Introduction to Septal Defects

What is a Septal Defect?

A septal defect is a congenital or acquired hole in the septum, the wall that separates the heart's chambers. There are two main types:

  • Atrial Septal Defect (ASD): A hole in the atrial septum (between the upper heart chambers).
  • Ventricular Septal Defect (VSD): A hole in the ventricular septum (between the lower heart chambers).

Causes and Risk Factors

Septal defects are usually congenital (present at birth) but can also develop due to trauma or complications from heart surgery. Genetic factors, maternal infections, or use of certain medications during pregnancy may increase the risk.

Symptoms

The severity of symptoms depends on the size of the defect: - Small defects: May cause no symptoms and close on their own. - Larger defects: Can lead to heart murmurs, fatigue, shortness of breath, frequent lung infections, and in severe cases, heart failure.

Diagnosis

Diagnosis is often made using: - Echocardiography (ultrasound of the heart) - Electrocardiogram (ECG) - Chest X-ray - Cardiac MRI or CT scan (in complex cases)

Treatment Options

Treatment depends on the defect size and symptoms: - Small ASDs or VSDs may close naturally without intervention. - Larger defects may require surgical closure or catheter-based repair to prevent complications such as heart failure, arrhythmias, or pulmonary hypertension. - Medications (diuretics, beta-blockers) may help manage symptoms, but they do not close the defect.

Possible Complications

If untreated, a septal defect can lead to: - Pulmonary hypertension (high blood pressure in the lungs) - Heart failure - Arrhythmias (irregular heartbeats) - Stroke (especially in ASD due to paradoxical embolism)

Conclusion

Septal defects vary in severity and impact on health. Early detection and appropriate treatment help prevent complications and ensure a good quality of life.

Source recommendations

1. American Heart Association Guidelines on Congenital Heart Defects

  1. https://www.heart.org/en/health-topics/congenital-heart-defects
  2. https://www.ahajournals.org/doi/10.1161/CIR.0000000000000603
  3. https://www.heart.org/en/health-topics/congenital-heart-defects/about-congenital-heart-defects
  4. https://professional.heart.org/en/guidelines-and-statements
  5. https://newsroom.heart.org/news/as-people-born-with-congenital-heart-defects-now-live-longer-challenges-evolve-over-time

2. European Society of Cardiology Guidelines on the Management of Grown-up Congenital Heart Disease

  1. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Grown-Up-Congenital-Heart-Disease-Management-of
  2. https://academic.oup.com/eurheartj/article/42/6/563/5898606
  3. https://pubmed.ncbi.nlm.nih.gov/20801927/
  4. https://academic.oup.com/eurheartj/article/31/23/2915/2398053
  5. https://pubmed.ncbi.nlm.nih.gov/32860028/

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