Pediatric Heart Expert Forum
Possible ASD?
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Questions in this forum are answered by pediatric cardiologists, cardiothoracic surgeons and anesthesiologists from The Children's Hospital of Philadelphia. This forum is for questions and support about pediatric heart problems, symptoms and topics such as heart murmurs, palpitations, fainting, chest pain, congenital heart defects (including management and intervention), fetal cardiology, adult congenital cardiology, arrhythmias and pre-participation athletic screening.

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Possible ASD?

My 13 yr old daughter had an abnormal ekg and is now awaiting an appointment w/a pediatric cardiologyst. The ekg showed enlarged right ventricle and enlarged left atrium. Her symptoms are shortness of breath with little activity..even during the night sometimes. Also she says it feels like her heart is squeezing. My question is, if she does have asd, how come it took this long for symptoms to show up? What do they do to repair it? She is a healthy fit 13 year old.
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773655_tn?1340656399
The findings of right atrial and right ventricular enlargement on an ECG are suggestive of an atrial septal defect, but it can also be seen with partially anomalous pulmonary venous connection (PAPVC) and primary pulmonary hypertension.  That is why it is important for your child to be thoroughly evaluated by a pediatric cardiologist as you have planned.  Atrial septal defects and PAPVC are notorious for being subtle forms of heart disease that can present at a variety of ages. That is because the heart tolerates the chamber enlargement for many years before clinical symptoms develop.  Not all forms of congenital heart disease present during infancy, as most people think.  Additionally, pulmonary hypertension can also present for the first time in teenagers.  
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Did you mean to say left atrium? (hers is the left atrium and right ventricle)
Thank you Doctor Gleason
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773655_tn?1340656399
No, my mistake. If it is the left atrium, that is much less reliable to interpret enlargement on an ECG.  Keep in mind that there are many times when an ECG is thought to be "abnormal" when in fact it is borderline, and ultimately nothing is found to be wrong with the heart.  The combination of left atrial enlargement and right ventricular enlargement on ECG is not classically consistent with an ASD.  It sounds like you will need to see the cardiologist before knowing what she might have, if anything.
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This Forum's Experts
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Jeffrey R Boris, M.D.Blank
The Children’s Hospital of Philadelphia
Philadelphia, PA
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Marie M Gleason, M.D.Blank
The Children’s Hospital of Philadelphia
Philadelphia, PA
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