Atrial septal defect complications

Atrial Septal Defect Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Priyamvada Singh, M.B.B.S. [[2]]; Cafer Zorkun, M.D., Ph.D. [3]; Assistant Editor(s)-In-Chief: Kristin Feeney, B.S. [[4]]

Overview

While atrial septal defect may serve as the underlying cause, many patients are susceptible to developing secondary conditions or comorbidities such as atrial fibrillation, pulmonary hypertension, heart failure, and stroke.

Complications involving comorbidity

Many atrial septal defect patients are at risk for developing comorbid complexes with the following conditions:

Atrial septal defect and atrial fibrillation

50-60% of atrial septal defect patients over the age of 40 experience atrial fibrillation issues. This late-onset is correlated as a major cause in morbidity and mortality. Some research suggests that pharmacologic therapy such as anticoagulants can assist with lower mortality risks associated with atrial flutter.

Atrial septal defect and pulmonary hypertension

15-20% of atrial septal defect patients develop pulmonary hypertension. Characteristically rare during youth, pulmonary hypertension has been observed in 50% of patients over the age of 40. In particular, Eisenmenger syndrome patients are at risk for severe pulmonary obstruction and can result in significant reversal of blood shunting from right-to-left. This can lead to systemic circulation conditions such as hypoxemia and cyanosis.

Atrial septal defect and right heart failure

Due to the nature of the defect, atrial septal defect patients of all ages experience strain on the right-heart complex. Patients may experience heart failure as a result of the cardiac volume overload the right side of the heart experiences during left-to-right shunting.

Atrial septal defect and stroke

Even without surgery, as many as 5-10% of all atrial septal defect patients experience thromboembolic events such as stroke and transient ischemia. Research suggests that paradoxical emboli in atrial septal defect patients is mutually exclusive of defect size and can potentially occur in all patients.