Pediatric Heart Expert Forum
4mm ASD
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4mm ASD

Dear Sir.
            My son was born on October 22nd 2009,we were able to diagnose his ASD on November 14th.He underwent echo.The first echo report states that he has ASD measuring about 4mm with L-R shunt.To reconfirm I consulted another Cardiologist on December 5th 2009,in which the report states that it is PFO WITH L-R shunt,rest everything is normal.I consulted many pediatricians,they all advised me to wait and watch till one year and after that he can undergo treatment.
Sir,could you please suggest me if my son needs any further treatment?
Thank you..
Noorshin Nilofar.
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773637_tn?1327450515
Dear Noorshin,

Without evaluating your son, I cannot say whether he needs treatment, or not.  However, atrial septal defects often close by age 3 years, and a patent foramen ovale often closes by age 1 year.  That said, the determination whether treatment is necessary, or not, is based on the not just the size of the defect but also on an estimate of the amount of left to right blood flow shunting across the defect.  We evaluate this by looking to see if the right atrium and/or the right ventricle are dilated.  If they are not, and the defect appears small (and 4 mm does constitute a small defect), then any kind of treatment is not warranted UNLESS your son has a disorder where he clots easily or he has had a stroke.  Approximately 25% of all adults have a patent foramen ovale, so these are quite common, typically silent, and not routinely closed unless there are known complications.
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