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ASD & Stroke Risk

Atrial Septal Defect (ASD) is a congenital heart disease. According to the Centers for Disease Control and Prevention, it affects 4 out of every 10,000 children born in the United States each year. Surgical treatment is usually suggested to prevent long-term health issues in later years. Identification of ASD type and understanding major long-term risks like stroke are important steps in making treatment decisions between the patient, family and the health practitioner.

  1. Identification

    • Atrial septal defect (ASD) is a defect in the septum between the heart's two upper chambers, or atria. The septum acts as a wall between the left and right side of the heart. When this defect or hole exists between the atria, the passage of oxygen-rich blood is disturbed, creating repetitive blood flow and creating additional work for the heart as blood is processed twice on the right side.

    Types

    • A.I. Dupont Hospital for Children reviews three types of ASDs. Secundum-type ASDs, the most common, encompass 85 percent of all ASD cases. While 20 percent of these defects close naturally within the first year of life, some infants and young children are often asymptomatic or undetected until school age or later. Sinus venosus ASDs encompass 5 percent to 10 percent of all cases, affecting the right, upper pulmonary veins. There is no chance for spontaneous closure in this case and surgical repair is necessary. Primum-type ASDs constitute between 5 percent and 10 percent of all ASDs. One or more heart valves are associated with this defect. This symptoms of this defect are recognized during early childhood and surgical repair is the only method of treatment.

    Risks

    • According to the CDC, if an ASD is not repaired in youth there are serious health problems than can occur in a patient's adult years, including an increased risk of stroke, infective endocarditis, frequent respiratory infections, high blood pressure in the lungs and heart failure.

    Strokes and ASDs

    • A stroke can occur when a blood clot or bubble travels to the brain. In a healthy heart, as a blood clot or bubble forms, it will usually be filtered out of the blood by the lungs. In a heart with an ASD, a clot could potentially bypass the lungs and this critical filtration. In addition, a common effect of ASDs is an irregular heartbeat. With an irregular heartbeat, the risk of a blood clot forming in the atria increases, raising the risk for stroke.

    Theories/Speculation

    • In 2003, a study completed by a team of doctors at affiliate hospitals and Marie Curie University in France reinforced a link between atrial septal abnormalities, atrial vulnerability and ischemic stroke in young patients. The study found significant association between atrial vulnerability and ASDs. As a result of this associated risk, it is usually recommended that the ASD defect be surgically closed when possible.

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