Heart Disease Expert Forum
ASD
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ASD

  I was recently diagnosed with ASD, and have had a heart cath which confirmed the defect.  My opening is 1.6cm, and I have received different opinions from my docs.  My internist says that surgery is definitely indicated; the cardiologist who did the heart cath says surgery is not needed; and my regular cardiologist is researching the condition. He said that if the defect was 1cm or smaller, that surgery would not be indicated, and if the defect was 2cm or larger, then surgery would definitely be indicated.  Since my defect is 1.6cm, I am on the borderline. The right side of my heart is enlarged, my blood pressure is high, I experience shortness of breath when doing some normal activities (like climbing stairs, or carrying groceries), have frequent headaches and do become light headed at certain times, and sometimes experience heaviness in my chest,and have attacks of tachycardia.  My pulse rate is extremely high. If I don't have the surgery, what are the risks later in life (I am a 49 year old female)?  And if I do have the surgery, will most of my symptons disappear?  Thank you for any help-I am confused!
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Dear Hannah
To give an intelligent opinion, a cardiologist would need to review your echo and catheterization data. However, based on what you have written, it would seem to me that closing the ASD would be the sensible thing to do. Studies have shown that closing an ASD, even in an adult, is likely to prolong their lifespan. It should help the shortness of breath and should keep the right side of the heart from enlarging. It sometimes makes the palpitations better, but even after ASD closure, you remain at risk of arrhythmia. Importantly, our pediatric interventional cardiologists are closing ASDs (in adults) in a procedure like a catheterization, with a sealing device - this avoids the need for surgery. You really ought to look into this possibility.
I hope this has been useful. Feel free to write back with further questions. Good luck.
Information provided here is of a general nature.  Specific diagnoses and treatments can only be made by your doctor.  If you would like to be seen at the Cleveland Clinic, please call 1-800-CCF-CARE for an appointment with a cardiologist at Desk F15.





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