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A small atrial septal defect rarely causes any problems and often closes in infancy.

Larger defects can cause serious problems, including:

  • Right-sided heart failure
  • Heart rhythm disorders (arrhythmias)
  • Increased risk of stroke
  • The reduction in life expectancy

Less common serious complications may include:

  • Pulmonary hypertension. If a large atrial septal defect is not treated, increased blood flow to the lungs increases blood pressure in the pulmonary arteries (pulmonary hypertension).
  • Eisenmenger’s Syndrome. Pulmonary hypertension can cause permanent damage to the lungs. This complication, called Eisenmenger syndrome, usually develops over many years and is rare in people with large atrial septal defects.

Treatment can prevent and help manage many of these complications.

Atrial septal defect and pregnancy

Most women with a small atrial septal defect can survive pregnancy without the problems associated with this defect. However, the presence of a larger defect or complications such as heart failure, arrhythmia, or pulmonary hypertension can increase the risk of complications during pregnancy.

Doctors strongly recommend that women with Eisenmenger’s syndrome do not become pregnant, because this can endanger their lives. The risk of congenital heart disease is higher in children of parents with congenital heart disease. Anyone with a congenital heart disease, whether repaired or not, who is considering starting a family should talk to a doctor. The doctor may recommend correcting the defect before pregnancy.