Atrial Septal Defect (ASD)

Atrial Septal Defect (ASD)

1. Definition: Atrial septal defect (ASD) is a congenital heart defect in which there's an opening in the septum (wall) between the heart's two upper chambers (atria).

2. Causes / Etiology: ASD occurs during fetal development when the wall between the heart's two upper chambers doesn't form correctly. It can also be caused by various factors such as genetic syndromes, infections during pregnancy, or exposure to certain toxins.

3. Types or Classification: There are several types of ASDs:

• Ostium primum ASD: This is a small defect located near the septal leaflet of the mitral valve.
• Ostium secundum ASD: This is the most common type of ASD, usually occurring in the middle part of the septum.
• Sinus venosus ASD: This type of ASD occurs near the top of the septum, near the entrance of the superior vena cava.
• Coronary sinus ASD: This is a rare type of ASD that occurs near the coronary sinus.

4. Pathology: Step 1 → Deoxygenated blood from the right atrium enters the left atrium through the ASD. Step 2 → This mixed blood (oxygenated and deoxygenated) then enters the left ventricle. Step 3 → The left ventricle pumps this mixed blood into the aorta and then into the rest of the body. Step 4 → Over time, this can lead to increased pressure and workload on the right side of the heart, resulting in right ventricular hypertrophy.

5. Clinical Features: General features:

• Fatigue
• Shortness of breath
• Chest pain or pressure
• Palpitations
• Swelling in the legs and feet

Specific features:

• A systolic ejection murmur heard over the left upper sternal border
• A fixed splitting of the second heart sound (S2)

6. Complications: Acute complications:

• Atrial fibrillation
• Pulmonary edema
• Cardiac arrest

Chronic complications:

• Right ventricular failure
• Pulmonary hypertension
• Arrhythmias

7. Diagnosis / Investigations: Routine tests:

• Electrocardiogram (ECG)
• Chest X-ray
• Echocardiogram

Special tests:

• Cardiac catheterization
• Cardiac MRI

8. Management: General management:

• Monitor for signs of heart failure
• Manage pulmonary hypertension
• Anti-arrhythmic medications for arrhythmias

Modern treatment:

• Surgical repair
• Catheter-based closure of the ASD

Dietary advice:

• Increase salt intake to reduce fluid retention
• Avoid strenuous exercise
• Follow a low-sodium diet if recommended by a healthcare provider

9. Homeopathic Therapeutics:
10. Calcarea carbonica

• Fatigue and weakness
• Shortness of breath
• Palpitations
• Swelling in the legs and feet

2. Ferrum phosphoricum

• Fatigue and weakness
• Shortness of breath
• Palpitations
• Swelling in the legs and feet

3. Digitalis purpurea

• Arrhythmias
• Heart failure
• Shortness of breath
• Fatigue

4. Nux vomica

• Chest pain and pressure
• Fatigue and weakness
• Shortness of breath
• Palpitations

5. Lachesis

• Palpitations
• Shortness of breath
• Fatigue and weakness
• Swelling in the legs and feet