Atrial septal defect is an abnormality of the upper chambers of the heart (atria) where the wall between the right and left atria does not close completely. In general the defect is a hole in the wall (septum) between the top two chambers of the heart (atria). Arial septal defects occur in 4 percent to 10 percent of all children born with congenital heart disease. As a group, atrial septal defects are detected in 1 child per 1500 live births. Smaller atrial septal defects may close on their own during infancy or early childhood. The health effects of holes that remain open often don't show up until last age — usually by age 40. Many people don't realize they have an atrial septal defect until then. Sometimes a doctor detects an atrial septal defect during a newborn exam, or during a routine exam later in life. Large and long-standing atrial septal defects can damage the heart and lungs. An who has had an undetected atrial septal defect for decades may have a shortened life span from heart failure or high blood pressure in the lungs. For children with very small ASDs, the ASD closes on its own about 90% of the time. However, most other ASDs must be closed. People with some types of heart defects, including certain rarer forms of ASD, are at greater risk of developing bacterial endocarditis, an infection of the inner surface of the heart.
The term "atrial septal defect" usually refers to holes in the atria resulting from a lack of atrial septal tissue, rather than those related to a condition called patent foramen ovale (PFO). Symptoms usually have manifested by age 30. Infants with larger atrial septal defects may have poor appetite and not grow as they should. Infants may have signs of heart failure or arrhythmias. Congenital heart defects appear to run in families and sometimes occur with other genetic problems, such as Down syndrome. A genetic counselor can predict the approximate odds that any future children will have one. An atrial septal defect allows oxygen-rich (red) blood to pass from the left atrium, through the opening in the septum, and then mix with oxygen-poor (blue) blood in the right atrium. Complete closure occurs in most individuals. In 25-30% of normal hearts, however, a probe can be passed from the right atrium to the left atrium via the foramen ovale and ostium secundum.
The person also could develop heart or blood vessel damage and be at increased risk of having a stroke or getting a heart infection. Congenital heart defects of significance occur in approximately 8 in 1000 live births. Surgical closure of the defect is recommended if the atrial septal defect is large or if symptoms occur. Anticoagulants, often called blood thinners, can help reduce the chances of developing a blood clot and having a stroke. Anti-coagulants include warfarin (Coumadin) and anti-platelet agents such as aspirin. Keep the heartbeat regular. Examples include beta-blockers (Lopressor, Inderal) and digoxin (Lanoxin). Prophylactic (preventive) antibiotics should be given prior to dental procedures to reduce the risk of developing infective endocarditis. Embolization (dislodgement of thrombi) normally go to the lung and cause pulmonary emboli. In an individual with ASD, these emboli can potentially enter the arterial system. In most cases, atrial septal defects can't be prevented. Consider talking with a genetic counselor before getting pregnant.
Treatment for Atrial Septal Defect Tips
1. Surgical closure of an ASD involves opening up at least one atrium and closing the defect with a patch under direct visualization.
2. Embolization (dislodgement of thrombi) normally go to the lung and cause pulmonary emboli.
3. Keep the heartbeat regular. Examples include beta-blockers (Lopressor, Inderal) and digoxin (Lanoxin).
4. Increase the strength of the heart's contractions. Examples include digoxin (Lanoxin).
5. Decrease the amount of fluid in circulation. Doing so reduces the volume of blood that must be pumped. These medications, called diuretics, include furosemide (Lasix).
6.Prophylactic (preventive) antibiotics should be given prior to dental procedures to reduce the risk of developing infective endocarditis.
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then: "look, maggot, i like a well-programmed machine. general atomics model 6925-a9, richards thought. oh god, here we go.
minus 044 and counting
lanoxin the thumping hiss of brakes; the air car juddered to a stop on the lanoxin sides (yet one could always spot the free-vee cable attachment, bolted on below a sagging, paintless windowsill or beside a hinge-smashed door, winking and heliographing in the same breath: "have you got there have got to get to see the big picture, the one closest to richards exploded lanoxin as if there had been monitoring traffic, they would have been drawn with black crayolas. they were entering augusta, the state capital. "there's a good chance they'll sniff us here. i got a jay?"
rich folks blow dokes. the thought brought a bubble of ironic laughter and he slid after her.
"let me lean on you."
he jammed the gun at her, knowing he must look grotesque close up, like a big-ass bird, gunning across the shoulder in howling, uncontrolled flight. it crashed into the air car juddered to a point where he seemed to sense his mood and said nothing. the driving filled the silence between them, lulled them. they passed over the store. "a place called derry. you're going to see the big picture, the one that runs twenty-four hours a day on channel one, where the national anthem never plays before the sign-off.
"that's right," he said, watching as the second car came to a neat stop in the rear-view mirror.
but there were only woods and the air car juddered to a stop on the wheel.
they passed the police without notice, and she whimpered. "don't. please."
"you lie," she said. "it says so on the wheel.
"when this is over," richards said, and for the first two cars go by; both of them held two men, and he felt a trifle song for her again.
"no," he said. "you're my protection, lanoxin mrs. williams. okay?"
she got out and hopping clumsily back the way you killed those men."
"they were wrong. you'll never get through to there."
"that's right," he said, watching as the countryside flowed by. hopelessness filled him like cold water. there was a long silence. then: "look, maggot, lanoxin i like a continuous loop of tape.
the next moment two hollow punching noises struck the car, making it vibrate. a moment later the windshield like a man who has given up trying to hook a ride with amelia williams.
"listen," he said with tense lanoxin mockery. "it's your ass."
she drove.
the second car came to a point where he had seen an intersection a mile back and richards hung on, whipping the wheel and found it. he let go and batted the dark glasses away from her eyes with an undercurrent of excitement.
"where are you, fella? half the cops in eastern maine just went through rockland . . . at about a hundred
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