Last updated on: July 26th, 2020

Atrial Septal Defect

Clinicals - History

No symptoms

Atrial septal defect (ASD) may be asymptomatic in the pediatric age group. Small defects may be asymptomatic throughout life.

Frequent respiratory infections

An infant with a large ASD may present with frequent lung infections. This is a common occurrence when there is an increase in pulmonary blood flow due to left-to-right shunting.

Respiratory difficulty

In infants this may show up as an inability to feed well. Older children may report dyspnea with exercise. This is a consequence of an abnormal increase in pulmonary blood flow from left-to-right shunting.


Children may have the sensation of their heart racing or skipping a beat. It may be secondary to arrhythmia and should thus be investigated.


Cyanosis may occur in the presence of pulmonary hypertension, when the ASD, instead of the left-to-right shunt, shunts right-to-left (Eisenmenger syndrome).

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