Evaluation and Treatment of
Structural Heart Disease

What are Atrial Septal Defects/Patent Foramen Ovales

Atrial septal defects (ASDs) or patent foramen ovales (PFOs) are abnormal communications between the top two chambers of the heart, the atrias of the heart. These abnormal communications are present at birth (congenital) and on occasion will not show symptoms until adulthood.

ASDs occur in up to 1 in 1500 births and make up approximately 30-40% of all adult congenital heart defects, while PFOs are present in up to 20% of all adults, although usually without symptoms.

What are Symptoms of Atrial Septal Defects/Patent Foramen Ovales

The symptoms result when these communications allow blood to flow between the two top chambers without being filtered by the lungs or receiving oxygen from the lungs. This can result in many different symptoms including shortness of breath with minimal exertion, low oxygen levels, congestive heart failure, strokes, decompression sickness, and even possibly migraines.

Decompression sickness results from the crossing of inert gases – found in the gas mixtures used in diving tanks – from the right to the left top chambers of the heart, forming large gas bubbles that can travel to the brain instead of being exhaled by the lungs. Strokes are caused by the same crossing mechanism but instead by small blood clots that form in the veins.

How are Atrial Septal Defects/Patent Foramen Ovales Diagnosed?

If you suspect that you have either one of these abnormalities, the physicians at Tampa Cardiovascular Associates will first obtain an echocardiogram (ultrasound of the heart) as well as an electrocardiogram. These two studies are usually sufficient to exclude these diagnoses. However, if there is still concern, we’ll proceed with a transesophageal echocardiogram (ultrasound of the heart performed endoscopically under sedation) for confirmation.

How are Atrial Septal Defects/Patent Foramen Ovales Treated?

The physicians at Tampa Cardiovascular Associates will discuss with you the different modalities available for the treatment of these communications. In most situations, we will start with a strict medical regimen and watch you closely; however, on occasion we will recommend closure of these communications.

This can be achieved by either surgical or minimally invasive methods. The physicians at Tampa Cardiovascular Associates perform the minimally invasive method, which has become the prominent method of closure due to its ease, minimal time commitment to the patient (one overnight stay in the hospital), and lack of any surgical scarring. On rare occasions, surgery is recommended; this will be discussed with you during your consultation.