Can atrial septal defect cause pulmonary hypertension?

Atrial septal defect can easily cause pulmonary hypertension, and these phenomena will pose a threat to our life and health, so we must pay attention to reasonable treatment and solutions. Patients can first use medication to help lower pulmonary artery pressure.

1. Atrial septal defect can cause pulmonary hypertension. Since the left atrial pressure of 1.07-1.30 kPa (8-10 mmHg) is higher than that of the right atrium of 0.4-0.67 kPa (3-5 mmHg), the presence of atrial septal defect will cause the blood flow from the left atrium to be shunted to the right atrium. The amount of shunt depends on the atrial pressure gradient and the size of the defect. In early childhood, the pressures on both sides of the atrium are relatively close, the shunt volume is not large, and the clinical symptoms are not obvious. As age increases, the atrial pressure difference increases and the left-to-right shunt volume gradually increases, reaching 2-4 times the systemic blood flow.

2. The load on the right heart increases, causing the right atrium, right ventricle and pulmonary artery to gradually expand, and the pulmonary artery pressure to rise. In the early stage, the pulmonary arterioles spasm, followed by hyperplasia of the intimal wall and thickening of the middle layer, narrowing of the lumen and increased resistance, finally leading to obstructive pulmonary hypertension.

3. The pressure in the right atrium and right ventricle increases, the shunt volume decreases, and even backflow from the right atrium to the left atrium occurs. In some cases, the thickening of the walls of the pulmonary arterioles during the fetal period fails to subside after birth, resulting in varying degrees of obstructive pulmonary hypertension. When the primary orifice defect is accompanied by a large valve tear, the regurgitation of the mitral valve increases the left-to-right shunt volume, and pulmonary hypertension appears earlier.

4. If atrial septal defect accompanied by pulmonary hypertension appears very early, there is still hope for treatment. As long as the right-to-left shunt has not reached a very late stage, it can be saved. Cases with atrial septal defect of appropriate size can be blocked without open-chest surgery. If the pulmonary artery pressure is not particularly high and causes right-to-left shunt, it can be blocked for treatment. If the pulmonary artery pressure is particularly high, it cannot be blocked.

5. You can also use drug therapy to lower the pulmonary artery pressure first. If the patient's pulmonary artery pressure is high and causes right-to-left shunt, use some drugs to lower the pulmonary artery pressure first. There is still a chance for surgery. Heart-lung transplantation is only performed in the terminal stage.