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Having ASD Of 25 Mm. Facing Cough And Severe Pain In Chest. Will It Be Cured By Surgery?

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Posted on Mon, 19 Nov 2012
Question: Hello Doctor
I am 50 year old, female having ASD of approximate of 25 mm my heart, i visited cradologist after eco they asked me that there is no possibility of surgery to correct the ASD, but few doctors says it is possible, please read my report and advise if any posibily and better hospital for this. now i am facing severe pain in chest and too much weakness and cough.
doctor
Answered by Dr. Arnab Maji (11 hours later)
Hi

Thanks for your query.

The decision to repair any kind of atrial septal defect (ASD) is based on clinical and echocardiographic information, including the size and location of the ASD, the magnitude and hemodynamic impact of the left-to-right shunt, and the presence and degree of pulmonary arterial hypertension.

In your age group there is in fact no chance of having spontaneous closure of ASD and the size is also large. But in your echocardiography report I have seen that you have developed severe pulmonary arterial hypertension (PAH) and presence of severe PAH is a contraindication to surgical repair of ASD.

Therefore I think in this situation it will be better not to go for surgery. It will be better to start medical therapy because in the presence of this much PAH surgery cannot be done. You can consult a cardio-thoracic vascular surgeon and take his opinion.

Hope I have answered your queries. If you have further queries you may write back to me freely. Kindly write a review on this answer.

Wishing you quick recovery,

Best Regards,
Dr Arnab Maji
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Arnab Maji (37 hours later)
Thank you Dr.
I want to know that in what form I can take medical therapy or there is any medicin available to relief any type of dizziness or chest pain what i feel usually,

If you can advise me any medicin for severe legs pain, due to that it is very difficult to walk even 50 mtr

pls also suggest if there isany diet plan or lifestyle follow up to increase my life span a liitle more.
Thanx
doctor
Answered by Dr. Arnab Maji (3 hours later)
Hi

Thanks for writing back.

See medications won't repair the hole, but they may be used to reduce some of the signs and symptoms that can accompany an atrial septal defect. Drugs may also be used to reduce the risk of complications after surgery. Medications may include those to:
1. Keep the heartbeat regular. Examples include beta blockers (Lopressor, Inderal) and digoxin (Lanoxin).
2. Reduce the risk of blood clots. Anticoagulants, often called blood thinners, can help reduce the chances of developing a blood clot and having a stroke. Anticoagulants include warfarin (Coumadin) and anti-platelet agents, such as aspirin.
3. To decrease PAH you may need to start prostanoids or endothelin receptor blocker
4. Oxygen supplementation is particularly helpful for you in PAH with ASD
5. If there is development of hyperviscosity phlebotomy may be helpful
6. Salt and protein restricted diet is useful for you.

You need to consult a reliable cardiologist, get yourself locally examined and discuss the issues which I have told you. Because without detailed physical examination and some other blood investigations this treatment should not be started.

Hope I have answered your queries. If you have further queries you can ask me freely.

Kindly write a review on this answer.

Get well soon.

Best Regards,
Dr Arnab Maji
Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Arnab Maji

Pulmonologist

Practicing since :2009

Answered : 661 Questions

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Having ASD Of 25 Mm. Facing Cough And Severe Pain In Chest. Will It Be Cured By Surgery?

Hi

Thanks for your query.

The decision to repair any kind of atrial septal defect (ASD) is based on clinical and echocardiographic information, including the size and location of the ASD, the magnitude and hemodynamic impact of the left-to-right shunt, and the presence and degree of pulmonary arterial hypertension.

In your age group there is in fact no chance of having spontaneous closure of ASD and the size is also large. But in your echocardiography report I have seen that you have developed severe pulmonary arterial hypertension (PAH) and presence of severe PAH is a contraindication to surgical repair of ASD.

Therefore I think in this situation it will be better not to go for surgery. It will be better to start medical therapy because in the presence of this much PAH surgery cannot be done. You can consult a cardio-thoracic vascular surgeon and take his opinion.

Hope I have answered your queries. If you have further queries you may write back to me freely. Kindly write a review on this answer.

Wishing you quick recovery,

Best Regards,
Dr Arnab Maji