Atrial and Ventricular Septal Defects
Incomplete septal separation between the right and left chambers of the heart, resulting in abnormal connections (hole in the wall) allowing the mixing up of oxygenated and deoxygenated blood, are referred to as atrial and ventricular septal defects.
- Septal defects occur in infants when the connections between the right and left chambers of the heart are not closed before birth.
- Most of the minor septal defects are asymptomatic and the holes may close spontaneously without any treatment.
- The typical symptoms lead to the diagnosis, and an echocardiography confirms it. Surgical closure may be necessary to treat serious septal defects.
Atrial septal defects occur in the wall separating the upper left and upper right chambers of the heart into which blood is emptied. A defect in the septum between the left and right ventricles which pump blood out of the heart is termed ventricular septal defect. These abnormal connections between the left and right chambers of the heart result in left-to-right shunting. Mostly, ventricular septal defects may close by the time the infants turn two. Defects in the atrial septum may close earlier, usually within the first year itself.
Septal defects may remain asymptomatic in infants and children. Children who are diagnosed with small septal defects should have echocardiography every year. If the defect is severe, some children may have fatigue, heart murmurs, and breathing difficulty. Occasionally, stroke may be the first indication of a septal defect. Children with atrial septal defects may have a worsening of the symptoms as they grow. Even heart failure can occur in a middle aged person with this condition.
Small ventricular septal defects may be asymptomatic or may have mild symptoms such as a heart murmur. They may close up eventually. However, a larger defect can result in severe symptoms in the infant. Ventricular septal defects result in more left-to-right shunting when compared to atrial septal defects, hence symptoms are also more severe.
It may cause heart failure and frequent infections in the lungs. Shunting usually increases in the first few weeks of life because of the typical way lung development progresses. The symptoms such as difficulty in feeding, rapid breathing, and sweating may become worse. Heart murmur may become louder too.
When symptoms indicate septal defects, echocardiography is done to confirm the condition. Diuretics like furosemide are used to treat the symptoms due to smaller septal defects. Captopril is a drug which lowers the resistance to the blood flow from the heart to the body. Large septal defects, and those which do not get closed in the early years of life, are surgically repaired.
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Yasser Elnahas
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