Atrial septal defect epidemiology and demographics


 * Associate Editor(s)-In-Chief: Priyamvada Singh, M.B.B.S. [mailto:psingh@perfuse.org]; Assistant Editor(s)-In-Chief: Kristin Feeney, B.S. [mailto:kfeeney@perfuse.org]

Overview
Atrial septal defects are the most common form of congenital heart disease, accounting for 20-40% of all congenital heart disease cases in adults. Atrial septal defects can be classified into : ostium secundum, ostium primum, and sinus venosus, coronary sinus ASDs and common or single atrium defects. Collectively, atrial septal defects account for 10% of all congenital heart disease. Infants and adolescent patients may be asymptomatic until later in life. By 40 years of age, approximately 90% of untreated atrial septal defect patients will experience an onset of symptoms.

Epidemiology and Demographics of Different Types of Atrial Septal Defects
There are four major types of atrial septal defects, ostium secundum, ostium primum, sinus venosus and coronary sinus type


 * The ostium secundum defect is the commonest type of atrial septal defect. It constitutes 75% of all types of atrial septal defect. It accounts for 7% of all congenital heart defects and 30-40% of all congenital heart disease in patients aged 40 or older.


 * The ostium primum defect is the second most common type of atrial septal defect. It accounts for 15-20% of all atrial septal defects. This particular form of atrial septal defect is also categorized as an atrioventricular septal defect and is associated with mitral valve abnormalities.


 * The sinus venosus defect is the third most common form of atrial septal defect. It accounts for 5-10% of all atrial septal defects. It is commonly associated with anomalous connection of the right-sided pulmonary veins and often requires additional imaging tests in diagnosis.


 * The coronary sinus ASD is the least common and forms less than 1% of all types of atrial septal defect.


 * Another form of inter-atrial communication is Patent foramen ovale. A patent foramen ovale is not an atrial septal defect as no septal tissue is missing. (PFOs) are quite common (appearing in 10 - 20% of adults) but are asymptomatic and therefore undiagnosed.

Pediatrics

 * As a group, atrial septal defects (ASDs) are detected in 1 child per 1500 live births.


 * It accounts for 10% of all congenital heart disease.

Adults

 * ASDs make up 20-40% of all congenital heart disease that is seen in adults and are the most common form of congenital heart defect in adults besides bicuspid aortic valve and mitral valve prolapse.

Sex

 * In general, atrial septal defect shows a female preponderance, with a female-to-male ratio of 2:1.

Age

 * By 40 years of age, approximately 90% of untreated atrial septal defect patients will experience an onset of symptoms.


 * Prior to 40, patients may be entirely asymptomatic and live without complication.