Atrial Septal Defect (ASD) Community
Grade 1 Diastolic Dysfunction Post ASD Repair
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WELCOME to the ATRIAL SEPTAL DEFECT COMMUNITY: This Patient-To-Patient Community is for discussions relating to Atrial Septal Defect (ASD) which is a hole in the part of the septum that separates the atria (the upper chambers of the heart). This hole allows oxygen-rich blood from the left atrium to flow into the right atrium instead of flowing into the left ventricle as it should. This means that oxygen-rich blood gets pumped back to the lungs, where it has just been, instead of going to the body.

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Grade 1 Diastolic Dysfunction Post ASD Repair

Greetings,

I am a 47 year old male who had an 18mm ASD repaired using a 22mm Amplatzer device a little over 7 months ago.  Good news: device is in place upon echo, with no intracardiac shunt.  Bad news: I experience dizziness on standing up from a sitting (but not from a lying down) position; dizziness that makes me feel that loss of consciousness will surely follow, and tire easily.  I have only fainted once, 3 weeks following the transcatheter closure - due to prescription of metoprolol that caused bradycardia, that was later discontinued (and symptoms abated).  As a child fainting was common for me, but it abated, and I was never diagnosed with ASD until I turned 46.  

Comparison of the echo reports from one month prior to the closure to 7 months post closure shows two things that concern me: (i) the post-closure report states "Spectral dopler shows impaired relaxation pattern of LV diastolic filling (grade 1)" - the pre-closure report read "Spectral dopler shows normal pattern of LV diastolic filling"; and (ii) the E/A ratio post closure is 0.67, with mitral valve deceleration time of 222 msec.  The E/A ratio pre-closure was 1.59, and MV decel time 248 msec.

There appears to be some diastolic dysfunction post closure; ought not the E/A ratio be > 1?  (1) Is this normal considering the operation, and time since?  Did closure cause this? (2) Will I progress (deteriorate) to "grade 2", then "grade 3"? (3) Are my syptoms (symptoms) related to the difference in diastolic function? (4) Is there anything that can/should be done nutitionally/pharmacologically, etc., to prevent futher deterioration and/or improve my symptoms?

Be happy to provide other numbers; can't think right now which would be helpful.  Many thanks.

GB
Tags: diastolic dysfunction ASD, asd closure, diastolic function changes
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