HEART DISEASE

[Charles5454]

I had an ASD repaired in 1979. I also had PAH, RBBB, Right Ventricular dilated, Right Ventricular Hypertrophy. I was also diagnosed with Paradoxical Septal Motion and Right Arterial Hypertonia. The closure of the ASD was a success but I have had on going problems with SOB and chest pains and fatigued. Now I have a Left Ventricular Bundle Branch Block, Ejection Faction/Left Ventricular Function depression, Hypertension, Pulmonary Arterial Hypertension, Left Ventricular Dilation, Left Ventricular Asynergic contractions, Excentrical, Left Ventricular Hypertrophy, Mitral Valve Regurgitation, Early Diastolic Function, Tricuspid Valve Regurgitation, and Limited Oxygen intake in blood. Could all this have started because of the ASD residuals?

[kenkeith]

Yes, your current symptoms can be related to ASD. For some insight a large ASD (>9mm), there will be shunting (blood flow from left atrium to right atrium). The extra blood from the left atrium may cause a volume overload of both the right atrium and the right ventricle. If untreated, this condition can result in enlargement of the right side, The increased size and overload will effect the entire lung vascular system and eventually pulmonary hypertension.

The right ventricle will be forced to generate higher pressures to try to overcome the pulmonary hypertension. This may lead to right ventricular failure with dilatation and decreased systolic function (contractility of the right ventricle) and  elevations of the right sided pressures relative to left sided pressures. Normally the left ventricle has higher pressure than the right ventricle, but higher abnormal pressure in the right ventricle will shunt blood de-oxygenated blood to the left side reversing the left to right shunt.

Once right-to-left shunting occurs, a portion of the oxygen-poor blood will get shunted to the left side of the heart and pumped into the body's vascular system and cause hypoxia (low blood oxgenated level to heart cells).  This condtion will stress the left side to pump more oxygenated blood.  As a result this will increase the size of the left ventricle (hypertrophy, dilation) and can effect contractility and irregular heartbeats (electrical impulse pathways are obstruced, LBBB).  The left ventricle's hypertrohy can cause mitral valve regurgitation which further decreases oxygenated blood to the system....Worst case scenario.

Thanks for your question, and if you have any further questions or comments you are welcome to respond.  Take care,

Ken