Atrial Septal Defect: Causes, Symptoms, and Treatment
Medically reviewed by Achuta Uppu, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Atrial Septal Defect?
A cardiologist, a heart doctor, treats atrial septal defect. Children may see a pediatric cardiologist, a heart doctor for children. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is Atrial Septal Defect?
An atrial septal defect (ASD) is a hole in the wall between the two upper chambers of the heart. The wall is called the septum. The hole is there at birth. That makes it a congenital heart defect, a heart problem a baby is born with. Normally, blood cannot flow between the two upper chambers. An ASD lets this happen. Blood most often flows from the left side to the right side, which makes the right side of the heart grow larger. Over time, pressure in the lungs may build up.
Symptoms
A person with a small defect may have no symptoms. Sometimes symptoms do not appear until middle age or later. Symptoms can begin at any time after birth. They can include:
- Shortness of breath with activity.
- Difficulty breathing.
- Frequent respiratory infections in children.
- Feeling the heartbeat, called palpitations, in adults.
Causes and who gets it
The defect happens when the wall between the upper chambers does not form right before a baby is born. Researchers often do not know what causes congenital heart defects, though changes in a baby's genes sometimes cause one. Several things may raise the chance that a baby has a congenital heart defect. These include having diabetes before pregnancy, having rubella during pregnancy, smoking or breathing secondhand smoke, and taking certain medicines such as ACE inhibitors or retinoic acids. The chance also goes up if a parent already has a child with a congenital heart defect.
How doctors diagnose it
The doctor looks at your symptoms, a physical exam, and heart tests. While listening with a stethoscope, the provider may hear a heart murmur, an abnormal sound from blood not flowing smoothly. An echocardiogram is a test that uses sound waves to make a moving picture of the heart. It is often the first test done. Other tests include an electrocardiogram (ECG), cardiac catheterization, and a heart MRI or CT. Some defects are found before birth with a fetal echocardiogram, an ultrasound of the baby's heart done between weeks 18 and 22 of pregnancy.
Treatment
An ASD may not need treatment if there are few or no symptoms, or if the hole is small and not linked to other heart problems. Small defects often close without treatment. Larger ones often do not close and may need a repair.
Surgery to close the hole is recommended when too much blood flows through it, the heart is swollen, or symptoms occur. Many people can instead have a closure procedure without open-heart surgery. A provider makes a tiny cut in the groin, threads catheters, thin tubes, into a blood vessel and up to the heart, and places a closure device across the hole. Open-heart surgery is more likely when the baby has other heart defects too. People who have a repair should get antibiotics before dental procedures in the period right after the procedure, but not later on. After a repair, regular follow-up with a cardiologist is needed for life.
When to see a doctor
Contact your doctor if you have symptoms of an ASD, such as palpitations, which means feeling your heartbeat. A larger or more complicated ASD raises the risk of stroke, heart failure, heart infection, and high blood pressure in the lung arteries. Call 911 or go to the emergency room if you have trouble breathing, sudden weakness on one side of the body, or you cannot speak.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either can arrange the first heart tests, keep up with regular follow-up over the years, and work with your cardiologist when more care is needed.
Common questions
Can an atrial septal defect close on its own?
Small defects often close without treatment. Larger ones often do not close and may need a repair. The outlook depends on the size of the hole, how much extra blood flows through it, and whether you have symptoms.
How is an ASD closed without open-heart surgery?
A provider makes a tiny cut in the groin and guides thin tubes called catheters to the heart. A closure device is then placed across the hole. This works for some people. It depends on the size and location of the hole.
What problems can an untreated ASD cause?
Larger or more complicated defects raise the risk of abnormal heart rhythms, especially atrial fibrillation, heart failure, heart infection, high blood pressure in the lung arteries, and stroke. Early detection can prevent some of these problems.
Can atrial septal defect be prevented?
There is no known way to prevent it. But some things may lower the risk before pregnancy, such as controlling blood sugar and not smoking. Talk with your doctor before getting pregnant if you have concerns.
Sources
- MedlinePlus - Atrial septal defect (ASD): MedlinePlus Medical Encyclopedia
- MedlinePlus - Congenital Heart Disease | Congenital Heart Defects
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
