Sometimes, congenital heart defects manifest for the first time in adulthood. One such defect is the atrial septal defect (ASD), a “hole” between the upper chambers of the heart, the left atrium and right atrium.
There are 3 major types of ASD: the secundum ASD, the primum ASD, and the sinus venosus ASD. Each has distinguishing anatomical features, but today, for the most part, we’ll consider them as group.
We won’t consider another type of “hole” between the upper chambers of the heart, the patent foramen ovale (PFO). In fetal life, the foramen ovale is a small hole which can persist after birth. A PFO is usually small and ordinarily does not pose risk to the patient or athlete.
How is an ASD Discovered?
In adulthood, an ASD is often discovered incidentally during a diagnostic test such as an echocardiogram. Adults can have no symptoms and be unaware of the defect. If there are symptoms, an ASD can produce fatigue, arrhythmias, heart failure, or stroke. An echocardiogram can delineate the exact type of ASD and also screen for any other types of structural heart disease which may be present.
A little bit of an aside for perspective….
In large-scale screening of school-aged athletes with echocardiograms, approximately 2% of individuals are found to have a structural heart problem. Approximately one third of those defects are ASDs.
What are the Consequences of an ASD?
If the ASD is large enough (approxim. 1.0 cm or more), blood will flow through the defect in a left-to-right direction. This results in extra blood in the right side of the heart and extra blood pumped to the lungs. We can quantify the amount of extra blood flow to the lungs as a shunt fraction, or Qp:Qs ratio. We say that the shunt is significant if the Qp:Qs ratio is greater than 1.5. This indicates that the blood flow to the lungs is 50% greater than normal.
If left untreated, the extra blood flow through an ASD can lead to enlargement of the right atrium and ventricle and irreversible changes to the pulmonary arteries that results in pulmonary hypertension.
Athletes should be aware that a large ASD may result in decreased exercise capacity.
Closure of ASD
We generally recommend closure of an ASD if:
1. The shunt fraction is >1.5.
2. There is evidence of enlargement or failure of the right heart chambers.
Many secundum ASDs can be closed with devices that are deployed by catheters threaded to the heart through the body’s blood vessels. We call this procedure a percutaneous device closure. This procedure is generally performed by a cardiologist and involves the procedure followed by a short hospital stay.
Ostium secundum and sinus venosus ASDs require conventional heart surgery for closure. These procedures are performed by a cardiac surgeon. Healthy patients usually require a short hospital stay after the operation.
The peri-procedural risk of these procedures is very low.
How quickly an athlete may return to their sports will depend upon the particular method of closure and also upon the demands of an athlete’s sport. This issue should be part of a discussion with the doctor before the procedure.
Recommendations for Athletes
The Congenital Heart Disease Task Force for the 36th Bethesda Conference on Eligibility Recommendations for Competitive Athletes with Cardiovascular Abnormalities made several recommendations for athletes with ASD:
1. Those with a small ASD, normal right heart volume, and no pulmonary hypertension can participate fully.
2. Those with a large ASD and no pulmonary hypertension can participate fully.
3. Those with an ASD and mild pulmonary hypertension can participate in low-intensity sports. Any athlete with ASD and associated cyanosis and large right-to-left shunt cannot participate in competitive sports.
4. After a satisfactory recovery, athletes can participate fully after ASD repair (device closure or surgical) after a period of 3-6 months.
5. After ASD closure, if an athlete has pulmonary hypertension, arrhythmias, heart block, or impaired heart function, there must be an individualized approach to the issued of continued participation.
As an athlete who had a very large ASD that caused an atrial septal aneurysm, and was playing college soccer on scholarship WITH that ASD (unknowingly), it shows anyone can have a heart defect as such. I had a massive R to L shunt (Actually it went both ways), and associated cyanosis as you mentioned. I also had pretty serious shortness of breath, pre-syncopal, and syncopal episodes, all of which I attributed to being “out of shape,” or “asthma.” In fact, I was (am), in incredible shape, and the harder I pushed myself, the worse the issues got. ALL athletes need to get thorough heart screenings! I cannot stress this enough. No one is immune to these issues…thanks for posting this!
Hi! I was recently diagnosed with ASD and am a college soccer player as well! I’m actually doing a project on ASD and was wondering if you would be willing to be interviewed via email over what it was like to be an athlete with ASD? Please respond to this post if you are and I will provide my email. Thanks!
Sure. My email address is on the front page of the blog.
Thanks for sharing that story. There are many ways for ASD to manifest. I agree with you that heart screening is important.
I have a very small ASD (I don’t know the Qp:Qs ratio). I went through a screening and the cardiologist said that it’s so small that I didn’t need the surgery. However, when I do heavy cardio, or when climbing high peaks (above 13k feet) my heart definitely feels like it’s working hard. It feels like its trying to do fewer, harder pumps. It’s pretty uncomfortable. Also, above 13K I can only walk about ten feet before needing a rest. This is unusual since I’m very fit. I am athletic and do cardio 4-5 days a week. I’m planning a trip to Nepal in two years where I’ll be climbing above 17K. Though it’s small, I feel the effects. Should I still get the surgery? Or just grin and bear these effects?
Thanks for sharing your story, Larisa. The trip to Nepal sounds awesome.
As you read in my post, very small ASD’s without significant shunt, are not generally closed. It’s always worth having a discussion with your doctor(s) when you think there are extenuating circumstances, though. And it might even be worth a 2nd opinion to give you peace of mind, regardless of what the first recommendation might be. There are sometimes legitimate differences of opinion.
Hi, I’ve been diagnosed with a leaking ASD and am awaiting surgery, I have recently started getting palpitations and find it hard sometimes to take a deep breath while resting. I do also get breathless if I get up and move quickly. I’ve recently tried to join a gym to get fitter and I love swimming, but the ” cardio consultant” at the gym seems to think I shouldn’t swim at all and may not be able to exercise, is this correct? I’m a 46 year old woman.
I don’t know enough about your particular situation to offer specific advice.
My general advice is….get the heart situation sorted out and treated….and THEN resume exercise.
I recently had open heart surgery i had endocarditis complicated by a previous graft and artificial aortic valve surgery from 3 years ago so I got human tissue to replace graft and valve had been doing great and started having low heart rate in the 40 to58 range also had low blood pressures ex 83/43 I have been taken off of bp meds metopropal a recent echo shows an astral septal anuryssm could these be related to recently being diagnosed with a total heart block my doctors are great and on top of this but I am curious about whether these could be related
I obviously don’t know enough about your particular situation to comment specifically.
For you and others who may be reading here, complete heart block (CHB) occurs when electrical signals in the upper (atrial) chambers of the heart can’t or don’t reach the pumping chambers (the ventricles) like they normally should. Often in that situation, the ventricles generate their own electrical activity, usually with a rather slow heart rate.
Complete heart block can be inherited or acquired. Acquired causes of CHB include infection, damage from too little blood supply, or from manipulation during surgery.
Atrial septal aneurysm is an outpouching of thin, often wispy muscle tissue from the atrial septum, the wall between the 2 upper chambers. Sometimes, this is associated with a “hole,” or atrial septal defect (ASD) as well. What, if anything, should be done about atrial septal aneurysm would depend upon what else was going n with the heart.
I have run cross country and swum competitvely throughout high school, and have always been in great shape. However, I struggle with the last 25-50% of nearly every race I participate in, and especially hills when running. My training load should well prepare me for hills and endurance races, and those who train at an equal or lesser volume often outperform me during these final moments of races, both swimming and running. Like a previous commenter, I attributed it to being out of shape, although I’m pretty sure that’s not the case. What initiated my research of heart conditions and the ASD was a comment by my cross country coach. Apparently, my lips turn blue after particularly intense workouts. I had no idea, and would like to know whether this points to an ASD. A relatively close family member who was a high level cyclist, as it turned out, had an undiagnosed ASD that was finally treated at age 30 or so. My question is, does this conclusively point to an ASD and should I get an echocardiogram?
It’s unusual for ASD to be associated with cyanosis (blue lips), but it can occur. In most cases, blood flows through an a ASD from the left TO the right side of the heart. Occasionally blood flows through an ASD in the opposite direction, from right to left….and that situation can result in cyanosis.
ASD doesn’t ordinarily produce a murmur, so it takes an echocardiogram (ultrasound) to determine if you have one.
There are many possible causes of cyanosis, some having nothing to do with the heart.
I was recently told I had an atrial septal aneurysm and SVT but the cardiologist said they couldn’t tell from the echocardiogram if I had an ASD and did not recommend further testing because I was asymptomatic. In hindsight, I’ve been thinking these heart problems may be behind my inability to improve my running or swimming speed. Do you think this is possible? I don’t expect to win any marathons but would like to know if these conditions are prohibiting me from improving my cardio fitness? I hate to compare myself with others but have an acquaintance who is about 50lbs overweight and can run a 5k faster than I. Any thoughts would be appreciated!
Good questions, Kristi.
Ordinarily a small ASD or PFO that was too small to visualize on an echocardiogram would not be significant to an endurance athlete, I wouldn’t think.
SVT, on the other hand, an arrhythmia involving the upper chamber(s) of the heart, could certainly have an influence on performance.
These issues would be worth discussion with your doctors, for sure.
Larry
Hi Kristi,
I completely understand how you feel. I’m a very fit individual, but my entire life people around me have been able to gain cardio fitness more quickly than I. I also have ASD, but like you, doctors said there would be no point in fixing it since I’m asymptomatic. I’m thinking of going to another doctor for a second opinion because last summer when I was climbing a 14K mountain, I had a really hard time keeping up with my husband, and at the time, he never worked out while I was working out every day! We’re planning a through hike of the Himalayas in a couple of years, and I want to be able to enjoy myself, not drag. Best of luck. 🙂
Thanks so much! I’m so glad to find this blog!
Hi, i’m a triathlete, run marathons, do long distance skiing and so on. I did also mountain guiding in africa. I have always had easily symptoms on high altitude. They start already quite early. The main problem is that i’m feeling like falling asleep while walking. The previous trek to my Kilimanjaro I made it to the top but then fell unconscience. I Was brought a kilometre down and I woke up after 8 hours at another camp.
Now in february 2016 a had a stroke. I recovered fully but I’ll be on mediaction the rest on my life. In examination they found a small asd which might be the cause of the attack. The asd will be Cloverfield soon.
I have wondered while my marathon result is not improving. The time has decreased onko for six minutes during the Past ten years eventhough I have had coutches and I have trained systematically. So I Think the asd is the reason – the side is smaller than a 1cm… The doctor decided to close it because of the stroke and my active participation in competitive sports.
I live in Finland…
Finn asks about the consequences of ASD.
In addition to whatever risk of stroke, there can certainly be a decrement in performance if the ASD is large enough (and there is a lot of blood flow through the defect).
Thank you for writing about this subject.
I had a PFO closure only five days ago. The hole was 1 cm and they used the HELEX device. The device was very soft and made of gore-tex. The procedure went well and I am feeling good 🙂
I am a triathlete and train for long distances. I am really looking forward to start training again. But I am not sure if I can just start training the many hours I am used to or if I should cut down and/or perhaps only train with low intensity? I am worried if the training can cause the device to move out of place? And what about the tissue that will cover the device over time. Can training have a negative effect on the growth of this tissue? (I was told it would take approximately 6 months before the device is covered in “tissue”)
Given the type of sport (endurance/no contact) – do you think I can start training again (of course listening to my body), or should I take other special precautions?
Kristian,
Thanks for sharing your story. Best to follow the advice of your doctor(s) who will be in the best position to know what’s best for you given your specific details.
Certainly, many endurance athletes are back to doing all of their activities after PFO device closure. Dislodgement of the device is rare, but may occur. I don’t know that such cases are related specifically to activity, though. You’re also right about “tissue ingrowth.” With time, the exposed surfaces of the device will be covered with fibrous or endothelial tissue. Again, I don’t know why that process would be impaired with activity. It might be impaired with medications such as NSAID’s, but that’s just a quick thought, off the top of my head.
Good luck with getting back to triathlon.
Hi,
I underwent a ASD closure more than year ago. Recently I starting walking long distances and once I walked 18 KMs in a stretch. Many people say that it is not good to walk such a distance due to the fact that I have underwent a surgery. I did not feel any unusual heart rate when I walked. I restricted my activities the later day after the walk and also took a days rest. Can I do such walks once a week or should I limit myself to shorter distances.
Thanks
Siva
Most people, athletes included, can return to exercise after ASD closure–whether it’s done by traditional operation or by catheter closure technique. Your doctor should be able to provide advice about how quickly to return, given your particular circumstances.
Some athlete patients who need ASD closure may have additional cardiac problems that must be considered as well when making decisions about exercise.
I am a professional mountain bike racer for 10 years. About five years ago after an overload training interval of 10 days I became very fatigued and have never been able to do back days of training or racing without debilitating fatigue. At aerobic HR 155bpm my cardiac output no longer increases although HR rate does. I get extreme hypoxic symptoms in my lower extremities at these higher HR while my breathing stays aerobic (30/min). I have suspected a heart defect or injury of some kind since I was at a world class level and now in a constant decline no matter what training or rest I do. My latest echo shows a small ASD at rest (38bpm). Is there any evidence that an ASD may dialate or worsen significantly at higher HR/pressure? Is there a way to test this? I have atrial enlargement but DRs just say that is because I am an athlete. Do ASDs cause persistent fatigue, sleep disruptions, severe cold/numbness and or pain in extremities? Are there any docs or studies regarding ASD manifestations in endurance athletes?
No particular studies or reading to point you to. Appreciate that you found my blog post.
It is true that the amount of blood flow through the ASD, as well as its direction, will influence any symptoms….and the amount of blood glow may depend on the exertion level.
It would be worth discussing your symptoms with your doctor. In particular, ask whether increased blood flow through the ASD with exercise might account for any symptoms.
Glad I ran across this article! I am 33, active and athletic, and suddenly had a small stroke last December. Three days ago I had a Gore-Helex occluder placed in my heart to cover a 14 mm hole–now I’m glad I had the stroke or I would never have known!
Other than a little soreness at the cath site, I actually feel better than I have in years. I didn’t realize I was operating under 100%, but evidently I was! It’s hard to take it easy and recover when you feel so good, but I’m trying to be good.
I read in another article that lifting weights isn’t recommended for ASD patients. Is this true, even after closure? I do a lot of HIIT training and weight lifting, and I know it will be a while before I’m allowed back to the intensity level I was at, but hopefully it’s not forever, right?
I’m interested to see how much better my cardio tolerance will be once I can work out again. I’ve always felt that for as much as I exercise, I should be in better shape!
Worth having a discussion with your doctor(s) about activity restrictions. There may be different restrictions for the short term (during the healing process) and for the long term.
I fill up my asd in 2002. Now I have svt after two or three months.but normally it stops by 15-20 minutes.if I am having a cold glass water.can I go for operate. Means rf ablation
Ablation may be a useful treatment for so e patients with SVT.
Wow this was an insightful article.. it’s very frustrating as I went from running a half marathon 2 years ago, to not being able to walk on a treadmill in the past year without getting short of breath immediately (then I start hyperventilating). I have a small ASD and recently got an echocardiogram. My cardiologist said it was okay for me to exercise and it shouldn’t be causing shortness of breath. .. Would it be beneficial for me to get a stress test to see why I am getting short of breath? I know it could be anxiety…. I’m hoping to be able to exercise again with confidence.
June 2014 Echo – “. Normal left ventricular wall thickness, chamber size and systolic function. Estimated
ejection fraction 64%. Normal diastolic function. Normal biatrial size. Small secundum
atrial septal defect with left to right negative contrast on aggitated saline study.
Calculated Qp/Qs ratio 1.5:1 Negative aggitated saline study for right-to-left shunting.
Right ventricular size appears to be at upper limits of normal.
. Normal valvular morphologies without significant flow abnormalities. Normal aortic root
and aortic arch dimensions.
. Normal estimated right-sided pressures. Normal sized IVC collapsing with inspiration.
No prior study.
No cardiology follow up visit scheduled. “
Shortness of breath should always get sorted out.
It’s usually possible with echocardiogram to be sure that the ASD repair is doing okay (or not).
I am a college soccer player recently diagnosed with both ASD and neurocardiogenic syncope. I am going to the Cleveland Heart Clinic next week and am unsure what to expect. Now that I know about my conditions, it seems to make sense why even after getting a good night sleep, I am always feeling tired. I also seem to notice my heart beating much faster; it seems like after my diagnosis, I am noticing many signs I thought were normal my entire life. Its very confusing to think about. What I am mostly curious about however, is if both of these conditions could be related?
Those are all good questions for your doctors at Cleveland Clinic.
Sometimes, it’s easy to think back and wonder about symptoms that might have gone unrecognized.
Dr.
Just curious, I had the PFO closure done two weeks ago at NY Presbyterian Hospital. I am a 50 year old, extremely active, triathlete, boxer, and personal trainer. My doctor says I can return to training now. I have never felt better, I can finally breath, and am able to sleep through the night (something I don’t ever remember doing.) I just want to be cautious since I have always trained very hard, almost every day.
Thanks.
I’m not the doctor, but I had the same question. I had the transcath closure of a moderately large ASD last August (with a gore-helex septal occluder), and I think each doctor’s opinion on training is a little different. My doctor told me to keep my HR under 140 for three months and only lift weights at 70% of my max. Once everything looked fine on the echo at 3 months, I was cleared to go “do burpees and sprints to my heart’s content.” It was hell not going hard for those three months when I felt so much better, but now I’m training harder and lifting heavier than I was ever able to before.
Apparently I have a ASD as well. Right to left shunting during valsalva manoeuvre. My questing is – is it ok to do extreme sports like Bungee Jumping. I remember doing this 20 years ago and all my eyes became blood shot where everyone else was fine.
You’re brave!
Maybe another reader can chime in. Sadly, I don’t know anything about the effects of bungee jumping on the heart.
I am so happy I found this site! I’ve been having heart palpitations for about two months. I brought it up with my GP and since my mother had mitrovalve prolapse she sent me for and ECHO. Well sure enough it came back that I have a secundun atrial defect. However, I’m an avid runner and have two half marathons within a week of each other at the end of the month. I don’t get my first appt with a cardiologist until the week after those races. My doctor recommended that it was an “urgent” need to get in with the cardiologist, but I would love to hear your thoughts on whether you think I should continue on with the races. Palpitations are still present and seem to be increasing a bit as I hit my training peak. I will begin to taper in a few weeks. Thanks so much!!!
Always best to get things sorted out before continuing training or racing.
Like everyone else I’m so happy to have found this article/ blog!
I’m 20 years old and had my ASD closure in December 2014 (using an Amplatzer device). When I went for my check up echo in January everything was going well and all blood flow had ceased. I’m a bit of a gym junkie, doing cardio 4 times a week and weight training 4 times also. I was told to wait at least 3 months before going back to lifting and that the tissue would be completely healed after 6 months, meaning I could resume all activity like a normal person. Are you able to tell me what kind of effects heavy lifting would have on the closure after 4 months/ what restrictions I should place on myself?
I was also told not to have any dental surgery without antibiotics for 1 year post op. My only concern is that I fainted before my surgery (how I found out about the ASD) cracking my front tooth, which was filled but has started to die and I do need a root canal. Do you think there is a risk of endocarditis if I leave the tooth as is until I see my specialist again in June, or should I be concerned? I did also receive a dose of antibiotics 1 month after the tooth fracture to ensure there was no infection, which was about 2 months before the heart surgery. I don’t think that I have any symptoms of endocarditis but I’m unsure of how long onset of symptoms/ main symptoms are.
I should also note that I’m on Clopidogrel and Asprin for 6 months. Thanks for your advice!
Thanks for sharing the story of your ASD closure.
Most athlete patients can return to their sports after they’ve healed up, so long as there are no other heart problems that must be considered. Ask your doctor what he/she thinks best.
Your doctor should also have specific advice about when it’s safe to have dental work done. For some forms of dental work, it’s necessary to stop taking medications like aspirin and clopidogrel.
Okay great, thanks for that.
One last question, would those two medications have an impact on heart rate while exercising? I find sometimes my heart rate increases quickly and is quite high around 145 for moderate cardio. I don’t feel lightheaded or anything, but should this be of concern?
MY DAUGHTER IS AN 26 YRS OLD ARMY OFFICER AND HAS BEEN NOW DETECTED WITH ASD SIZE OF 2.6 CMS
SHE WAS IN COLLEGE BASKET BALL AND HAND BALL TEAM AND WAS GRADED AS EXCELLENT IN HER PHYSICALS DURING ARMY TRAING I AM SURPRISED WHY IT WAS NOT DETECTED EARLIER AND HOW SHE SURVIVED THE ARMY TRAINING AND IS GOING TO BE TREATED BY USING THE ASD CLOSING DEVICE WHAT ARE CHANCES OF LEADING A VERY ACTIVE LIFE NOW AND SUBSEQUENT ISSUE S OF MARRIAGE AND PREGNANCY WE ARE WORRIED SANJAY
Most ASD’s are discovered in childhood, but there are certainly many cases of this diagnosis being made in a patient’s twenties.
ASD repair, either by catheter techniques or with surgery, is nearly always successful and can be accomplished at little risk. After repair, most patients can return to any activities they’d like….including marriage and pregnancy.
Was recent diagnosed with humongous atrial septal aneurysm with large atrial septal defect (left-to-right shunt by color Doppler) located at the upper portion of the inter atrial septum. What’s concerning is I had several heart test in 2010 which I thought would have showed abnormalities as I was being tested for blockage and heart dease. I have PTSD with pre hypertension and spikes during my PTSD attaches is it possible for hypertension to cause an aneurysm or cause the shunting
An atrial septal defect (ASD) is usually a congenital problem….affected individuals are born with the problem. Most ASD patients are identified in childhood, but some escape identification until adulthood, where it is discovered because of testing such as echocardiogram.
The “aneurysm” involved with the ASD is not caused because of high blood pressure.
Hi ..my 14 year old daughter was diagnosed with a 9 mm ASD2.
She has been an active soccer and rugby player all her life. The cardiologist said she can continue sports but we need to keep checking on her every year.
she gets dizzy and cold sweato when she plays.
I am not sure if we should let her continue with her beloved sports…please advise.
From afar, I don’t have sufficient information to provide advice about your daughter and continued participation.
Symptoms like dizziness and cold sweats deserve attention. You should take up these issues with your daughter’s doctor(s).
Hi. Great site.
So I recently had a pfo closure through the artery. Right now it’s week three post surgery. I’m finding that I can take more air into my lungs. Do you think this is just in my head? I hope not. I like the idea that my body is now getting the right levels of oxygen it needs. In fact I feel like I’ve gained a few IQ points as I feel I’m also thinking better. Can a pfo closure have this kind of effect. I mean if my body adapted to 30% less oxygen and suddenly it’s gone up to a 100% have I had some sort Captain America transformation?
Oh. One question. Would it be safe for me to start light jogging this week? Dr said after four weeks I can go back to regular activity so I’m sure light jogging at the end of week three should be okay?? I’m more curious than anything to test this extra oxygen capacity to see if I can run laps around the block without getting tired…like Captain America.
Probably best to follow your doctor’s advice.
Glad to hear you’re recovering.
Not sure about the Captain America transformation.
Hi, I have Forame Ovale is that the same as ASD?
What i’m trying to figure out is if i can train with HIIT high intensity interval training and if i can what rate should my heart stay at.
Thankyou.
Everybody has a foramen ovale, an opening in the inter-atrial septum, during in ute to development. It usually closes. If it does not close, we say there is a patent foramen ovale (PFO).
If a PFO is large, significant amounts of blood glow may pass through the opening, just as in ASD.
Whether or not a PFO should be closed is an issue to take up with your doctor(s).
Hello, I’m 51 & & have been suffering Dreadful shortness of breath & fatigue for past 2 /2 yrs., transthorasic echo. & Doppler exam. Indications PFO. Conclusions. 1. Hypermobile inter-atrial septum with probable shunt. Findings. ECG. Sinus. Stage 1diastolic dysfunction.
Trivial mitral regurgitation.
Right ventricular systolic pressure consistent with Mild Pulmonary Hypertension. Mild Tricuspid regurgitation.
IVC. Normal inferior RNA cava appearance & respiratory collapse. Normal pulmonary artsy size. Pulmonary ratio. 1.9 . Very worried could this be contributing to SOB?
Please Reply!!!!!
Lot’s to sort through here. Too much from afar, really.
Holes in the heart (eg, septal defects) with blood glow through them….can sometimes cause shortness of breath.
I had my ASD closures in 2013 and my shunt put in. I had my year check up with my cardiologist last year and all is healed and looking well. I was playing up until that point a full contact sport but she advised me to quit saying that consistent hits to the chest could dislodge the device. I am following her advice but I miss playing the sport I once played and wondered if you had any further comments about playing contact sports post ASD closure. I would also like to add that a different cardiologist told me that I was able to play before I saw her last year so am confused. Thanks.
From the newly published 2015 ACC guidelines for young competitive athletes, regarding ASD closure:
“Three to 6 months after operation or intervention, athletes without pulmonary hypertension, myocardial dysfunction, or arrhythmias may participate in all sports.”
Your doctor(s) would be in the best position to know if that describes your situation correctly.
I am a 33 year old athlete. I have been active and played sports all my life. I ran 3 half-marathons last year and did my first sprint triathalon this Spring. I started to have dizziness, shortness of breath, fatigue and nausea with multiple PVCs in the Spring. After a battering of tests, I was found to have a moderate ASD. My symptoms, especially the dizziness and shortness of breath with exercise, increased up to my surgery a few weeks ago. My dizziness is gone since the surgery, but now I am having mild shortness of breath with minimal activity, like doing errands around the house, that comes and goes. Some days are worse than others. I have had 3 or 4 EKGs with no major arrythmias found, an Echo 1 week out that revealed my device was still in place, and a CT of the chest which ruled out a pulmonary embolism. So far no answers to why I get short of breath intermittnently. Walking with an O2 sat monitor in the office my O2 sats dropped into the 80s with my shortness of breath. A second trip around the office 20 minutes later did not lead to reproducible results. (This inconsistent O2 drop has happened twice with two different visits.) I am frustrated as my shortness of breath is worse after surgery, although my dizziness is now gone which is a plus. All 3 of my cardiologists (surgeon, EP, and primary) do not have answers at this point. Anyone else have worsening of shortness of breath after surgery like this? Did it improve over time? Can you develop pulmonary hypertension after surgery when it was not present prior to surgery? I see my cardiologist again next week, so hoping he maybe has an answer or more tests to run? I am getting a bit tired of all the tests. Any insight would be greatly appreciated.
Thanks for sharing your story. Perhaps others will chime in with their own experiences.
I think it would be unusual to develop new pulmonary hypertension early after ASD closure.
Hi Katie,
I had a similar experience after my ASD closure which was a year ago in December. I would get dizzy and have shortness of breath before the surgery and I found that afterwards It had worsened. About 1 month after my surgery I was back in hospital with severe palpitations and a second degree AV Block. I was told that the reason I was experiencing all of this was because my body was getting used to the device as its a foreign object and that my body is under stress, which had increased because I was worried about the device and what was happening to me at the time.
I waited another month before I went back to exercising and I found that by only sticking to cardio for the first 4 months, although gradually easing into it, improved my shortness of breath and dizziness significantly. I also stopped drinking alcohol in that time and focused on getting enough sleep each night. 1 year on and my cardiovascular fitness and strength is far beyond what it was before I even knew I had the ASD.
I know it’s a stressful time and it’s frustrating not being able to jump back into your normal routine, although everyone is different and will react to the device differently. If your doctors can’t find a medical explaination, maybe you just need more rest and to de-stress. It certainly worked for me and I’m only 20 🙂
Hope you find the answers you’re looking for soon.
My daughter 12 yrs having asd of .5””m m Want to know wether it need to close ,can send her for swimming or games.
ASD’s do come in various sizes, but ordinarily the important consideration is how much blood is flowing through the ASD. Ordinarily, an echocardiogram is used to sort this out.
Hi,
I am 30 year old male, hitting gym 4 times a week for 1.5 hours for the last 5 years. Competitive swimmer in my childhood – teens.
I started experience dizziness a year and a half ago. Went to multiple doctors, all kinds, from eye surgeons to balance doctors. Done 2 EKG’s, 2 chest X-rays, wore a heart beat monitor and finally was sent to Echo. Echo revealed a small secundum atrial septal defect. I found out about it while visiting my GD for unrelated skin rash. He casually told me that Echo discovered a small ASD. No indication on how small it is. After the diagnosis, I started experiencing very uncomfortable chest sensations. Not exactly pain, but tightness that travels across the chest depending on the time. Sometimes it get worse when I take a deep breath. I don’t know if this is due to anxiety or my heart started acting up. I had the similar problems twice before. Each time I went to doctor, each time he sent me to EKG + Chest X ray, which showed nothing.
I am depressed and can’t live my life normally after the diagnosis. I was sent to heart surgeon who informed me that he doesn’t deal with congenial heart defects and I have to seek a different doctor. Don’t know how much time will go by before I can talk to a specialist.
Can I continue working out with a small asd? Do I need it to get repaired? It will drive me crazy if I stop lifting weights.
Thanks
It is generally safe for athletes with a small (untreated) ASD to participate in sports if:
1. The size/function of the right side of the heart are normal,
2. The pressure in the pulmonary artery is normal,
3. There are no other heart problems.
The decision about whether to repair an ASD usually hinges on how much blood flow (“shunt”) there is through the ASD.
Ordinarily, the echocardiogram can sort this all out.
Yury,
You’re not alone. I’m a fit 32 yo female – was diagnosed 2 years ago with a small ASD (when I started getting palpitations)…after I started getting on & off dizziness, SOB and chest discomfort. My cardiologist said the defect doesnt need to be fixed right now…so I’m continuing to lift weights and working out regularly. It’s not easy living with these symptoms. But try to hang in there and get a cardioligist’s opinion! All the best. And thank you Dr. Creswell for such a helpful website!
Hey Sam. Thank you for your kind words. I actually went to a heart surgeon for a comprehensive opinion and he requested another ultrasound, this time with the bubble test, as he said sometimes small ASDs are misdiagnosed. We’ll see. I feel somewhat better now. I think a lot of symptoms manifest themselves due to mental strain any sort of diagnosis puts on the person.
Thank you.
I was dx in 2013 with Atrial Septal Aneurysm by cardiac scan. At the time was told not to worry … at the time I was also dx with exercise induced HTN started on lisinpril and BP was great but developed cough and taken off no new BP meds prescribed 6 months later ……. Then in 2015 I had a stent after 90% blockage LAD was found…. given metroprol ER 25 mg daily …. one year later still have Exercised induced HTN even on medication … now increased to 2x day am and pm 25 mg metropol. Should I be concerned that no one is concerned about the Atrial Septal Aneurysm , it is never even mentioned
Thanks
I am 52 years old
There is ordinarily little consequence to atrial septal aneurysm….and usually no treatment is needed.
My son is 20 y/o. He is crew captain at his university. He trains on the erg and in the water 6 days a week. A year ago he noticed his hands and feet turning blue with with maximal exertion. In the last few weeks this cyanosis goes half way up his arms and legs and involves his whole face. He reports substantial chest pressure at the same time.
My son is otherwise very fit and healthy. He is not a heavy drinker and does not abuse substances. There is no family history of cardiopumonary disease.
His symptoms make me think of exercise induced shunting and cyanosis. Seems odd to arise out of the blue. I am having him see a cardiologist as soon as possible.
Any thought to a possible diagnosis?
For the readers here, cyanosis is the medical term used for the bluish discoloration of the skin that results from too little oxygen in the blood.
As Dr. Cady points out, one potential cause of cyanosis can be an inherited defect in the heart which allows de-oxygenated blood to be pumped to the body. The typical examples are “holes” between the chambers of the heart such as atrial septal defect (ASD) or ventricular septal defect (VSD). There are other, less common, defects that can produce the abnormal shunting of blood.
The starting point for diagnosis starts with the physical exam, looking and listening for evidence of the various conditions that can produce the shunt. Often, the echocardiogram (ultrasound) is used to identify or rule out the various possibilities.m if doubt remains after the echocardiogram, cardiac MRI or CT scan can be used to study the anatomy of the heart (and the large arteries/veins that carry blood from/to the heart).
Good luck with the upcoming cardiology visit. If you get the chance, please check back and let us know how things turn out with your son’s evaluation.
Hi, I am 18 years old, I was diagnosed with infective endocarditis last year and was treated with IV antibiotics. The doctors suggested closing my congenital VSD and ASD and I underwent an open heart surgery in January. I’ve always been an active person and love running, but I’m not sure when I should start running again, the doctors said it should be fine but I’m afraid of the jumping impact. Even when running across the road my heart feels weird, I don’t know if it’s just psychological. Can you give me some advice? Thank you!
Many athlete patients note some difficulties and apprehension getting back to exercise (or training) after operation.
Most patients with corrected ASD and/or VSD can once again participate fully in their sports.
For most athletes, it is wise to check I. With your doctor(s) after resuming exercise to talk about your experience and get any additional advice.
Hii all
I was daignose with ASD during annual medical. I m defence person. A civil dr told me that i have 11 mm ASD during TEE check up but in millitary hospital dr told that it is 15 mm after TEE. I asked him why size is differ, he replied that it differ with angle of approaching.
Now i wnt to ask is it happen that size differ with angle of approaching
Second thing on 1 4 mar 16 i have gone under cather treatment where the doc told that ASD is very small it is not 15 or 11 mm, it is less than measured size even there was aneurysam than dr took 22 mm length of one side so that aneurysam can also resolved and 10 mm lenghth of closure device with another side
Now they took echo view and found with no L to R without aneurysam.
How many time taken by tissue to fully cover the device
Plz reply i m worried to know and what type of restriction during this cover period like walking, driving ,eating related
There can be small differences in the measured size of an ASD when measurements are made with different machines, on different days, with different people doing the measuring. What’s most important is the amount of blood flow through the ASD. We sometimes call that the “shunt fraction.”
You also mention “aneurysm.” There can be so-called aneurysm of the inter-atrial septum, the wall between the upper chambers of the heart, where that wall is billowing, like a sail.
You also ask about restriction to activities after a closure procedure. Most athletes can return to their sports after a successful percutaneous ASD closure once the tissues have had a chance to heal up.
Thanks a lot sir
Sir after ASD treatment, in my ECG it shows sinus arrhythmia which was not before ASD closure. Dr told its normal n it happens but i m little bit worry abt that, in the month of sep i’ll complete six mnth after this closure n again going for check up.
Pls suggeste me anythng which i supposed to ask to Dr.
Thank you
Hi, I am 15 years old. I was diagnosed with 1cm of ASD(not sure which type) last winter. I am planning on getting my closure surgery this summer. I play tennis, and I was wondering if I will be able to continue playing tennis after about 2 months getting the surgery. Is it ok for me to keep playing tennis after the surgery? What do you suggest?
Most athletes can return to sports fairly quickly after ASD closure.
Thanks for a great blog post. My question is fairly simple: Would the maximum heart rate be lower in athletes with an ASD or PFO? A trial runner, for example, that can run 13.1 events, yet never is able to get max HR over 150 bpm even with maximal exertion. The age of the runner is 50 y.o. A PFO is suspect due to migraines and a mother with PFO (diagnosed at 70 y.o.).
Thanks for any insight into the heart rate. An echo will be done soon (some palpitations and a mild mitral valve murmur).
I’m not sure there would be a consistent relationship between maximal HR and the presence (or absence) of an ASD or PFO.
I would think that, in the case of a large ASD, there would be an artificially ELEVATED heart rate for any particular pace (since there would be additional shunting of blood through the ASD).
I am posting about an ASD closure for those 40-something athletes. I discovered the hole in my heart in 2008 after moving to Denver, Colorado and experiencing a change in altitude. Prior to that, for the first 34 years of my life, I just thought I was in worse shape than everyone else. I was always short of breath, had heart palpitations regularly but other than that, normal. In 2008, when we moved to Colorado, I went on my first hike as a new resident and thought my heart was going to explode. I chalked it up to altitude. Well, a few months later, I had an episode sitting on the couch where I thought I could be having a heart attack. At the University of Colorado, they discovered severe shunting and an Atrial Septal Defect. While under the care and progress of the doctors at U.C., we had to move for my job to Phoenix. I immediately got a cardiologist there who changed the diagnosis to a PFO (smaller hole) and did not recommend a procedure to close the PFO. I will never forget what he said…”think of your heart as an engine, sometimec engines just don’t run perfectly but they keep running just fine, it just might have a sputter”. He then handed me a psychological services pamphlet and implied I might need counseling for anxiety. I knew that he was completely wrong but didn’t pursue another opinion in Phoenix. My symptoms continued over the next two years, I had regular scary episodes where my wife would have to massage my chest lightly and give me aspirin to make it subside. After going through now a total of four years of wondering what was wrong, we moved for work again, this time to Utah. I got a new cardiologist who diagnosed me with a large PFO or a small ASD. I began to experience headaches, severe shortness of breath, multiple palpitations each day and my ability to workout was diminishing. He completed an internal echo and recommended that we close the hole with the Gore Helix Amplatzer II device. The bad news, my intense workouts would stop for a while. For the first month, nothing, for the next five months light cardio and no lifting over 25 lbs. On February 18, I was wheeled in and the procedure began. A short time later, I was back in my room with my wife. The cardiologist came in and said that it was a good thing we closed the hole, he could have driven a semi through it and he had to use the largest device made by Gore and it almost wasn’t enough. I am now at the six month mark. I am exercising regularly, still lifting light weights until I get further clearance. What I do not have is shortness of breath, I do not have headaches and have only had one “episode” since the closure. I am not as strong as I once was and my workouts have changed from mostly lifting to mostly light weights at a rapid pace and lots of reps. I still feel an occasional pull or tug in my chest and I believe that is the device simply present in my heart. Regardless of the scar tissue closing over it, it is still a metal frame the size of a half dollar in my chest, I am going to feel it. Had we not persistently continued to change cardiologist as we moved, I may have never had the surgery and discovered it was in fact, a large ASD. Who knows what that could have meant for me as a father of four and a happily married man. I missed most of the ski season last year, this year I am looking forward to skiing without panting and having to stop on every run to slow down my breathing. I encourage you to be persistent when you know your body, no one else knows it as well as you.
Thanks for sharing your account!
Hi, my daughter is a div.1 college soccer player. She collapsed with a seizure last February. Tests found nothing wrong neurologically, but found a large hole in her heart. They fixed the hole and found 3 smaller holes bunched together and fixed those as well. 4 days later she had another seizure. She has had 5 total, about 1 per month. Growing up she suffered sever pain in her extremities after games in cold weather. She also has a very slow heart rate and occasional heart block. 2 times the heart block was 3rd degree. Can this all be due to the ASD?
Thank you!
I’m not sure about your daughter’s exact situation, but yes, heart block problems can be present in patients with ASD.
Hello. My brother had ASD closure last May 2015. He wants to participate in swimming competition now in their school. Is it ok for him to do a competitive swimming now?
Exercise and sports are usually safe, without restrictions, for patients with closed ASD (by whichever technique). Exceptions would be for those with other heart problems in addition.
Hi , I am 34 year old and a healthy person,going regular Gym and participate in sports. Recently in regular health checkup doctor find ostium secundum asd with 24 MM size. Does It require to close .And as you mentioned “If the ASD is large enough (approxim. 1.0 cm or more), blood will flow through the defect in a left-to-right direction” can it be safe without closing it.
Closure is recommended for patients in whom the left-to-right shunt causes the right side of the heart to suffer. Usually echocardiogram can sort out this issue.
What are some symptoms when your ASD closure goes wrong? I had my closure in July and I feel that tool that closed up the hole came off.
I would think that your original symptoms (if any) would return. If there were no symptoms, then dislodgement of a closure device would only be discovered by some sort of imaging test, perhaps echocardiogram.
Hi, I am a 16 year old female hockey player and I am starting to wonder if I have ASD. I am in good shape and I always push myself as hard as I can go but I am really struggling, when I play I almost instantly get so tired that I feel as if I could fall asleep and my legs and hands feel really “heavy”( not due to poor nutrition). I do have asthma and I have always blamed it on that, but i’m starting to think asthma is not the culprit. I have done some research and I do have other symptoms such as my hands and feet swelling randomly and excessive sweating all the time. Also, my coaches always tell me my complexion looks awful during and after practice. Is this something I should look into? I’m kind of nervous to talk to my mom about this because I think she might think i’m being ridiculous.
Many small ASD’s produce no symptoms at all. If there is a lot of (unwanted) blood flow through the ASD, The most common symptom is shortness of breath, particularly with exertion.
Thank you so much for the information on this page.
I am a 25-year-old Olympic weightlifter who had a successful closure of my ASD two weeks ago. I was given instructions to not do any Olympic weightlifting until 3 months after the procedure. I really want to try to reduce muscle loss as much as possible. If any, what kind of lifting exercises can I do? Any barbell, dumbells exercises you can recommend? I was also told that I could do cardio, do you have any thoughts on high-intensity cardio workouts?
Thank you 🙂
We generally recommend holding off on exercise for a few weeks after ASD closure to let the device begin to heal into the surrounding heart muscle. Wouldn’t want to jeopardize a good result. I know it’s frustrating to wait, but….
This is really a helpful site. Can you tell us about your recovery and back to weight lifting? How long did it take to get back to cardio exercise? What the follow up showed?
Hi, I want to subscribe for this weblog to obtain most up-to-date updates, thus where can i do it please assist.
Sadly, I’m not sure how to subscribe.
Hi!
I’m a 20 year old female who was recently diagnosed with an ASD, the right side of my heart is slightly enlarged and the doctors thinks that’s why I’m having severe symtoms, but that it will go back to normal size after my surgery, but the pressure in my lungs are normal. I will have my hole closed via catheter closure (the Amplatzer device) this February or maybe sooner if I’m lucky.
I can’t wait til my surgery and to get this over with and start feeling better again and like myself. But now I’m a bit worried about my surgery, I wasn’t that worried before to be honest, but now I’ve read online that the device can move out of place and it could be very dangerous if that happens?? I was shocked after reading that, the doctors never told me anything about the device being able to move out of place..
Maybe because it isn’t common that it happens? I feel very anxious about that right now, I thought I would have my surgery, revocer and then everything would be 100% normal again but now I feel like I will still be afraid post surgery.
Do you have anything to say in that matter? 🙂
Good luck with your upcoming procedure for ASD closure.
Most patients can return to exercise without restrictions following ASD closure. Be sure to ask your doctor.
I have a new born boy of age 1 month. After ECG, we know that he has a small PFO type of ASD of 5 mm size with left to right shunt. Please tell me more about this disease and the treatment for it.
Thanks
Best to rely on the advice of your doctors who will know the particulars.
Thank you very much for this post. This helped me a lot when i was looking for a resourceful blog about ASD. I was diagnosed with ASD last February 2016 and undergone device closure on May 23 the same year. When my cardiologist told me about my situation that I needed to do the surgery ASAP because the hole is getting bigger as the time passed. I was 29 at that time and cannot accept the fact that I carried that defect since I was a baby. I was very physically active, did boxing, mountain climbing, and jogging regulary and felt fine. How can I did not noticed it.When I read the information in here I fully understand my case and helped me decide to do the surgery.
I, too, thank you for the post. Although I’m not a competitive athlete, I do run, bike, lift and climb big mountains in Colorado. It’s reassuring to hear from you and others that I may get back to normal after the procedure. It was recently discovered that I have a 10-15mm secundum ASD and right heart enlargement which means I need it closed.
One question I have for your or others is if the pre procedure symptoms typically will go away after closure? In my case it is heart palpitations and occasional, mild chest pains. All my other tests have indicated that I have a good heart, other than the ASD issues.
We can see if other chime in….
Hello, I really appreciate your thoughts.
I have the secundum ASD (L->R) which I am tracking since I was 6 years old. Now, I’m a 35 year old man.
I did not have any side effects due to my ASD and so far cardiologist told me that I do not need to close my ASD since it is small (4mm).
Three-four years ago my Qp:Qs was around 1.3, but on last test it was Qp:Qs was 1.6.
I have a question regarding my cycling activities.
Since that one year ago I have started more seriously with amateur cycling and I have participated in several amateur cycling marathons (200-300km).
However, since that on my last test I have had Qp:Qs=1.6, my cardiologist told me that I should stop with cycling activities. I was wondering should I stop totally with cycling or I should just reduce intensity, that is, avoid cycling marathons?
From afar, and without knowing all of your information, I’m not sure exactly what activities would be safe.
You should ask your cardiologist that question and get very specific advice about very specific activities.
Sometimes a second opinion could be helpful in sorting out what’s safe.
hello Doctor thank you for this amazing site with very helpful answers .. i am at the end of 20 yo with 186 height and 80 kg and i have discoverd an 27*22 mm secundum ASD in routine check and the doctor told that right ventricle is expansion too much as well as the pulmonary hypertension is 35 mm with too much failure in front edge of heart with good systolic function of both ventricle and my surgery at 26 december knowing that i started swimming from 3 years ago about 20 min daily even in witer without stop and do so much pull ups and push ups with lifting weight and i didnt feel any symptoms…so my question is the would the expansion in the right ventricle go back ? and what about the front edge ? would i back swim like befor surgery ?? and do pull ups ??
Good luck with your upcoming procedure.
Most athletes with secundum ASD can return to their sports without restriction after repair.
The right heart may function better after repair.
hello doctor larry thanks so much for your reply … i had the operation 8 months ago now i am very good and i started trainig normal but i would like to start crossfit training can i do that ? and what about weights lift can i increase the weight like 80% of my one rep max ? is there any risk on my heart from weight lifting ?
That’s a good question for your doctor who will know the particulars of your case.
I wrote a comment/question back in 2014, 5 days after I had a closure (Gore Helex device). 10 mm hole. I was (very) concerned that I could no longer do high intensity training, participate in triathlons, etc. Doctors gave me very different advices…. Wait for 6 months… Start easy in a few weeks… And for the same reason I search all the info avalible and found this blog .. Thanks 🙂
My story/follow up: I had the closure in May 2014. I trained relatively hard already 3 weeks after. Ran a marathon in october the same year. Ran my first sub 3 marathon in 2015. Participated in several Ironman races from 2015-2017 ending up with racing in Kona in 2017. I know we all have different stories. But with my own initial concerns I just wanted to share my story. Based on my experience you will still be able to compete/train at any level after the procedure.
/ Kristian Brinckmann, Denmark
Thanks for sharing your story, Kristian!
Glad to hear that you’re doing well.
I have been fighting with chest pain and palpitations after exertion for the past three years. Light jogging or low intensity exercise don’t cause ant issues. However if I hit the weights or go on a long intense run I get chest pain and palpitations an hour or so later that can last for days. On the first episode (2015) my troponin was mildly elevated. Heart cath show no issues, subsequent cardiac MRI showed no signs of infarction.
Three years later I am still fighting this. Started experiencing SOB about a month ago. CT scan normal. Echo shows mild RV enlargement with positive right to left atrial shunting that was trivial. My cardiologist seems to think it’s not an issue and it’s due to overly sensitive nerves or muscle skeletal.
To me it’s more on the line of exercised induced shunting. I mentioned doing a TEE to determine the cause and he brushed it off as PFO and a normal occurrence.
Any ideas? The palpitations make it impossible to sleep. They’ll resolve in a week or so thankfully. Just want to get back to the gym!
Not sure what to make of this from afar.
Sometimes, when you reach an impasse with your current doctors and evaluation and still have concerns….a second opinion may be helpful. I’ve written recently here at the blog about how that can sometimes be helpful.
If the palpitations are the primary concern, perhaps investigation such as a Holter monitor to record the type of heart rhythm might inform your discussions about implications and, perhaps, treatment.
I would really appreciate any help with regards to when I can’t start exercising and at what intensity. I’m one week post PFO closure, performed in Leeds England. 11mm hole and feel fine other then a bit anxious. I had a stroke 12 weeks ago which made me aware of the issue but now fully recovered, with no side effects. Dr offering little or no help with regards to above questions, so frustrating!
Most cardiologists say that athletes can return to exercise in the first month after ASD closure.
If there are any issues with leg artery healing or with complete closure of the ASD with the occluded device, it may take longer for exercise to be safe.
Am I happy to have found this article…
I am a 43 yo female w/ ASD. The flow is bidirectional as found on TEE (6/25/18). I have an appt w/ the surgeon next week where we’ll discuss and schedule the procedure.
I’m amazed at how much I was able to “explain away” was never, in fact, normal. The fatigue…slow recovery from training…dizziness. I figured as a mom of 6 who trains hard that it made sense to be tired! Hmmmm, not so!
I have two main questions, though I could ask sooo many more! Ha ha!
1. Can ASD cause abdominal swelling? I’ve read this here and there, but nothing’s clear.
2. Can this cause shoulder pain? I get pain in my left shoulder during cardio (restricted from lifting now ☹️) and I don’t know what to make of it. It def comes on with increased heart rate and eventually subsides.
Thank you again for this article and for also being attentive to posts. I know you can’t diagnose, treat etc (wink, wink), but your general opinion would be appreciated!
Hi Dr. Creswell,
Your site was very helpful to me last year when my then almost 19 year old daughter, a college field hockey player, was diagnosed with a very large asd. She had it closed in June 2017 and made a remarkably fast recovery; she was back to playing in August 2017. Her follow-ups all went well.
This season began very well, but I have noticed a change in her stamina that looks like what I noticed before her closure. She is an extremely fit person and quite a fast runner, but something has changed and because it seems familar, it of course makes me think of her heart. What are the numbers for Amplatzer occluders failing or moving after a year plus? How would she know?
She says she has no other symptoms. She also recently had a sinus infection requiring a zpac and subsequent short term steroids but nothing I have found suggested they would cause a reduction in stamina.
Thanks in advance for any thoughts or comments, before we contact her cardiologist!
I’m not sure about exact numbers for “failure” rate after this type of ASD closure. No doubt, the rate is very low, but not zero.
Fortunately, that possibility is usually easily assessed with a repeat echocardiogram. You could ask your daughter’s doctor(s) if that would be useful to help sort out a cause for her fatigue.
Thank you!
Sharing recent personal experience here. 34 y/o healthy female – played sports my whole life and continue to play soccer and exercise 5+ times a week now. Diagnosed in June 2018 with an 18mm ASD, shunt ratio > 2.1. Growing up I fainted frequently and had mild palpitations. ASD was discovered in 2018 after an increase of uncomfortable palpitations, with an echo showing a moderately dilated right ventricle. After several opinions (surgical v trans catheter repair) and with the guidance of my cardiologist, I decided on surgical ASD closure via robotic, or minimally invasive, surgery. I underwent a successful repair surgery in early December 2018, and returned to slow jogging 2.5 wks post surgery. By 3 months post surgery I was playing soccer, and now 6 months post surgery I feel healthier than before. Thank you to Dr. Creswell for this resource – it was reassuring to read before and after my surgery and made me feel confident I would return to full activity post surgery. I wish there were more resources out there for adults like me who feel perfectly healthy and are told out of the blue that they need heart surgery! Thanks for sharing your knowledge.
That’s terrific news, Lauren. Thanks so much for sharing your experience. And congratulations for getting back to your activities!
Is cycling affect the patient of ASD congenital heart disease?
Cycling is probably no different from other endurance sports when it comes to ASD.
Thanks for this site Dr Creswell, as it has helped put me a bit at ease with regard to my upcoming ASD Closure 10/31/19. I’m a 5’6″ 142 lb 61 years old and never been an elite athlete. I have run a couple marathons and continue to run recreationally and weight train. I had a 10 second TIA losing left arm function in June, labeled as cryptogenic, and following tests a closure was recommended. My question is in your experience is my age a factor in making a full recovery and/or competing at a higher level than this past year. Lots of great success stories here, thank you again. I will give an update that will hopefully help others. Peace . . .
Good luck with your upcoming procedure, Perry. I suppose that, in general, younger patient recover more quickly than older patients, regardless of the type of procedure. But I would also expect that patients of any age should be able to return to their activities after ASD closure.
Hi. I had my asd closed via device (occlutech) 2 months ago and I feel quite normal except the preoccupation of device in my heart. After 1.5 month I did running of mild intensity and some light weight lifting. In the follow up everything seems normal but I asked the doctor what movements should I avoid. He said no running no competitive sports. I wonder should I do nothing?
Thank you for the reply, I appreciate it. Reading all these comments from both you & all the others has been comforting. In hopes of helping others, I’ll report back with a couple updates on my experience following the procedure on 10/31.
Perry
Hello all . . . So I wanted to report back with a few details in regard to my experience. I’m a 61 year-old guy small in stature at 5’6″ 143 lbs. Had a 10-second TIA affecting my left arm back in June of this year. Attempted to hike Kilimanjaro in Sept, but didn’t summit as my oxygen level got dangerously low on day 6 of 8 and I had to descend – still had a great experience ! I decided to have an ASD Closure using the Gore Cardioform device as an outpatient 10/31/19. It seems that all went well with the procedure, just a little sore & bruised in groin area with 2 small incisions. I was out for most of it but remember a few snippets and felt zero pain. In recovery I was told to not lift anything over 10 lbs for two weeks, but I could resume my non-desk job in 3 days and to just walk normally. After 2 weeks they said I could resume my running & weight training, but to start out slow. So I did 6 one-rep sets of lifting on the 14th day, and ran an easy 3 miles on the treadmill at 9-minute mile pace day 15. I do feel as though I’m huffing & puffing less upon completion of reps and when done running. Could be placebo affect, but that’s fine by me, I just feel a little better after a workout. I think I’ll be close to my 5-mile 8:30 pace runs and full lifting workouts after this week. I have a follow-up exam with echo in 3 weeks and I’ll give my last update then. I’m happy I chose to have the procedure done. Thanks again for this site Dr Creswell, it really helped me leading up to the procedure. Till next time . . .
Hello Dr Creswell & others . . . Its been over a year now since I had the ASD Closure procedure. I recently had an Echo & bubble test here in Nov 2020 and the tests came back good. I’ve been exercising with 5 mile runs & weight training for a year since the test in 2019. As I mentioned earlier, my improved recovery time is the major benefit I can notice. But One line in the Dr’s followup notes states:
“The left atrium is severely enlarged in size based on measured volume indexed to body surface area.”
My cardiologist said this enlargement is not an issue with exercise regimen and does not see it as a limitation. I am wondering, Dr Creswell, if you think an enlargement like this is something I need to be concerned about when exercising ?
Thank you in advance for your response.
Perry