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ASD and VSD - Which is worse?
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ASD and VSD - Which is worse?

Among the Atrial Septal Defect (ASD) and Ventricular Septal Defect (VSD), which one is the worse - which affects the person with more complications, and how? Thanks.
773637_tn?1327450515
Dear Kris,

This is not exactly a straightforward question, actually.  I guess that, overall, VSDs are more likely to be worse, in that they can cause congestive heart failure early on wihle ASDs typically don't (although, if there is enough left to right flow, they can cause some decreased exercise tolerance).  However, it's a bit more complicated.  The complications of these are dependent upon the size of the defects.  The size of the defects are what allow a given volume of blood to recirculate through the lungs instead of being sent out to the body.  Small ASDs and VSDs typically don't cause a problem, with specific rare exceptions.  Small ASDs have the potential to let blood clots from the right side of the heart/body (if the patient actually has them) cross over and go to the brain or somewhere else (called a paradoxical embolus).  Small VSDs below the aortic valve can deform the aortic valve and cause it to leak.  Moderate and large defects are the bigger and more consistent troublemakers.  VSDs of this size allow much more blood to cross over and recirculate; this leads to congestive heart failure, with the body's calories going for cardiopulmonary work instead of brain and body growth.  ASDs of this size can cause a bit of exercise intolerance and have a risk of paradoxical embolus, but overall are well tolerated initially.  However, the increased blood volume load on the right side of the heart can lead to arrhythmias later in life as well as decreased exercise tolerance and, rarely, pulmonary hypertension, or high blood pressure across the lungs.  

This is probably more than you bargained for when you asked this question, but, again, it's not a straightforward answer.
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Avatar_m_tn
Iam from india . This information regarding about my daughter health when she was 4 months old  our family Pediatric  doctor notice about her mummer .After that we have taken eco test then we found that 6.6mm OS ASD.  Dr. said that its going to be cure  .Is it going to be cure ?  .Can u guide me . Whats the reason for OS ASD, and what are the symptonm and whats  the next treatment? now she is 1 1/2 year old. What kind of food that we can gave  her regularly to cure OS ASD. My mother she has diagnose ADS when she was 38 years old  .Is it a genetic diseases. After open heart surgery she is oky now  she is 50 years .  Dear dr iam waiting for your replay .
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773637_tn?1327450515
Dear Bindugopika,

Your daughter has what would be considered a moderate to large ostium secundum (OS) atrial septal defect (ASD), or hole in the wall between the upper two chambers of the heart.  Without evaluating her, i cannot say exactly what will happen with her.  However, I can say that a 6.6 mm defect is likely to not close by itself.  However, the information that you have is over one year old, and she needs to be evaluated again.  

We do not know what causes ASDs, or any congenital cardiac defect for that matter, outside of any genetic syndromes.  However, they certainly can run in families.  There are no specific foods that can be used to treat this.  They often have no symptoms in childhood, although occasionally we can see some fatigue with activity relative to their peers.  Typically, with time, the defect can become smaller or even close.  However, if it is a defect that has not closed, we routinely close the defects that are considered medium or large around age 3-5 years.  In experienced hands and depending on some factors with the defect, it does not require open heart surgery.  A procedure called a cardiac catheterization can be done, and a device can be placed in the hole to plug it.

At this time, i recommend that you have her seen by your pediatric cardiologist for a follow-up echocardiogram to assess the size of the defect and to assess her symptoms.  The cardiologist can discuss a further plan with you.
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Avatar_m_tn
dear Dr,

Very very thank you for your consultant i keep in touch with you after analysis  god bless you
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Avatar_m_tn
happy new year Dr
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