Overview

Diagnosis

Some atrial septal defects (ASDs) are detected before or shortly after birth, while smaller defects may not be discovered until later in life. During a physical examination, a healthcare professional may hear a heart murmur — a whooshing sound caused by abnormal blood flow — using a stethoscope.

Tests to Diagnose Atrial Septal Defect (ASD)

Echocardiogram
This is the main test for diagnosing ASD. Sound waves create moving images of the heart. It clearly shows the heart’s chambers, valves, and how blood flows between them.

Chest X-ray
This imaging test provides a view of the heart and lungs, helping detect enlargement or fluid buildup.

Electrocardiogram (ECG or EKG)
A quick and painless test that records the electrical activity of the heart. It helps detect abnormal rhythms known as arrhythmias.

Cardiac MRI
This test uses magnetic fields and radio waves to produce detailed images of the heart. It is often used if other tests don’t provide a clear diagnosis.

CT scan
A CT scan uses X-rays to create cross-sectional images of the heart. It can help confirm the diagnosis when other tests are inconclusive.

Treatment

Treatment for atrial septal defect depends on several factors, including the size of the hole and whether other heart conditions are present.

  • Small defects may close on their own during childhood.

  • Regular health checkups may be all that’s needed for mild cases.

  • Closure procedures are often required for larger defects.

  • Repair is not typically recommended in patients with severe pulmonary hypertension.

Medications

Medications cannot close an atrial septal defect, but they can help manage symptoms and reduce complications. Common options may include:

  • Beta blockers to help control heart rate.

  • Anticoagulants (blood thinners) to reduce the risk of blood clots.

  • Diuretics to ease fluid buildup in the lungs or body.

Surgery or Procedures

When a medium to large ASD requires closure, a procedure is typically performed to prevent long-term complications such as pulmonary hypertension, heart failure, or arrhythmias.

Catheter-based repair
This minimally invasive procedure is commonly used for secundum-type ASDs. A thin catheter is inserted through a vein (usually in the groin) and guided to the heart. A mesh patch or plug is placed to close the hole. Over time, heart tissue grows around the patch, permanently sealing the defect.

Open-heart surgery
For primum, sinus venosus, or coronary sinus ASDs, open-heart surgery is required. A surgeon makes an incision in the chest wall and places a patch over the defect. This is the most effective way to repair larger or complex defects.

Minimally invasive or robot-assisted techniques may also be used in some cases to reduce recovery time.

Long-Term Care

  • Regular follow-up visits with imaging tests are necessary to monitor heart and lung function.

  • Those who undergo repair generally have good long-term outcomes.

  • Untreated large ASDs can lead to complications such as reduced exercise capacity, irregular heart rhythms, and pulmonary hypertension.

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