Atrial septal defect other considerations


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

Overview
As with any condition, it is important for atrial septal defect patients to be knowledgable of all considerations prior to medical or surgical therapy. Atrial septal defect patients should consider the influence of altered physical states such as atmospheric pressure or pregnancy, in particular, as there are known clinical considerations for these conditions.

Other pre-operative considerations
Prior to medical or surgical therapy, it is important to consider other potentials for increased risk for complications.

Atmospheric pressure
Atrial septal defect patients are highly susceptible to the strains of atmospheric pressure. Patients should be monitored when they experience high or low atmospheric pressure. Situations such as scuba diving or high-altitude climbing could pose serious health risks. High atmospheric pressure situations, such as scuba diving, can increase the risk of decompression illness and paradoxical emboli. Low atmospheric pressure situations, such as high-altitude climbing, can increase the risk of increased right-to-left shunting and oxygen desaturation. Patients must consult with a physician.

Pregnancy
Women with an atrial septal defect may experience complications with pregnancy such as arrhythmias, thromboembolism, and increased bleeding. There is no evidence that pregnant patients require different indications for defect closure criteria. The ACC/AHA guidelines, however, do dictate clear deviations in course of treatment.