Materiały źródłowe

• #1 Isolated atrial septal defects (ASDs) in children: Classification, clinical features, and diagnosis – UpToDate

  https://www.uptodate.com/contents/isolated-atrial-septal-defects-asds-in-children-classification-clinical-features-and-diagnosis/print

  Atrial septal defects (ASDs) are common, accounting for approximately 10 to 15 percent of congenital heart disease. The apparent reported prevalence of ASD has increased because of increased use of echocardiography in the neonatal period. ASDs account for approximately 10 to 15 percent of congenital heart disease, with a reported birth prevalence of approximately 1 to 2 per 1000 live births. […] Many secundum ASDs or incompetent foramen ovales identified on echocardiograms obtained for nonspecific indications in early infancy close spontaneously during later infancy or early childhood.

• #2 Atrial Septal Defect: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/162914-overview

  In the last half century, there has been an increasing prevalence of congenital heart disease and atrial septal defects (ASDs), with the former diagnosed in an estimated 9 per 1000 live births and the latter in 1.6 per 1000 live births. […] The three major types of ASD account for 10% of all congenital heart disease and as much as 25-30% of congenital heart disease presenting in adulthood. […] ASD occurs in about 25% of children. […] There is a female-to-male ratio of approximately 2:1. The recurrence rate of ASD in the offspring of women with ASD is 4-6%; in males with ASD, it is 1.5-3.5%. […] Patients with ASD can be asymptomatic through infancy and childhood, although the timing of clinical presentation depends on the degree of left-to-right shunt. Symptoms become more common with advancing age. By age 40 years, 9 in 10 untreated patients exhibit exertional dyspnea, fatigue, palpitations, sustained arrhythmia, or indications of heart failure.

• #3 About Atrial Septal Defect (ASD) | Congenital Heart Defects (CHDs) | CDC

  https://www.cdc.gov/heart-defects/about/atrial-septal-defect.html

  About 13 of every 10,000 babies in the United States are born with an atrial septal defect. This means that about 5,240 babies are born with an atrial septal defect each year. […] An atrial septal defect may be diagnosed during pregnancy or after the baby is born. […] In many cases, an atrial septal defect may not be diagnosed until adulthood. […] People with atrial septal defects should schedule routine checkups with a cardiologist (heart doctor) to stay as healthy as possible.

• #4 Isolated atrial septal defects (ASDs) in children: Classification, clinical features, and diagnosis – UpToDate

  https://www.uptodate.com/contents/isolated-atrial-septal-defects-asds-in-children-classification-clinical-features-and-diagnosis

  Atrial septal defects (ASDs) are common, accounting for approximately 10 to 15 percent of congenital heart disease. The clinical consequences of an ASD are related to the anatomic location of the defect, its size, and the presence or absence of other cardiac anomalies. […] ASDs account for approximately 10 to 15 percent of congenital heart disease, with a reported birth prevalence of approximately 1 to 2 per 1000 live births. […] The apparent reported prevalence of ASD has increased because of increased use of echocardiography in the neonatal period. Many secundum ASDs or incompetent foramen ovales identified on echocardiograms obtained for nonspecific indications in early infancy close spontaneously during later infancy or early childhood.

• #5 Atrial Septal Defect – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK535440/

  Atrial septal defect (ASD) is one of the most common types of congenital heart defects, occurring in about 25% of children. […] The prevalence of congenital heart disease, including ASDs, has risen over the past 50 years. Congenital heart disease was diagnosed in less than 1 per 1,000 live births in the 1930s. Recent data indicate a prevalence of 9 per 1,000 live births. Similarly, ASDs were identified in less than 0.5 per 1,000 live births between 1945 and 1949, but recent epidemiologic studies estimate their occurrence at 1.6 per 1,000 live births. […] Factors associated with the higher prevalence of congenital heart disease include advanced maternal age. Economic and geographical differences also influence diagnosis rates, with congenital heart disease more commonly identified in individuals from developed countries with higher incomes.

• #6 Atrial Septal Defects and Patent Foramen Ovale: Current Data Update – Cardiac Interventions Today

  https://citoday.com/articles/2022-jan-feb/atrial-septal-defects-and-patent-foramen-ovale-current-data-update

  Patent foramen ovale (PFO) and atrial septal defects (ASDs) represent the most common and second most common congenital heart abnormalities, with a prevalence of 25% to 30% in the general population and 1.65 per 1,000 live births, respectively. The prevalence of PFO is 15% to 35% via autopsy and 15% to 25% in echocardiographic studies, with a tendency to decrease with aging. The most common ASDs are isolated secundum ASD, which accounts for 7% of all congenital heart defects; they are generally sporadic, although sometimes are associated with a few genetic mutations and genetic syndromes (ie, Down syndrome, Noonan syndrome). […] Given the high prevalence of PFO in the general population, transcatheter PFO closure should be reserved for patients with a high probability of a PFO-related embolic event, whereas medical therapy should be considered if the probability is low. […] ASDs are among the most common congenital heart abnormality and can manifest through a wide clinical spectrum. Sometimes they are an incidental finding in otherwise asymptomatic patients with preserved RV function or they can cause significant RV heart failure and PH.

• #7 Atrial Septal Defect in Children: The Incidence and Risk Factors for Diagnosis

  https://www.techscience.com/chd/v15n5/40251/html

  Atrial septal defects is the third most common congenital heart defect (CHD), with an estimated incidence of 56 in 100 000 live births. […] The yearly overall incidence of ASD II was 150 per 100 000 live births. However, this incidence ranged from 449 per 100 000 live births to 1737 per 100 000 live births, with higher incidence among preterm children. […] Preterm children have a higher incidence of ASD II than previously found, increasing with lower gestational age at birth. […] The overall incidence of ASD II in children born in Sweden in this national population-based register study was 150 per 100 000 live births. […] Preterm children in our study have, depending on degree of prematurity, a three to fourteen times higher incidence of ASD II diagnosis, compared to term children. […] The increased association between ASD II diagnosis and incidence among preterm children in our study indicates that a structured follow-up program in preterm born children is needed, assessing a development of cardiac and pulmonary morbidity.

• #8 Atrial Septal Defect – MN Dept. of Health

  https://www.health.state.mn.us/diseases/cy/atrial.html

  Using data from Minnesota births between 2014-2018, we found 859 babies were born with atrial septal defects, resulting in a rate of 26 babies per 10,000 births. […] Annually, about 172 babies were born with atrial septal defects.

• #9 Trends in the Prevalence of Atrial Septal Defect and Its Associated Factors among Congenital Heart Disease Patients in Vietnam

  https://www.mdpi.com/2308-3425/7/1/2

  Atrial septal defect (ASD) is a non-physiologic communication between the two atria, allowing the shunt between systemic and pulmonary circulation. Data about ASD prevalence among congenital heart disease patients (CHD) in Vietnam are still scarce. We aim to assess the trends in the prevalence of ASD patients and associated factors among CHD patients. The overall prevalence of ASD among CHD patients was 18.5% between 2010 and 2015. The prevalence varied between periods, ranging between 15% and 31.9% during the period. The prevalence of ASD women among CHD (25.9%) was significantly higher than for men (16.0%). The prevalence of ASD increased gradually when the age group increased. The factors associated with increased ASD prevalence were being a female and being in an older age group. The findings suggest that targeted policy should provide more-specific health-care services of ASD for women and older patients.

• #9 Trends in the Prevalence of Atrial Septal Defect and Its Associated Factors among Congenital Heart Disease Patients in Vietnam

  https://www.mdpi.com/2308-3425/7/1/2

  In Vietnam, some studies on ASD were conducted, but their sample size was small, and they focused more on surgery techniques. However, the data about the status of ASD as the hospital-based level are still scarce, so the aim of this study was to assess the prevalence of ASD among CHD patients and its associated factors among CHD patients who used surgical and transcatheter closure intervention in Vietnam. […] The prevalence of ASD was found to increase with increasing age, a pattern already seen in other Southeast Asian countries. According to our results, some factors affecting being clinically treated for ASD either by surgical or transcatheter procedures were being a woman and older in age. The study has some limitations that we would like to address. The study was based upon the cross-sectional design; thus, it did not allow us to conclude about the casual relationship.

• #10 Facts about Atrial Septal Defect (ASD) – MyHealth

  https://redcliffelabs.com/myhealth/heart/facts-about-atrial-septal-defect-asd/

  Atrial septal defects are not rare. In fact, in India, around 10% of infants suffer from different types of atrial septal defects. According to a recent case report made in India, the prevalence of heart defects was around 26.4% for every 1000 patients. Out of which 18.9% cases were that of atrial septal defect. […] With this heart defect becoming so common among newborn babies, it is very important to educate the population about the atrial septal defect. […] An atrial septal defect is a congenital disorder that occurs in newborn babies. Most often, there are no symptoms depicted by newborn babies. However, if left untreated, atrial septal defects can show certain symptoms during adulthood. […] The main cause of the atrial septal defect is still unclear. The most possible causes of ASD are genetics, underlying medical conditions, medicines, and lifestyle factors. […] It is assumed that the average age of death in people with ASD does not exceed 50 years. However, in some cases, you can live with untreated ASD for more than 80 years as well.

• #11 Ostium Secundum Atrial Septal Defects: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/890991-overview

  Isolated secundum atrial septal defects account for approximately 7% of congenital cardiac defects. Congenital heart defects of significance occur in approximately 8 per 1000 live births. Therefore, 5-6 cases of secundum ASD occur per 10,000 live births. This number refers only to defects that are large enough to come to clinical attention. Many small defects that remain undetected occur in addition to numerous cases of patent foramen ovale, as mentioned above. […] Secundum ASD occurs more commonly in females than males, with a female-to-male ratio of 2:1. […] Secundum ASD is a congenital abnormality and, therefore, is present at birth. It may be diagnosed at any age, including early infancy, although the characteristic findings on physical examination often escape detection until the patient reaches a few years of age. An acquired defect occurs only iatrogenically.

• #12 Atrial Septal Defect (ASD) | Concise Medical Knowledge

  https://www.lecturio.com/concepts/atrial-septal-defect/

  Atrial septal defects account for approximately 15% of all cases of congenital heart disease (CHD), making ASDs the 2nd most common CHD. […] Account for 10%-15% of all cases of CHD. […] Incidence: 0.6-2.1 per 1,000 live births. […] Girls outnumber boys, with a girl-to-boy ratio of 2:1. […] The mortality rate is low, at 1%.

• #13 Atrial septal defect – Wikipedia

  https://en.wikipedia.org/wiki/Atrial_septal_defect

  Atrial septal defects are detected in one child per 1500 live births. […] PFOs are quite common (appearing in 10-20% of adults), but when asymptomatic go undiagnosed. […] ASDs make up 30 to 40% of all congenital heart diseases that are seen in adults. […] The ostium secundum atrial septal defect accounts for 7% of all congenital heart lesions. This lesion shows a male:female ratio of 1:2.

• #14 Atrial septal defect | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/atrial-septal-defect-2?lang=us

  Atrial septal defects account for 10% of congenital heart disease and are more common in women, M:F = 1:2. Close family history of ASD was found in 2%. […] Even with good healthcare, more than 50% do not present until adulthood and the onset of complications such as atrial fibrillation, pulmonary hypertension, and right heart failure. […] By the age of 60 years, almost all will be symptomatic ref.

• #15 Long-term outcome of percutaneous closure of secundum-type atrial septal defects in adults | EuroIntervention

  https://eurointervention.pcronline.com/article/long-term-outcome-of-percutaneous-closure-of-secundum-type-atrial-septal-defects-in-adults

  Our results demonstrate that transcatheter closure of ASDs of the secundum type in an adult patient population is safe and effective during long-term follow-up using an Amplatzer device. However, using the Cardioseal device is related to a high rate of major complications. […] Percutaneous closure of a secundum-type ASD in adults is safe and effective, especially when using the Amplatzer device. The larger Cardioseal/Starflex devices are possibly related to a higher rate of embolisation.

• #16 Atrial Septal Defect | Causes, diagnosis, & treatment | Children’s Wisconsin

  https://childrenswi.org/medical-care/herma-heart/conditions/atrial-septal-defect

  Atrial septal defect occurs in 5 to 10 percent of all babies with congenital heart disease. […] Atrial septal defects are relatively rare and can be difficult to distinguish from other types of holes in the heart. […] Most atrial septal defects occur sporadically (by chance), with no clear reason for their development. […] This heart defect can cause lung problems if not repaired. […] The larger the volume of blood that goes to the lungs, the higher the pressure. […] Once an atrial septal defect is diagnosed, your child’s cardiologist will evaluate your child periodically to see whether it is closing on its own. […] The decision to close the ASD may also depend on the size of the defect. […] The majority of children who have had an atrial septal defect surgical repair will live healthy lives.

• #17 Content – Health Encyclopedia – University of Rochester Medical Center

  http://www.urmc.rochester.edu/Encyclopedia/Content.aspx?ContentTypeID=90&ContentID=P01766

  ASDs are common and account for about 10% to 15% of congenital heart disease. […] Most atrial septal defects occur by chance. There is no clear reason why they happen. […] Symptoms include tiring easily, fast breathing, shortness of breath, poor growth, arrhythmias, and frequent respiratory infections. […] ASDs range from small to large. […] Small ASDs may close on their own. ASDs that are large or cause symptoms can be repaired. […] Most children who have had an ASD repair will live healthy lives.

• #18 Risk factors for isolated atrial septal defect secundum morbidity | Scientific Reports

  https://www.nature.com/articles/s41598-024-55446-2

  Atrial septal defect secundum is a common type of congenital heart defect and even more common among children born premature. […] Preterm birth in children was not associated with an increased risk of ASD II cardiac morbidity. […] A birth prevalence of 164 in 100,000 live births have been reported and it is demonstrated to be even more common among children born premature. […] Cardiac morbidity due to ASD II was not independently associated with premature birth, although persistent pulmonary hypertension and BPD was more common among children born preterm. […] Down syndrome was independently associated with increased morbidity due to ASD in our study.

• #19 Arrhythmias and conduction disorders associated with atrial septal defects – Williams – Journal of Thoracic Disease

  https://jtd.amegroups.org/article/view/23665/18016

  Atrial tachyarrhythmias are commonly seen in patients with ASDs, regardless of ASD type. […] Atrial arrhythmia prevalence is also correlated with size of shunt and hemodynamic complications such as pulmonary hypertension, as well as with other comorbidities. […] Incidence of atrial tachyarrhythmias is decreased post-closure, but recurrence rate may still be significant, particularly in patients who underwent ASD closure at older age, had larger shunts, or with other comorbidities. […] Both sinus node and AV nodal conduction abnormalities have been reported in patients with ASDs. […] Risk of developing sinus node dysfunction is correlated with larger shunt size and older age at closure. […] AV block may also be found in patients with ASDs secondary to mutations in a family of closely-associated myocardial transcription factors that are active in early embryologic development, NKX2.5, GATA4 and TBX5.

• #19 Arrhythmias and conduction disorders associated with atrial septal defects – Williams – Journal of Thoracic Disease

  https://jtd.amegroups.org/article/view/23665/18016

  Atrial septal defects (ASDs) are the most common form of congenital heart disease. […] Atrial septal defects (ASDs) are the most common form of congenital heart disease, and account for approximately 610% of congenital heart defects, with approximate population incidence of 13 per 1,000. […] Risk for arrhythmias is increased with late age of ASD repair, shunt size, other factors such as pulmonary hypertension and comorbid conditions. […] Arrhythmia incidence is decreased after ASD closure, but remains elevated compared to general population. […] Conduction disorders are rare. […] Sinus node dysfunction may be seen with late age of repair and large shunt size. […] Risk of AV block with surgical repair or device closure of secundum ASD is rare. […] Familial ASDs and other forms of congenital heart disease may be seen with mutations in associated myocardial transcription factors NKX2.5, GATA4, TBX6, along with conduction disorders such as AV block.

• #20

  https://link.springer.com/article/10.1007/BF00146368

  The possible effect of environmental factors during pregnancy on the occurrence of atrial septal defect (ASD-secundum) in the offspring was studied in 50 cases and 756 controls. […] Maternal alcohol consumption during the first trimester of pregnancy appeared to double the risk of atrial septal defect (OR =1.9, Cl95 =1.1- 3.4). […] The risk of ASD was not associated with maternal smoking, or coffee, tea or acetosalicylic acid consumption. […] It is concluded that some common physical and chemical exposures during early pregnancy should not necessarily be considered risk factors for atrial septal defect.

• #21 Contemporary epidemiology of rising atrial septal defect trends across USA 1991–2016: a combined ecological geospatiotemporal and causal inferential study | BMC Pediatrics | Full Text

  https://bmcpediatr.biomedcentral.com/articles/10.1186/s12887-020-02431-z

  Atrial Septal Defect (secundum type) (ASD) is one of the commonest of the cardiovascular congenital anomalies which are themselves the commonest form of congenital defect. Congenital defects are the commonest cause of mortality in children under the age of 5 years. The Centres for Disease Control Atlanta, Georgia, (CDC) publishes rates of congenital anomalies across the USA annually based on reports from state-based registries through the National Births Defects Prevention Network which CDC sponsor. Review of these data indicate that in recent years ASD appears to be increasing in some US States for reasons which were not apparent. […] Previous reports from Hawaii and Colorado had linked ASD with cannabis exposure. Indeed the report on Colorado showed that ASD incidence (ASDI) followed a sigmoidal trajectory and closely tracked the decade of cannabis legalization there. Canada Health recently issued a major report of that nations teratological experience which noted a rise in total cardiovascular defects in the northern territories of Canada which are known to consume more cannabis. Since ASD is one of the most common cardiovascular defects it is likely that ASD was represented in this general increase. Government reports from Australia similarly link high ASDI with areas of high cannabis use. Moreover 34 congenital defects including nine cardiovascular defects were recently noted to be more common in the highest quintile of cannabis using states in the USA than in the remainder of the country.

• #21 Contemporary epidemiology of rising atrial septal defect trends across USA 1991–2016: a combined ecological geospatiotemporal and causal inferential study | BMC Pediatrics | Full Text

  https://bmcpediatr.biomedcentral.com/articles/10.1186/s12887-020-02431-z

  The data for the 37 states contributing data are shown in eTable 1 and map-graphically in eFigure 1. […] The mean rate in 1991 was 27.4/10,000 births and 82.4/10,000 in 2014, a 3.02-fold rise. […] In multivariable geotemporospatial regression the cannabinoid-ASDI link was confirmed across space and time together and was robust to adjustment for other socioeconomic and ethnodemographic variables. […] Hence this study made affirmative findings in relation to all three opening hypotheses. ASDI is indeed rising; drug and cannabinoid exposure account for this in a manner robust to adjustment for the usual socioeconomicodemographic covariates in final geospatial models; and finally the cannabinoid-ASDI relationship fulfills criteria for causality.

• #22 CHD | Atrial Septal Defect in Children: The Incidence and Risk Factors for Diagnosis

  https://www.techscience.com/chd/v15n5/40251

  Secundum atrial septal defect (ASD II) is a common congenital heart defect, and interatrial communications among preterm children is even more common. The objective of this study was to calculate the incidence of ASD II in children, with assessment to gestational age at birth. […] The yearly overall incidence of ASD II was 150 per 100 000 live births. However, this incidence ranged from 449 per 100 000 live births to 1737 per 100 000 live births, with higher incidence among preterm children. […] Preterm children have a higher incidence of ASD II than previously found, increasing with lower gestational age at birth. Preterm birth is an independent risk factor for ASD II diagnosis with three to four times, suggesting that this group of children may need new structured follow up program with careful assessment of indication when need of treatment and closure.

• #23 Spontaneous Closure of a Secundum Atrial Septal Defect | Methodist DeBakey Cardiovascular J

  https://journal.houstonmethodist.org/articles/10.14797/mdcj-14-1-60

  Atrial septal defect (ASD) is a common congenital disorder with a prevalence of approximately 2 per 1,000 live births. […] Secundum ASDs are the most common, making up more than 70 of all ASDs. […] The reported rate of spontaneous ASD closure ranges from 4 to 96, with the variation due to different selection criteria in the study cohorts. […] The most important predictor for spontaneous closure is the size of defect, with smaller defects more likely to close. […] Spontaneous closure also correlates with age at diagnosis and is more likely to occur when the ASD is detected at an earlier age. […] Consequently, the relatively older age at diagnosis (4.5 years) in the study by McMahon et al. was a likely factor in the extremely low spontaneous closure rate (4). […] Predictors of ASD closure are dependent on defect size and patient age. […] Routine clinical follow-up with serial echocardiography is the best way to identify those patients who close spontaneously and those who will require closure.

• #24 Incidence of atrial septal defects in children attended the Cardiac Center of Ethiopia during January 2016 to December 2018 | bioRxiv

  https://www.biorxiv.org/content/10.1101/2020.02.12.945360v1.full-text

  An ostium secundum is the most common type of ASD; accounting for 75– 93.2% of all ASD and females constitute 65–75% of patients with the secundum ASD. […] Therefore, this survey was designed to document the incidence and echocardiographic profiles of ASDs in children who attended in the cardiac referral center of Ethiopia (Cardiac Center of Ethiopia). This study may provide a baseline data for the currently lacking statistics and for future studies on ASDs. Moreover, it may help in the management and follow-up of children with ASD.

• #24 Incidence of atrial septal defects in children attended the Cardiac Center of Ethiopia during January 2016 to December 2018 | bioRxiv

  https://www.biorxiv.org/content/10.1101/2020.02.12.945360v1.full-text

  Background Although it appears that an atrial septal defect (ASD) occurs frequently in Ethiopia there are only a few published studies available so far on this matter. This study is therefore aimed to evaluate the prevalence and echocardiographic characteristics of ASDs in children (aged ≤ 15 years) attended a cardiac referral center in Ethiopia. […] A total of 116 children (56.9% females and 43.1% males) with a mean age of 3.47± 3.72 years (range: 15 days to 15 years) were diagnosed with ASDs. […] The most prevalent age groups were infancy (50%) and early childhood (29.3%). […] All the studied cases were diagnosed with ostium secundum ASD while there were no cases with ostium primum, sinus venosus and coronary sinus defects. […] The most frequent ostium secundum ASD was large size (61.2%) and was more frequent in infants (23.3%) and young children (21.6% of all cases).

• #25 Atrial and ventricular septal defects – epidemiology and spontaneous closure – PubMed

  https://pubmed.ncbi.nlm.nih.gov/16753766/

  Objective: To present data on the epidemiology and spontaneous closure for septal defects (secundum atrial septal defect (ASD) and/or ventricular septal defect (VSD)). […] There were 78 infants with an ASD, 195 with a VSD, and 19 had both an ASD and a VSD. The overall prevalence of septal defects was 4.1 per 1000 livebirths. […] Eighty-one percent of the cases had an isolated cardiac malformation. […] Secundum ASD has a high rate of spontaneous closure. […] Perimembranous and muscular VSDs seem to be two different diseases with different epidemiology and natural history.

• #26 Pathophysiology and Management of Arrhythmias Associated with Atrial Septal Defect and Patent Foramen Ovale | AER Journal

  https://www.aerjournal.com/articles/pathophysiology-and-management-arrhythmias-associated-atrial-septal-defect-and-patent?language_content_entity=en

  Atrial septal defects (ASDs) are among the most common of congenital heart defects and are frequently associated with atrial arrhythmias. […] Closure of an ASD reduces the immediate and long-term prevalence of atrial arrhythmias, but the evidence suggests that patients remain at an increased long-term risk in comparison with the normal population. […] Atrial arrhythmias (AAs) atrial fibrillation (AF) and/or flutter (AFL) are significantly increased in patients with ASDs; the prevalences are summarised in Table 1. […] In unoperated adults, the estimated incidence of AAs is approximately 10 % under the age of 40 years, rising to at least 20 % with increased age, pulmonary arterial pressure and systemic hypertension. […] There is strongly supportive evidence that the prevalence of AAs is decreased following closure of an ASD.

• #26 Pathophysiology and Management of Arrhythmias Associated with Atrial Septal Defect and Patent Foramen Ovale | AER Journal

  https://www.aerjournal.com/articles/pathophysiology-and-management-arrhythmias-associated-atrial-septal-defect-and-patent?language_content_entity=en

  However, many AAs may recur in the longer term (5 years), their progression stalled rather than terminated. […] Given the future propensity for AAs, and the challenges of intervention post-device closure, there may be a subgroup of patients that would benefit from risk stratification and prophylactic interventional electrophysiological procedures, a dilemma that as yet remains unanswered.

• #27 Atrial Septal Defect in Adulthood

  https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2022/07/29/14/01/Atrial-Septal-Defect-in-Adulthood

  ASD is the most common congenital heart disease diagnosed in adulthood, accounting for 25-30% of diagnoses. […] Echocardiography remains the first-line imaging modality for ASDs. Information obtained by echo includes size and location of defects, assessment of right ventricular chamber size, and estimation of right ventricular pressures. […] Atrial flutter and atrial fibrillation are common in patients with ASD, with prevalence increasing with age. In patients 60 years of age, 20% experience atrial flutter and 50% experience atrial fibrillation.

• #28 The Burden of Migraine in Adults with Atrial Septal Defect: A Nationwide Cohort Study | Scientific Reports

  https://www.nature.com/articles/s41598-019-43895-z

  Patients with an atrial septal defect (ASD) had an increased risk of receiving a migraine diagnosis (HR 3.4 (95% CI: 2.64.6)) and receiving migraine medicine (HR 1.8 (95% CI: 1.22.5)). […] Migraine and use of migraine medicine were increased in atrial septal defect patients. The use of medicine was not diminished by closure of the defect. […] The ASD patients had an increased risk of receiving an in-hospital migraine diagnosis 54 (2.4%) of the ASD patients, and 154 (0.7%) of the comparison cohort), with a HR of 3.4 (95% CI: 2.54.6). […] The overall risk of receiving prescription migraine medication was increased in the ASD patients compared with the comparison cohort with a HR adjusted for gender and stroke of 1.8 (95% CI: 1.22.5). […] Patients with an ASD have an increased risk of receiving a hospital related migraine diagnosis, of receiving prescription migraine medicine and have a higher risk of having very high plasma serotonin levels when compared with a gender and age matched comparison cohort. The risk of using migraine medicine is not reduced 10 year after closure. […] Migraine was not associated with very high levels of serotonin in the patients with a small or spontaneously closed ASD.

• #29 Migraine prevalence in patients with atrial septal defect | The Journal of Headache and Pain | Full Text

  https://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/1129-2377-14-63

  Patients with a patent foramen ovale have a high prevalence of migraine with aura (MA). However, whether patients with an atrial septal defect (ASD) have a high prevalence of migraine remains unclear. […] The overall prevalence of migraine seemed to be higher in the present study than in the Japanese general population (24.2% vs. 9.4%, respectively). […] Patients with ASD had a 1.8- to 3.6-fold higher prevalence of migraine (24.2%; 95% CI, 16.7 – 33.7%) than the 9.4% found in the Japanese general population after adjusting for sex and age. […] The reported prevalence of migraine in patients with ASD ranges from 11 to 22% for MA and 12 to 28% for MO. […] In our previous study, we found an increase in the overall prevalence of migraine after ASD closure.

• #30 Hidden burden of arrhythmias in patients with small atrial septal defects: a nationwide study | Open Heart

  https://openheart.bmj.com/content/6/1/e001056

  These results support the guidelines for management of adults with small ASD, recommending continued follow-up every 2-3 years with a clinical focus on arrhythmias. […] The present study was designed to examine the covert burden of arrhythmia, as this might identify those at risk of developing symptomatic arrhythmia in the future and might cast light on the underlying mechanisms of arrhythmia, prior to the confounding effects of sustained arrhythmia itself. […] Our data showed that despite the ASD having closed spontaneously in the majority, 16% of patients had asymptomatic atrial arrhythmias, a number comparable to a previous study, reporting atrial arrhythmias (although many symptomatic) in 18.9% of patients with large significant ASD. […] Patients diagnosed with a small, unrepaired ASD without a known diagnosis of AF had a hidden burden of both atrial and ventricular tachyarrhythmias, predominately non-sustained atrial arrhythmia and NSVT. […] Arrhythmias were present despite spontaneous closure of the ASD and were associated with increased RV/LV area ratio, suggesting that associated changes in atrial and ventricular myocardium are partly irreversible.

• #31

  https://link.springer.com/article/10.1007/s12471-015-0663-z

  Secundum atrial septal defect (ASDII) is a common congenital heart defect that causes shunting of blood between the systemic and pulmonary circulations. […] Atrial septal defect (ASD) is a common congenital heart defect, with an estimated birth prevalence of 1.6 per 1000 live births and a 97% probability of survival into adulthood. […] ASDII constitutes about 75% of these defects, has a female predominance of approximately 2:1, and is frequently diagnosed in adulthood. […] Patients with an isolated ASDII often remain asymptomatic during childhood and adolescence. However, most will become symptomatic from the third or fourth decade, and life expectancy is reduced overall. […] Closure confers a survival benefit in all ASDII patients, regardless of age. […] However, eventual life expectancy is dependent on age at closure.

• #31

  https://link.springer.com/article/10.1007/s12471-015-0663-z

  An often-cited study into the long-term outcome after surgical repair showed normal survival after closure under the age of 25. […] In contrast, patients operated later in life, especially at ages over 40, experienced increased mortality. […] Current evidence suggests the beneficial effects of defect closure to be inversely related to patient age, supporting timely closure after diagnosis. […] Treated patients, especially those with pre-existing PAH or dysrhythmia and those treated later in life, remain at increased risk for cardiovascular morbidity and should stay under medical surveillance.

• #32 Prevalence of congenital septal defects among congenital heart defect patients in East Africa: A systematic review and meta-analysis | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0250006

  Congenital heart defects (CHDs) are the most common congenital defects and accounts for nearly one-third of all major congenital anomalies. Of all CHD types, ventricular septal defect (VSD) and atrial septal defect (ASD) accounted 51% of cases with an increasing trend over time. […] The pooled prevalence of ventricular septal defect and atrial septal defect in East Africa was found to be 29.92% (95% CI; 26.1233.72; I2 = 89.2%; p0.001), and 10.36% (95% CI; 8.0512.68; I2 = 89.5%; p0.001) respectively. […] Based on this review, the pooled prevalence of VSD and ASD is still high and alarming; this signifies that the emphasis given for congenital heart defect in East African countries is limited. […] The pooled prevalence of ASD in East Africa is 10.36% (95% CI; 8.0512.68). This result was relatively low compared to the prevalence of ASD in systematic reviews and meta-analyses conducted globally in the years 19702017 and 19302010, which was 15.37 (95% CI: 13.49217.363) and 13% respectively.

• #32 Prevalence of congenital septal defects among congenital heart defect patients in East Africa: A systematic review and meta-analysis | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0250006

  The pooled prevalence of ASD among CHD patients is 13.44% in Ethiopia, 13% in Djibouti, and 9.76% in Sudan. […] The result signifies that, the emphasis given for congenital heart disease in East African countries is limited. Therefore, it needs critical interventions at the grass-root level in the region to loosen the burden.

• #33 Epidemiologi Atrial Septal Defect – Alomedika

  https://www.alomedika.com/penyakit/kardiologi/atrial-septal-defect/epidemiologi

  Data epidemiologi memperkirakan atrial septal defect (ASD) atau defek septum atrium sebagai jenis penyakit jantung bawaan ketiga terbanyak. Insidensi ASD diperkirakan sekitar 56 per 100.000 kelahiran hidup. Meski demikian, seiring semakin majunya teknik pencitraan yang memampukan deteksi silent defects oleh echocardiography, estimasi ASD diperkirakan meningkat menjadi 100 per 100.000 kelahiran hidup.[6] […] Seiring kemajuan modalitas pemeriksaan echocardiography, deteksi atrial septal defect (ASD) menjadi semakin mudah. Hal ini diperkirakan menyebabkan semakin tingginya angka insidensi dari ASD. […] Data yang memuat prevalensi atrial septal defect (ASD) di Indonesia masih sangat terbatas. Secara keseluruhan, Perhimpunan Dokter Spesialis Kardiovaskular Indonesia (PERKI) mencatatkan ada sekitar 40 ribu anak yang dilahirkan dengan penyakit jantung bawaan (PJB) di Indonesia.[7]

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