Heart hole in young mother treated without surgery

• Congenital condition remained undiagnosed for 30 years.
• Early detection key to prevent complications later in life

November 2, 2014, Ras Al Khaimah, UAE.A young mother of two in her 30s started complaining of intermittent fast heart beat and variety of other complications all of a sudden. She decided to seek expert opinion and consulted Dr. S. Radhakrishnan, Consultant Cardiologist at RAK Hospital during his recent visit to RAK. She was experiencing rapid heart beat and breathlessness due to a “Hole in the Heart” which was confirmed after careful examination and evaluation. Her heart hole was successfully closed without surgery by the specialist Doctor through the use of a revolutionary recent technique. This was an adult case of Atrial Septal Defect (ASD) which remained undiagnosed for almost 3 decades. Atrial septal defect (ASD) is a heart defect that is present at birth (congenital). While the baby is in the womb, there is normally an opening between the upper chambers of the heart (atria) to allow blood to flow around the lungs. This opening usually closes around the time when the baby is born. If the opening does not close, the hole is called an atrial septal defect, or ASD.

She never had any complications even during childbirth which according to Dr. Radhakrishnan is typical of these holes as complications start abruptly in such cases. Septal defects are the most common heart problems that babies are born (1 in 1000) with and many times go unnoticed, it’s important to have regular prenatal checks, heart screenings for the infants and tests for children especially if you notice any symptoms which may indicate a problem. After all early detection and treatment can save your child from possible complications later which may include heart failure, heart infections, pulmonary hypertension (high blood pressure in the arteries of the lungs), stoke etc.

“People needn’t be scared and should know that 80% of such cases can be solved without an open heart surgery. With the use of recently developed revolutionary technique, a small blocking device is placed into the heart through a blood vessel, which is then moved into place with guide wires to block the hole.  This completely eliminates the need for an Open surgery; however this procedure is available only at specialist hospitals such as RAK Hospital which pioneers the cause in UAE”, added Dr. Radhakrishnan.

Owing to the fact that these are congenital defects, health insurance companies usually don’t cover such procedures; however Doctor emphasized the need to have it covered under insurance. The procedure just takes an hour and the patient can be usually discharged the next day which happened in this case as well. During pregnancy, there are prenatal screening tests to check for birth defects and other conditions. This kind of defect might be seen during an ultrasound but depends on the size of the hole and its location. In some babies, the defect is present at birth, but many do not have any signs or symptoms. Signs and symptoms of a large or untreated atrial septal defect may include the following:

• Frequent respiratory or lung infections
• Difficulty breathing
• Tiring when feeding (infants)
• Shortness of breath when being active or exercising
• Skipped heartbeats or a sense of feeling the heartbeat
• A heart murmur, or a whooshing sound that can be heard with a stethoscope
• Swelling of legs, feet, or stomach are
• Stroke

Treatment for an atrial septal defect depends on the age of diagnosis, the number of or seriousness of symptoms, size of the hole, and presence of other conditions. If a child is diagnosed with an atrial septal defect, the health care provider may want to monitor it for a while to see if the hole closes on its own. During this period of time, the health care provider might treat symptoms with medicine. A health care provider may recommend surgery for a child with a large atrial septal defect, even if there are few symptoms, to prevent problems later in life. Surgery may also be recommended for an adult who has many or severe symptoms. Surgery involves fixing the hole and may be done through cardiac catheterization or open-heart surgery. After surgery, follow-up care will depend on the size of the defect, person’s age, and whether the person has other birth defects.