Atrial septal defect (ASD) is a heart defect that is present at birth (congenital). Atrial septal defect (ASD) is a form of a congenital heart defect that lets blood flow between the normally separated two upper chambers, the atria of the heart. Atrial septal defect is characterized by a defect in the interatrial septum allowing pulmonary venous return from the left atrium to pass directly to the right atrium. During development of the fetus, the interatrial septum develops to separate the left and right atria. After birth, the pressure in the right side of the heart drops as the lungs open and begin working, causing the foramen ovale to close entirely.

6 Nursing Diagnosis for Atrial Septal Defect

A person with no other heart defect, or a small defect (less than 5 millimeters) may not have symptoms, or the symptoms may not occur until middle age or later.

Symptoms that do occur may begin at any time after birth through childhood. They can include:

  • Difficulty breathing (dyspnea)
  • Frequent respiratory infections in children
  • Feeling the heart beat (palpitations) in adults
  • Shortness of breath with activity
The doctor may hear abnormal heart sounds when listening to the chest with a stethoscope. A murmur may be heard only in certain body positions. Sometimes, a murmur may not be heard at all. A murmur means that blood is not flowing through the heart smoothly.

The physical exam may also show signs of heart failure in some adults.

An echocardiogram is a test that uses sound waves to create a moving picture of the heart. It is often the first test done.

Other tests that may be done include:
  • Cardiac catheterization
  • Coronary angiography (for patients over 35 years old)
  • Doppler study of the heart
  • ECG
  • Heart MRI
  • Transesophageal echocardiography (TEE).

6 Nursing Diagnosis for Atrial Septal Defect
  1. Risk for Decreased Cardiac Output.
  2. Activity Intolerance.
  3. Altered Growth and Development.
  4. Risk for Infection.
  5. Risk for Injury.
  6. Altered Family Processes.