HemoChat

Evidence-Based AI Medical Search

← Back to guidelines
Cardiology72 papers

Acquired cardiac septal defect

Last edited: 4/22/2026

Overview

Acquired cardiac septal defects (ASDs) are uncommon and typically result from trauma, surgical complications, or other pathological processes affecting the heart's septum postnatally. Unlike congenital defects, these are not present at birth but develop later in life due to various etiologies including blunt chest trauma, previous cardiac surgeries, and certain environmental exposures.

Diagnosis

  • Clinical Presentation: Symptoms may include dyspnea, palpitations, and signs of heart failure 58.
  • Echocardiography: Primary diagnostic tool for identifying defects and assessing hemodynamics 58.
  • Cardiac Imaging: MRI or CT angiography for detailed anatomical assessment 8.
  • Angiography: Confirmatory test for complex cases, especially when surgical intervention is considered 16.
  • Hemodynamic Monitoring: Useful in assessing shunt direction and magnitude 25.

    • Management

  • Surgical Repair: Indicated for symptomatic patients or those with significant hemodynamic abnormalities 517.
  • Medical Management: Includes management of symptoms and underlying causes (e.g., anticoagulation for post-surgical complications) 5.
  • Device Closure: Percutaneous closure may be considered in selected cases, particularly for ventricular septal defects 17.
  • Follow-Up: Regular echocardiograms to monitor defect closure and detect complications 17.

    • Special Populations

  • Pregnancy: Caution is advised due to potential hemodynamic instability; anesthetic considerations are crucial 9.
  • Pediatrics: Traumatic ASDs are rare but require prompt diagnosis and intervention 5.
  • Elderly: Increased risk of comorbidities; individualized treatment plans are necessary 5.

    • Key Recommendations

  • Echocardiography as Initial Diagnostic Tool: Essential for identifying and characterizing acquired ASDs 58. (Evidence: Strong)
  • Surgical Intervention for Symptomatic Patients: Recommended for those with significant hemodynamic compromise or symptoms 517. (Evidence: Moderate)
  • Consider Percutaneous Closure in Selected Cases: Particularly useful for ventricular defects where surgical risks are high 17. (Evidence: Moderate)
  • Regular Follow-Up Monitoring: Essential to assess closure efficacy and detect late complications 17. (Evidence: Expert opinion)

    • References

    1 Wang Y, Ren Y, Ning X, Li G, Sang N. Environmental exposure to triazole fungicide causes left-right asymmetry defects and contributes to abnormal heart development in zebrafish embryos by activating PPARγ-coupled Wnt/β-catenin signaling pathway. The Science of the total environment 2023. link 2 Steimle JD, Moskowitz IP. TBX5: A Key Regulator of Heart Development. Current topics in developmental biology 2017. link 3 Tsang MY, Abudiab MM, Ammash NM, Naqvi TZ, Edwards WD, Nkomo VT et al.. Quadricuspid Aortic Valve: Characteristics, Associated Structural Cardiovascular Abnormalities, and Clinical Outcomes. Circulation 2016. link 4 Kaizuka T, Mizushima N. Atg13 Is Essential for Autophagy and Cardiac Development in Mice. Molecular and cellular biology 2016. link 5 Ortiz Y, Waldman AJ, Bott JN, Carlan SJ, Madruga M. Blunt chest trauma resulting in both atrial and ventricular septal defects. Echocardiography (Mount Kisco, N.Y.) 2015. link 6 Zhao C, Guo H, Li J, Myint T, Pittman W, Yang L et al.. Numb family proteins are essential for cardiac morphogenesis and progenitor differentiation. Development (Cambridge, England) 2014. link 7 Torgersen JS, Takle H, Andersen Ø. Differential spatial expression of mef2 paralogs during cardiac development in Atlantic cod (Gadus morhua). Comparative biochemistry and physiology. Part B, Biochemistry & molecular biology 2011. link 8 Sinisalo JP, Sreeram N, Jokinen E, Qureshi SA. Acquired left ventricular-right atrium shunts. European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery 2011. link 9 Kanniah SK. Caesarean delivery in a parturient with Holt-Oram syndrome and implantable cardioverter defibrillator: anaesthetic considerations. Archives of gynecology and obstetrics 2009. link 10 Kawahara A, Nishi T, Hisano Y, Fukui H, Yamaguchi A, Mochizuki N. The sphingolipid transporter spns2 functions in migration of zebrafish myocardial precursors. Science (New York, N.Y.) 2009. link 11 Takahashi M, Kojima M, Nakajima K, Suzuki-Migishima R, Motegi Y, Yokoyama M et al.. Cardiac abnormalities cause early lethality of jumonji mutant mice. Biochemical and biophysical research communications 2004. link 12 Katz SG, Williams A, Yang J, Fujiwara Y, Tsang AP, Epstein JA et al.. Endothelial lineage-mediated loss of the GATA cofactor Friend of GATA 1 impairs cardiac development. Proceedings of the National Academy of Sciences of the United States of America 2003. link 13 Compernolle V, Brusselmans K, Franco D, Moorman A, Dewerchin M, Collen D et al.. Cardia bifida, defective heart development and abnormal neural crest migration in embryos lacking hypoxia-inducible factor-1alpha. Cardiovascular research 2003. link 14 Ozawa T, Mickle DA, Weisel RD, Koyama N, Wong H, Ozawa S et al.. Histologic changes of nonbiodegradable and biodegradable biomaterials used to repair right ventricular heart defects in rats. The Journal of thoracic and cardiovascular surgery 2002. link 15 Plum A, Hallas G, Magin T, Dombrowski F, Hagendorff A, Schumacher B et al.. Unique and shared functions of different connexins in mice. Current biology : CB 2000. link00690-4) 16 Kaplan M, Murat Demirtaş M, Sayrak H, Cimen S, Dagsali S, Ozler A. An anatomopathologic study of membranous septum aneurysms and significance of their surgical treatment. Cardiovascular surgery (London, England) 2000. link00074-0) 17 Grünenfelder J, Kiaffas M, Bartram U, Herlong R, Van Praagh R. Patch repair of subsemilunar conal septal defect resulting in severe left ventricular outflow tract obstruction. The American journal of cardiology 1997. link00696-6) 18 Monnet E, Orton EC, Gaynor J, Boon J, Peterson D, Guadagnoli M. Diagnosis and surgical repair of partial atrioventricular septal defects in two dogs. Journal of the American Veterinary Medical Association 1997. link 19 Lazebnik N, McPherson E, Rittmeyer LJ, Mulvihill JJ. The floating harbor syndrome with cardiac septal defect. American journal of medical genetics 1996. link1096-8628(19961218)66:3<300::AID-AJMG12>3.0.CO;2-Q) 20 Bierkamp C, Mclaughlin KJ, Schwarz H, Huber O, Kemler R. Embryonic heart and skin defects in mice lacking plakoglobin. Developmental biology 1996. link 21 DeLeon SY, Downey FX, Baumgartner NE, Ow EP, Quinones JA, Torres L et al.. Transsternal repair of coarctation and associated cardiac defects. The Annals of thoracic surgery 1994. link91096-0) 22 Moens CB, Stanton BR, Parada LF, Rossant J. Defects in heart and lung development in compound heterozygotes for two different targeted mutations at the N-myc locus. Development (Cambridge, England) 1993. link 23 Upfold JB, Smith MS, Edwards MJ. Interference with neural crest migration by maternal hyperthermia as a cause of embryonic death due to heart failure. Medical hypotheses 1991. link90240-y) 24 Okoshi T, Noishiki Y, Tomizawa Y, Morishima M, Koyanagi H. Development of an antithrombogenic cardiac wall substitute which can be reconstructed by infiltration of host cells. ASAIO transactions 1988. link 25 Fletcher R, Jögi P. Increased alveolar deadspace after closure of cardiac septal defects: pulmonary air embolism or failure of homeostasis?. Clinical physiology (Oxford, England) 1986. link 26 Peter CA, Bowyer K, Jones RH. Radionuclide analysis of right and left ventricular response to exercise in patients with atrial and ventricular septal defects. American heart journal 1983. link90360-5) 27 Murtra M, Mestres CA, Igual A. Right coronary artery - right atrial fistula and anomalous connection of the superior vena cava to the left atrium of latrogenic origin. The Thoracic and cardiovascular surgeon 1983. link 28 Kawamura M, Sakakibara K, Minamikawa O, Yokochi H, Kobayashi A. High-flow total body perfusion with severe hemodilution and normothermia in infants weighing less than 10 kg--safe limits of hemodilution in cardiopulmonary bypass in infants. The Japanese journal of surgery 1977. link

    Original source

    1. [1]
      Environmental exposure to triazole fungicide causes left-right asymmetry defects and contributes to abnormal heart development in zebrafish embryos by activating PPARγ-coupled Wnt/β-catenin signaling pathway. — Wang Y, Ren Y, Ning X, Li G, Sang N The Science of the total environment (2023)
    2. [2]
      TBX5: A Key Regulator of Heart Development. — Steimle JD, Moskowitz IP Current topics in developmental biology (2017)
    3. [3]
      Quadricuspid Aortic Valve: Characteristics, Associated Structural Cardiovascular Abnormalities, and Clinical Outcomes. — Tsang MY, Abudiab MM, Ammash NM, Naqvi TZ, Edwards WD, Nkomo VT et al. Circulation (2016)
    4. [4]
      Atg13 Is Essential for Autophagy and Cardiac Development in Mice. — Kaizuka T, Mizushima N Molecular and cellular biology (2016)
    5. [5]
      Blunt chest trauma resulting in both atrial and ventricular septal defects. — Ortiz Y, Waldman AJ, Bott JN, Carlan SJ, Madruga M Echocardiography (Mount Kisco, N.Y.) (2015)
    6. [6]
      Numb family proteins are essential for cardiac morphogenesis and progenitor differentiation. — Zhao C, Guo H, Li J, Myint T, Pittman W, Yang L et al. Development (Cambridge, England) (2014)
    7. [7]
      Differential spatial expression of mef2 paralogs during cardiac development in Atlantic cod (Gadus morhua). — Torgersen JS, Takle H, Andersen Ø Comparative biochemistry and physiology. Part B, Biochemistry & molecular biology (2011)
    8. [8]
      Acquired left ventricular-right atrium shunts. — Sinisalo JP, Sreeram N, Jokinen E, Qureshi SA European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery (2011)
    9. [9]
      Caesarean delivery in a parturient with Holt-Oram syndrome and implantable cardioverter defibrillator: anaesthetic considerations. — Kanniah SK Archives of gynecology and obstetrics (2009)
    10. [10]
      The sphingolipid transporter spns2 functions in migration of zebrafish myocardial precursors. — Kawahara A, Nishi T, Hisano Y, Fukui H, Yamaguchi A, Mochizuki N Science (New York, N.Y.) (2009)
    11. [11]
      Cardiac abnormalities cause early lethality of jumonji mutant mice. — Takahashi M, Kojima M, Nakajima K, Suzuki-Migishima R, Motegi Y, Yokoyama M et al. Biochemical and biophysical research communications (2004)
    12. [12]
      Endothelial lineage-mediated loss of the GATA cofactor Friend of GATA 1 impairs cardiac development. — Katz SG, Williams A, Yang J, Fujiwara Y, Tsang AP, Epstein JA et al. Proceedings of the National Academy of Sciences of the United States of America (2003)
    13. [13]
      Cardia bifida, defective heart development and abnormal neural crest migration in embryos lacking hypoxia-inducible factor-1alpha. — Compernolle V, Brusselmans K, Franco D, Moorman A, Dewerchin M, Collen D et al. Cardiovascular research (2003)
    14. [14]
      Histologic changes of nonbiodegradable and biodegradable biomaterials used to repair right ventricular heart defects in rats. — Ozawa T, Mickle DA, Weisel RD, Koyama N, Wong H, Ozawa S et al. The Journal of thoracic and cardiovascular surgery (2002)
    15. [15]
      Unique and shared functions of different connexins in mice. — Plum A, Hallas G, Magin T, Dombrowski F, Hagendorff A, Schumacher B et al. Current biology : CB (2000)
    16. [16]
      An anatomopathologic study of membranous septum aneurysms and significance of their surgical treatment. — Kaplan M, Murat Demirtaş M, Sayrak H, Cimen S, Dagsali S, Ozler A Cardiovascular surgery (London, England) (2000)
    17. [17]
      Patch repair of subsemilunar conal septal defect resulting in severe left ventricular outflow tract obstruction. — Grünenfelder J, Kiaffas M, Bartram U, Herlong R, Van Praagh R The American journal of cardiology (1997)
    18. [18]
      Diagnosis and surgical repair of partial atrioventricular septal defects in two dogs. — Monnet E, Orton EC, Gaynor J, Boon J, Peterson D, Guadagnoli M Journal of the American Veterinary Medical Association (1997)
    19. [19]
      The floating harbor syndrome with cardiac septal defect. — Lazebnik N, McPherson E, Rittmeyer LJ, Mulvihill JJ American journal of medical genetics (1996)
    20. [20]
      Embryonic heart and skin defects in mice lacking plakoglobin. — Bierkamp C, Mclaughlin KJ, Schwarz H, Huber O, Kemler R Developmental biology (1996)
    21. [21]
      Transsternal repair of coarctation and associated cardiac defects. — DeLeon SY, Downey FX, Baumgartner NE, Ow EP, Quinones JA, Torres L et al. The Annals of thoracic surgery (1994)
    22. [22]
      Defects in heart and lung development in compound heterozygotes for two different targeted mutations at the N-myc locus. — Moens CB, Stanton BR, Parada LF, Rossant J Development (Cambridge, England) (1993)
    23. [23]
      Interference with neural crest migration by maternal hyperthermia as a cause of embryonic death due to heart failure. — Upfold JB, Smith MS, Edwards MJ Medical hypotheses (1991)
    24. [24]
      Development of an antithrombogenic cardiac wall substitute which can be reconstructed by infiltration of host cells. — Okoshi T, Noishiki Y, Tomizawa Y, Morishima M, Koyanagi H ASAIO transactions (1988)
    25. [25]
      Increased alveolar deadspace after closure of cardiac septal defects: pulmonary air embolism or failure of homeostasis? — Fletcher R, Jögi P Clinical physiology (Oxford, England) (1986)
    26. [26]
      Radionuclide analysis of right and left ventricular response to exercise in patients with atrial and ventricular septal defects. — Peter CA, Bowyer K, Jones RH American heart journal (1983)
    27. [27]
      Right coronary artery - right atrial fistula and anomalous connection of the superior vena cava to the left atrium of latrogenic origin. — Murtra M, Mestres CA, Igual A The Thoracic and cardiovascular surgeon (1983)
    28. [28]
      High-flow total body perfusion with severe hemodilution and normothermia in infants weighing less than 10 kg--safe limits of hemodilution in cardiopulmonary bypass in infants. — Kawamura M, Sakakibara K, Minamikawa O, Yokochi H, Kobayashi A The Japanese journal of surgery (1977)
    Share:TwitterRedditLinkedIn

    HemoChat

    by SPINAI

    Evidence-based clinical decision support powered by SNOMED-CT, Neo4j GraphRAG, and NASS/AO/NICE guidelines.

    ⚕ For clinical reference only. Not a substitute for professional judgment.

    © 2026 HemoChat. All rights reserved.
    Research·Pricing·Privacy & Terms·Refund·SNOMED-CT · NASS · AO Spine · NICE · GraphRAG