What should I do if there is a murmur of atrial septal defect?

The heart is a very important organ for the human body. It is like the engine of a machine. The heart is the core energy of the human body. However, the heart is also a relatively fragile organ, and it is more prone to some adverse reactions. Atrial septal defect with murmur is a condition caused by heart disease. In the face of this situation, people need to pay special attention. The following is a detailed introduction on what to do with atrial septal defect murmur?

Atrial septal defect is one of the most common types of congenital heart disease. The vast majority are single-hole type, a few are multi-hole type, and a very small number of patients are cribriform type. Patients can be treated with two methods: interventional treatment and surgical treatment. Special attention should be paid during interventional treatment. The relationship between the maximum atrial diameter and the defect should be carefully calculated to reduce the possibility of occluder displacement. Try to choose an occluder with the same or closest diameter to the defect. Do not blindly increase the size of the occluder to avoid making the occluder too large, thereby affecting the function of other important structures.

Atrial septal defects can be divided into four types: primary foramen thorax, also known as type 1 atrial septal defect; secundum foramen thorax, also known as type 2 atrial septal defect. The most common clinical type is the secundum atrial septal defect, also known as the 2-hole atrial septal defect. The defect is located in the oval fossa in the center of the atrial septum, and is also called central atrial septal defect. The primary foramen ovale atrial septal defect, also known as 1-hole atrial septal defect, is located at the junction of the endocardial cushion and the atrial septum, accounting for approximately 15% clinically. This type is often combined with anterior mitral valve dehiscence and septal tricuspid valve dehiscence. In this case, the disease is called partial endocardial cushion defect. Of course, the main difference between the two lies in the diagnosis of echocardiography.

Treatment principles

Surgical treatment and interventional occlusion treatment can be used.

Treatment strategy

All children with a clearly diagnosed atrial septal defect should undergo surgical repair, especially those with a larger defect.

Surgery

1. Indications and contraindications for surgery: All children with a clearly diagnosed atrial septal defect should undergo surgical repair, especially those with a larger defect. The ideal age for surgical treatment is between 1 and 5 years old. Surgery is contraindicated in patients with severe pulmonary hypertension, clinically significant cyanosis, and heart failure.

2. Treatment methods: There are currently two methods for the treatment of atrial septal defect: ① Surgical treatment: According to the surgical repair method, it can be divided into patch method and direct repair method. The patch can be made of polyester patch or autologous pericardial patch. ②Interventional occlusion treatment.

Other treatments

The incidence of postoperative sinus bradycardia is higher in elderly patients with atrial septal defect. Isoproterenol or atropine can be used to increase the heart rate, and placement of temporary pacing electrodes during surgery is an effective measure.

Prognosis

Most patients with unoperated atrial septal defects grow to adulthood, but their life span is shortened and they die of congestive heart failure. After the operation, due to the improvement of hemodynamics, the patient's symptoms were significantly alleviated or disappeared, and their long-term survival rate was not significantly different from that of normal people.