An atrial septal defect (ASD) is a hole in the atrial septum, the upper wall of the heart separating the right and left atria. Surgery is occasionally necessary to close an atrial septal defect in a child. This most commonly occurs in the setting of a large or moderate size hole. The most common indication for surgery is the presence of dilation of heart chambers, specifically the right ventricle, due to long-standing excess blood flow. Typically surgery is performed between 2 and 5 years of age, although it can easily be accomplished earlier if necessary.
When you look at somebody from the outside they appear symmetric. In other words, one side of the body looks exactly the same as the other. On the inside, however, this is not the case. Each side of the body is unique. For example, the right side of the body contains certain organs (for example, the liver) that the left side of the body does not contain. Likewise, the left side contains organs (stomach, spleen, etc.) that the right-sided does not contain. Each side forms in a unique fashion. A good analogy to use when thinking about the symmetry or asymmetry of the body is that of a city. From an airplane at 20,000 feet, the city of Dallas looks symmetric. Up close, however, it is very clear that Dallas is completely unique; one side of the city is not simply a mirror image of the other.
To understand chest pain in children, it's important to first understand chest pain in older people. With age, we are all prone to developing narrowings or blockages in the arteries feeding the heart muscle with blood. This process is known by the technical term atherosclerosis. Atherosclerosis refers to the process by which cholesterol and fat deposits in the arteries throughout the body (“plaque” build-up). This causes a gradual decrease in the opening of the artery which slows the flow of blood. This can ultimately result in a near or complete blockage of the artery. If this happens in one of the arteries feeding the heart muscle with blood, it is termed a myocardial infarction or “heart attack”. A person experiencing a heart attack may feel chest pain due to the heart muscle not receiving enough blood.
A cardiac catheterization is a procedure by which a catheter (a long, thin, flexible tube) is passed into the heart to allow for more exact testing than noninvasive studies can provide. Cardiac catheterizations are performed in a hospital setting with the use of sedation or anesthesia. We offer full cardiac catheterization services at Pediatric Heart Specialists.
The aortic valve connects the left ventricle and the aorta. When the heart squeezes, the valve opens, allowing blood to pass from the left ventricle into the aorta (see normal heart anatomy and normal blood flow). When the heart relaxes, the valve closes, preventing backflow of blood into the heart. Aortic valve stenosis refers to a condition in which the valve is abnormally narrowed. Aortic valve stenosis in children is usually a congenital heart defect, in other words, a birth defect of the heart. Congenital heart defects are the most common form of birth defects, occurring in approximately 1 in 150 children. Aortic valve stenosis is one of the more common congenital heart defects; the overall incidence is 0.2-0.5 per 1000 children. Most cases of aortic valve stenosis in young people are due to a bicuspid aortic valve. In this situation, the aortic valve has only 2 leaflets instead of the normal 3. This typically causes some degree of narrowing or leakage of the valve. In occasional instances, a bicuspid aortic valve may be an inherited or genetic problem.