When symptoms occur, they are mainly:
- Shortness of breath
- Tiredness and fatigue
- Decreased physical performance
- Water retention in the abdomen and legs
In the case of ventricular septal defect, the symptoms usually occur earlier and in greater severity. By additional congenital anomalies or defects of the heart, the circulatory conditions in atrial or ventricular septal defect can be further additionally changed. For example, additional pulmonary stenosis (narrowing of the valve in the right ventricle) in the presence of higher-grade ventricular septal defect favors premature right heart strain with shunt reversal.
Complications of ventricular septal defect.
Significant atrial septal defects but especially ventricular septal defects can lead to the following complications:
- Myocardial insufficiency of the right heart.
- Stress on the pulmonary circulation with pulmonary hypertension
- Shunt reversal
Without timely effective treatment in the form of surgery, the life expectancy of patients with large cardiac septal defects is significantly reduced.
Diagnostics of the heart defect
Already in the unborn, heart defects can be detected with ultrasound; the diagnosis of a significant cardiac septal defect can be confirmed by ultrasound and cardiac catheterization even in newborns.
Of crucial importance for the further treatment plan are the size of the defect as well as the extent of the resulting additional blood flow due to the short circuit between the right and left heart. Acquired cardiac septal defect is usually a serious complication of myocardial infarction and is also diagnosed by ultrasound or by cardiac catheterization.
Therapy of cardiac septal defect.
In principle, surgical or drug therapy can be considered. In the long term, the only effective treatment option is cardiac surgery with closure of the defect by the surgeon. The timing of the operation should ideally be chosen here so that the conditions in the heart can be normalized before the onset of myocardial weakness, pulmonary circulation stress, or even shunt reversal.
- Congenital ventricular septal defect: In individual cases, cardiac surgery may be indicated before the first year of life, especially for the large ventricular septal defect. In less severe cases of a ventricular septal defect, the hole also partially closes itself or at least recedes, so that surgery can be postponed.
- Congenital atrial septal defect: In the case of atrial septal defect, precise criteria also exist on the basis of a cardiac catheterization, which can be used to determine the necessity and timing of surgery.
- In the case of acquired cardiac septal defect, which usually occurs as a complication of an extensive myocardial infarction, either emergency surgery is performed or waiting until the acute infarction phase has subsided. The further procedure is then again depending on the size of the defect.
At any time of the disease, especially before surgery, additional attempts can be made to stabilize the circulatory conditions by medication, although only limited treatment success can be expected.
Preventive measures
As with all diseases of genetic basis, there are unfortunately no possibilities for prevention. However, the course of the disease can be favorably influenced by early diagnosis, regular follow-up visits to the treating specialist, and, if necessary, timely cardiac surgery. With regard to the acquired cardiac septal defect, the same precautionary measures apply as for all cardiovascular diseases.
