Atrial Septal Defect Health Article

Follow-up care

Children with atrial septal defects require lifelong monitoring, even after a successful surgery or procedure to close the defect. Along with routine medical care and standard immunizations, periodic heart check-ups are necessary. Usually, heart check-up appointments are scheduled more frequently just after the diagnosis or following the treatment procedure. Additional immunizations, such as the influenza vaccine, may be recommended.

Medical identification

In case of emergency, a medical identification bracelet or necklace should be worn to alert all health care providers of the child's heart condition.

Prognosis

The outlook for children with atrial septal defects has improved markedly in the past two decades. Individuals with small defects can live a normal life, but larger defects require surgical correction. Less than 1 percent of people younger than age 45 die from corrective surgery. Five to ten percent of patients can die from the surgery if they are older than 40 and have other heart-related problems. There is a 25 percent lifetime risk of death if the atrial septal defect is not repaired. When an atrial septal defect is corrected within the first 20 years of life, there is an excellent chance for the child to live a normal and productive life.

Prevention

Atrial septal defects cannot be prevented. However, to protect patients with atrial septal defects and those with implanted closure devices from heart infections (endocarditis), the American Heart Association recommends regular dental check-ups to prevent infections of the mouth, as well as the preventive use of antibiotics. Preventive antibiotics should be taken before surgery, invasive tests or procedures, and all routine dental cleanings and procedures. A 2003 study reported that preventive antibiotics are underused in people with congenital heart conditions, possibly because they do not understand their increased risk of developing bacterial endocarditis.

Parental concerns

If the child needs surgery or a catheter-based cardiac implant, it is important for him or her to be as healthy as possible for the procedure. If the child has a fever, cough, or cold, the parent should inform the medical team to determine whether the procedure should be delayed. The medical team can help parents prepare the child for the procedure, and can instruct them on how to explain the procedure based on the child's age, ability to understand, and emotions. Once an atrial septal defect has been closed, it is unlikely that more surgery will be needed. Rarely, a patient may have a residual hole that may require further treatment, depending upon its size.

Most children with atrial septal defects can be fully active and are encouraged to exercise. An American Heart Association scientific statement advises children and teens with genetic heart conditions to seek advice from their doctors about the types of physical activities that are safe. The statement was intended to help doctors counsel patients who have an increased risk of sudden cardiac death during physical activity. Certain athletic activities such as competitive sports may be limited, depending on the child's type of defect and medical condition. A child with an atrial septal defect may tire more easily than other children; frequent breaks and rest periods should be encouraged as needed during activities. Parents should obtain a doctor's note to explain their child's specific exercise limitations to teachers and coaches.

A child with an atrial septal defect has a greater risk of having a child with a heart defect. The frequency of the condition increases from less than 1 percent in the general population to 2–20 percent when a parent is affected. Genetic counseling and further testing, such as chromosome analysis before pregnancy, or amniocentesis during pregnancy, may be recommended in adults with atrial septal defects.

Treatment and care for a child with an atrial septal defect can be costly, and some health insurance plans may not cover all expenses associated with a child's hospitalization or surgery. Help is available to cover medical expenses. The parents can discuss financial aid with the hospital. Some organizations, including The Heart of a Child Foundation and Little Hearts on the Mend Fund, provide financial assistance to children in need of heart surgery.

Caring for a child with an atrial septal defect is demanding. Support groups are available to help parents and caregivers cope with the challenges of providing care for children with special medical needs. It is important for parents to take care of themselves, too, by eating properly, exercising regularly, maintaining personal hygiene, keeping in contact with friends and family members for support, and managing stress by practicing relaxation techniques.

See also Congenital heart disease.