Atrial Septal Defect Essay

An atrial septal defect is a congenital birth defect of the heart in which there is a hole in the septum that divides the atria. The hole can vary in size and may close on its own or may require surgery. The Centers for Disease Control and Prevention recently estimated that each year about 1,966 babies in the United States are born with an atrial septal defect. About 5% to 10% of all coronary heart disease are atrial septal defects and are responsible for about 30% of the congenital heart defects diagnosed in adults. Atrial septal defects are twice as common in females as in males. Most atrial septal defects occur periodically as a result of spontaneous genetic mutations even though hereditary forms have been found, also linked extra-cardiac congenital defects are present in 25% of infants with atrial septal defect, and about one third have a hereditary syndrome.

In many cases, it may not be diagnosed until adulthood. What happens in smaller atrial septal defects is that minor blood shunting within the heart occurs and it has no hemodynamic significances. Larger defects are usually accompanied with significant shunting, which can lead to volume overload of the right atrium, right ventricle, and pulmonary arteries. The degree of left-to-right shunting depends on the size of the atrial septal defect, the relative compliance of both ventricles, and the pulmonary and systemic vascular resistance. If left untreated, this can cause pulmonary hypertension, right ventricular failure, reduced right ventricular compliance, and has the potential to cause right-to-left shunting.

Three nursing diagnoses for atrial septal defects are as follows:

1. Activity intolerance related to fatigue, generalized weakness and lack of adequate oxygenation.

2. Decreased cardiac output related to cardiac dysfunction.

3. Risk for disorganized infant behavior, risk factor is invasive