ASD again?

[CHADDY]

Not long ago I was diagnosed with an Atrial Septal Defect.  When the dr. did the heart cath. about 1 1/2 months ago it closed while he was looking at it through the camera.  The symptoms subsided somewhat after that.
However, recently I am having shortness of breath, palpitations, tightness in my chest, a feeling like I am breathing but not getting any breath (if that makes sense), fatigued most of the time and easily winded.  When I walk a short distance I am out of breath.  When I lay down I can't breathe well.  And lastly sometimes when I walk I feel like I am "walking through mud".  It feels like I am being held back.  Does that make sense?
I am wondering:
1.  Is it possible for an ASD to come open again?
2.  Can an ASD open and shut randomly?  If so, what is the possiblity of this happening?
3.  What are the surgical options for an ASD?  The dr. that I went to at first said that it could only be corrected with open heart surgery, according to the kind I have, but are there any new procedures that I should check in to if it has come open, if possible?
4.  what does a murmur sound like through a stethascope?  I listened to it last night and it sounded like every 2nd beat of the heart was accopanied with another tiny thump noise.  

Any info is certainly appreciated to help put my mind at rest.  If it is not something like this, please advise me of anything else that it could possibly be.

Thank you very much!
Chad

[CCF-M.D.-RCJ]

Chad,

Thanks for the questions.

I don't fully understand what you mean when you say that the ASD closed while the doctor was looking at it.  It does not sound like that you were implying that he "closed" it, so I'll assume that the doctor thought that it just happened to close during the inspection.

(1,2) A better question is "do ASDs spontaneously open and close?"  The answer is sometimes.  The flow through an ASD depends on the pressures in the heart.  These pressures change depending on many things, such as your activity, your position, which medications you are taking, etc.  I think that it is possible that you have an ASD that either opens/closes spontaneously depending on the pressures in your heart, or that the ASD actually never closed.

(3) Some ASDs can be closed with percutaneous devices that require catheterization, not surgery.  Your potential candidacy for one of these devices would best be determined by an expert.  Centers with special interest in this regard include the Cleveland Clinic and Massachusetts General Hopsital, among others.

(4) What does the wind sound like?  If I could tell you how to interpret your heart sounds in a paragraph, I would have a very marketable description indeed.  Doctors spend careers perfecting their skill in auscultation.  Moreover, ASDs can be difficult to detect even by the skillful cardiologist.

The description you provided of your symptoms could indicate something that would range from the very benign to more serious.  Return of the ASD is certainly within the realm of possibilities as a potential cause of your symptoms.  You need to see your doctor to discuss them.

Hope that helps.

[CHADDY]

Also do you now of any place that I can find info on adult ASD so I can get some info about it from there as well? thank you

[mollielaw]

I had an ablation in 98 for wolffe parkison white and then found out i have ASD. THey said that PVCs are normal. I hate the way they make me feel. Is there any thing to stop PVCs? Doctor said meds would help but iam pregnant and would like to stay drug free. I get chest pains sometimes but I am always told this is normal when I go to hospital. Dose ASD incrase chances of more heart ailments? by the way i dont drink caffien or eat choclate the Pvcs just start for no reasons.

Mollie

[KWD]

Hi, I also had WPW ablation. I was very lucky because no tests were taken in the time taken and so I was misdiagnosed and told I was suffering from Panic Attacks. I continued to get very bad arrythmias up to 200 bpm and one night was admitted to A&E where the diagnosed correctly and therefore was scheduled for an emergency ablation. Since the operation I have suffered from chest pain (specific area) and worsening symptoms over the past two and a half years. The sympoms now are so bad that I have had to stay home and now have been unemployed for over three months.  Recently, it has been brought to my attention that I have Parosysmal re entry tachycardias linked to AV nodal circuit.  I have not had a bad episoded for three months though I continue to experience all the other symptoms especially fatigue and breathlessness.(among other symptoms)

I get the same symptoms.  Shortness of breath, tightness in chest, breathing like I cannot get air in. Constant fatigue and cannot walk far without feeling like I am going to collapse.
I've had various tests to try and figure out what is happening.
It strikes me as coincendental many people with ASD have these particular symptoms.  How do you diagnose such a condition?

[KWD]

Hi, I also had WPW ablation. I was very lucky because no tests were taken in the time taken and so I was misdiagnosed and told I was suffering from Panic Attacks. I continued to get very bad arrythmias up to 200 bpm and one night was admitted to A&E where the diagnosed correctly and therefore was scheduled for an emergency ablation. Since the operation I have suffered from chest pain (specific area) and worsening symptoms over the past two and a half years. The sympoms now are so bad that I have had to stay home and now have been unemployed for over three months.  Recently, it has been brought to my attention that I have Parosysmal re entry tachycardias linked to AV nodal circuit.  I have not had a bad episoded for three months though I continue to experience all the other symptoms especially fatigue and breathlessness.(among other symptoms)

I get the same symptoms.  Shortness of breath, tightness in chest, breathing like I cannot get air in. Constant fatigue and cannot walk far without feeling like I am going to collapse.
I've had various tests to try and figure out what is happening.
It strikes me as coincendental many people with ASD have these particular symptoms.  How do you diagnose such a condition?

[CHADDY]

An echocardiogram is a good way to start but the heart catheter is a definite way to rule it out.  Best wishes to you!  chad

[SSS]

I've been reading the archives and found almost my exact ASD diagnosis posted in September 1998 by "Christy!" Astounding! Just so you know -- I'm 43 with a repaired ASD Ostium Primo, cleft Mitral valve -- the opening was "the size of a quarter" per the surgical report.  I was 18 years old when it was fixed -- #100 patient of the guy who perfected the technique of using a synthetic patch (dacron/teflon -- basically non-stick velvet).  The surgery was done 6/6/78 at Columbia Presby NYC by Fredrick Bowman.  And, he said then I would only need to be seen by my local cardiologist once and then not again "until I wanted to get pregnant."  He also told me the only thing I could not do in life was "play linebacker for the Green Bay Packers!"  (I'm a female from CT -- why would I WANT to do that anyway?) So, I didn't see a cardio again until I was ready to have a baby -- that was 20 years later!  (Yes, she STRONGLY admonished me!) And, this Cardiologist added me to some study and she tells me I've had "one of the best results ever -- better than people who've had these done far more recently with far more advanced technology available!  (I could KISS Dr. Bowman!)  And, she told me to go get pregnant!  (And, that I could push!) So, I have a daughter now, too.


That brings me to the answer Christy was given back in 1998 -- actually YES migrane headaches can and are caused by ASD with mitral valve insufficiency!  That was how mine was detected!  And, all the "top docs" at the time agreed -- St. Francis Hospital in Hartford CT (Pediatric Cardiologists) and Dr. Bowman at Columbia-Presby.  I had migranes and a heart murmur.  Post-op, no more migranes and a murmur virtually "indetectable" except I squeak a little now that I'm "middle-aged" and had a baby.  AS for having that baby -- that's what made me decide to get it fixed at 18 years old -- someday I wanted to have a baby and not go through what #101 went through the day I had my surgery.  That is, she had an unrepaired ASD that went bad -- Dr. Bowman was working on her heart on one end while they were delivering her by c-section on the other.  That was the first thing he told me when I woke up to illustrate "you made the right decision."  Everyone has to decide for themself but the odds have got to be better now almost 25 years later.

Thanks -- I just had to get that off my chest!