Hi, thank you for your question. Atrial septal defect (ASD) is a defect that produces a hole in the wall between the 2 top chambers of the heart. Small ASD which does not affect the heart function usually do not require treatment but will still need to do periodic follow-ups to make sure nothing has changed.

Meanwhile, if the ASD is too big, blood from the left side of the heart can flow to the right side of the heart due to higher pressure in the left heart. As a result, extra blood is pumped to the lungs, making both heart and lungs work harder and less efficiently.

When this occurs, there is a higher risk of developing other heart and lung issues. Right heart failure is one of it. Increased pressure in the right heart weakens the heart muscles and decreases its ability to pump effectively, leading to heart failure. Arrhythmia (heart rhythm abnormality) can also happen and result in irregular and rapid heart beats, such as atrial fibrillation.

If blood clot travels to the left side of the heart to the brain, it can result in stroke as well. Besides, pulmonary hypertension can occur when increased blood flow to the lungs increases the blood pressure in the lung arteries. This may damage lung arteries permanently. Lastly, Eisenmenger syndrome is a serious condition.

This happens when the blood flow reverses and deoxygenated blood flows from right heart into left heart due to pulmonary hypertension. Other organs will not receive sufficient oxygen in this case. It is a life-threatening condition and you may develop symptoms like bluish or grayish skin colour, shortness of breath, chest pain, fatigue, dizziness and fainting.

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