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Further Information
Atrial septal defect is usually asymptomatic early in life, even when large. Symptoms may not develop until adult life. The onset of symptoms is due to reversal of the initial left-to-right shunt as a result of increasing right ventricular hypertrophy and pulmonary hypertension. The ensuing rightto-left shunt is associated with cyanosis and dyspnoea, and ultimately leads to congestive cardiac failure. There are several types of atrial septal defects, including:
Secundum – This is the most common type of ASD and occurs in the middle of the wall between the atria (atrial septum).
Primum – This defect occurs in the lower part of the atrial septum and might occur with other congenital heart problems.
Sinus venosus – This rare defect usually occurs in the upper part of the atrial septum and is often associated with other congenital heart problems.
Coronary sinus – In this rare defect, part of the wall between the coronary sinus — which is part of the vein system of the heart — and the left atrium is missing.
It is not known why all atrial septal defects occur, but some congenital heart defects appear to be familial and sometimes occur with other genetic problems, such as Trisomy 21 (Down’s syndrome). Some conditions during pregnancy can increase the risk of having a baby with a heart defect, including acute infections such as Rubella infection; drug, tobacco or alcohol use, or exposure to certain substances (such as cocaine) during the first trimester of pregnancy; and underlying systemic conditions, such as diabetes or systemic lupus erythematosus.
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