady or irregular. It also can detect enlargement of one of the heart's chambers, which can help to diagnose a heart defect.
Chest X Ray
A chest x ray takes a picture of the heart and lungs. It can show whether the heart is enlarged or whether the lungs have extra blood flow or extra fluid, which can be a sign of heart failure.
Pulse Oximetry
Pulse oximetry shows how much oxygen is in the blood. A sensor is placed on the fingertip or toe . The sensor is attached to a small computer unit, which displays a number that indicates how much oxygen is in the blood.
Cardiac Catheterization
During cardiac catheterization, a thin, flexible tube called a catheter is put into a vein in the arm, groin, or neck and threaded to the heart. A dye that can be seen on an x ray is injected through the catheter into a blood vessel or a chamber of the heart. This allows the doctor to see the flow of blood through the heart and blood vessels on the x-ray image.
Cardiac catheterization also can be used to measure the pressure inside the heart chambers and blood vessels and can determine whether blood is mixing between the two sides of the heart. It's also used to repair some heart defects.