If large secundum type atrial septal defect caused enlargement of right atrium and ventricle with moderate tricuspid regurgitation and moderate elevation of right ventricular systolic pressure, how serious this problem is? Does it need to be treated right way? What happens if not treated right way?
I assume you know the structual anomaly of ASD. If the hole beween the right and left atria is small, the pressure of the left side will force some oxygenated blood into the rightside. The oxygenated blood with the unfiltered blood will go to the lungs and no problem. But when the hole is larger, and when the right side chamber increases in size the pressure is now greater than the left atrium will shunt (pass) and unfiltered blood back into circulation. This in itself will cause a medical problem.
Complications of an uncorrected secundum ASD include pulmonary hypertension, right-sided heart failure, atrial fibrillation or flutter, stroke, and Eisenmenger's syndrome. Right sided heart failure begins with an enlarged right ventricle and high systolic pressure. An enlarged right ventricle will lose contractility and not adequately pump enough blood to the lungs. This decrease of blood to the lungs will reduce the amount of blood from the lungs to the left ventricle to be pumped into circulation. The reduced cardiac output will cause heart failure. Also a problem is tricuspid regurgitation. This adds to the reduction of blood pumped to the lungs, as some blood flows backward into the right ventricle rather than to the lungs.
Heart problems related to ASD include right heart chamber enlargement, blood leaking backwards in the valve between the right heart chambers (tricuspid valve regurgitation), heart failure, pulmonary hypertension, atrial fibrillation or stroke. So it should be treated without much delay. Actually, treatment should have been done before there was a right heart enlargement.
Hope this helps, and thanks for sharing. If you have any further questions, you are welcome to respond. Take care.
Hi. Patients with moderate to large defects should have ASD closed ideally between ages 2 to 6 years of age. ASDs repaired during childhood have lower perioperative mortality rate and improved long-term survival rates. However before repair, patients with large shunts and heart failure should be treated with medications (e.g. digoxin, diuretics or ACE inhibitors). On the contrary, uncorrected secundum may lead to increased risk of infections (e.g. viral meningitis), blood clots (emboli) and poor gas exchange (similar to decompression sickness). To know more about ASD, it might be best to talk to your cardiologist about it. Hope this helps.
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