Atrial Septal Defect (ASD)

Atrial Septal Defect (ASD)

Atrial Septal Defect (ASD) and Patent Foramen Ovale (PFO)

Atrial septal defects (ASD) and Patent Foramen Ovale (PFO) are connections between the right and left side of the heart.

An ASD, often referred to as a “hole in the heart” is an opening which allows oxygenated and deoxygenated blood to mix, called a shunt. It is the gradient of this shunt and the severity of symptoms which will determine the course of treatment.

A PFO is a hole in the heart which did not close as it should after birth. It is common, but usually presents no symptoms and can go undetected and found during routine assessments.

What are the symptoms of ASD and PFO?

Patients with these connections may present with palpitations, shortness of breath, leg swelling, migraines or history of stroke.

What assessment do I need if I have ASD and PFO?

The first investigations to consider for the formal diagnosis is a bubble echo study to visualise whether microbubbles, which are injected into the blood supply, pass through the PFO. Transoesophageal echo may also be used to accurately assess the hole.

A CT and/or MRI may also be considered if the echocardiogram does not visualise the pulmonary venous anatomy sufficiently.

What are the treatments for ASD and PFO?

These connections can be closed with minimally invasive techniques or with open heart surgery. The need to close the hole will be weighed up depending on current or future risks and symptoms.

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