Atrial septal defect natural history
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Claudia Hochberg, M.D.
Associate Editors-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Keri Shafer, M.D. [3]; Priyamvada Singh, MBBS [[4]]
Assistant Editor-In-Chief: Kristin Feeney, B.S. [[5]]
Overview
The majority of atrial septal defect patients are asymptomatic until adulthood. Symptom onset and severity hinges largely on the size of the defect. Without intervention, the mortality rate for symptomatic adults is greater than 50%. Possible complications include atrial fibrillation, pulmonary hypertension and stroke.
Natural history
As many atrial septal defect patients are asymptomatic, it is common to survive into adulthood without any need for intervention. Many atrial septal defects smaller than 8mm in diameter spontaneously close during infancy. Spontaneous closer is uncommon in children and adults. Adulthood, however, can lead to onset of symptoms and altered life expectancy. Beyond 40-50 years of age, survival without intervention is under 50% with an attrition rate of about 6% per year. Complications may onset later in life and include associated conditions such as atrial fibrillation, pulmonary hypertension, and stroke.
Complications
Complications involving comorbidity
Atrial fibrillation | Pulmonary hypertension | Right heart failure | Stroke