Atrial Septal Defect Symptoms: Understanding Secundum Atrial Septal Defect

Secundum atrial septal defect (ASD) is a common type of congenital heart defect, and the severity of symptoms largely depends on the size of the defect. In cases where the hole in the atrial septum is small, the amount of blood shunting from the left atrium to the right atrium is minimal. As a result, many children may not exhibit any noticeable symptoms.

Undiagnosed Small ASDs

Small atrial septal defects often go undetected during routine physical exams because they may not produce a heart murmur or other obvious clinical signs. These defects are typically discovered incidentally during an echocardiogram performed for unrelated reasons. Since the condition doesn't cause significant hemodynamic changes, children may live without any symptoms for years, sometimes even into adulthood.

Symptoms of Larger ASDs

When the atrial septal defect is larger, the volume of left-to-right shunting increases, leading to more pronounced symptoms. One of the most common signs is frequent respiratory infections. This occurs due to increased pulmonary blood flow and congestion, which makes the lungs more susceptible to infections such as bronchitis and pneumonia.

Long-Term Complications

Over time, persistent shunting can cause pulmonary hypertension as the blood vessels in the lungs become overloaded. This elevated pressure can lead to irreversible damage if left untreated. Additionally, children with larger ASDs may experience delayed growth and development due to the heart working harder to pump extra blood to the lungs.

When to Seek Medical Attention

Parents should consult a pediatric cardiologist if their child experiences repeated respiratory infections, fatigue during physical activity, or poor weight gain. Early diagnosis and treatment can prevent long-term complications and improve quality of life. Echocardiography remains the gold standard for confirming the presence and size of a secundum atrial septal defect.