Dawaa Reference

chronic

Atrial septal defect

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources3 sources

Atrial Septal Defect - StatPearls - NCBI Bookshelf - https://www.ncbi.nlm.nih.gov/books/NBK535440/ · ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class KD55.00 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care

Verified against1 document
  • No dose - referral pathway, no medicine given in primary care

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (5)

  • Often causes no symptoms at all, especially with small defects
  • Untreated large defects can cause reduced exercise tolerance, palpitations, and more frequent pneumonia [palpitations]
  • Eisenmenger physiology brings chronic cyanosis, breathlessness on exertion, fainting and higher infection risk [breathlessness · cyanosis · syncope]
  • Larger defects present with breathlessness, fatigue, poor exercise tolerance and palpitations [breathlessness · fatigue · palpitations]
  • A stroke or TIA, especially after a peripheral clot, should raise suspicion for an underlying ASD

Signs — what you find (1)

  • A soft systolic ejection murmur at the pulmonic area with wide, fixed splitting of the second heart sound is characteristic [heart murmur]

Tests (5)

  • Transthoracic echocardiogram is the gold-standard test, showing defect size, shunt direction, and pulmonary pressures
  • Transesophageal echo is better for detecting rarer atrial septal defects
  • Chest x-ray is less diagnostically useful but can show cardiomegaly and pulmonary artery enlargement over time
  • Exercise testing can assess whether shunt reversal responds to activity
  • Cardiac catheterization is not indicated in young patients with small, uncomplicated defects

If not this — what else fits (4)

  • Ventricular septal defect, a hole between the ventricles
  • Cyanotic congenital heart disease from a sinus venosus or coronary sinus defect
  • Total anomalous pulmonary venous return, where pulmonary veins drain abnormally
  • Other outflow tract anomalies: pulmonary stenosis, truncus arteriosus, or tricuspid atresia

SourceStatPearls "Atrial Septal Defect" - disease-level clinical article

Presentation findings are traced to the source above.

1

NO DRUG THERAPY IN PRIMARY CARE (REFERRAL & ADVICE)

1st line
Adult dose and duration

Atrial septal defect is usually picked up on a murmur or incidental echo; the GP refers to paediatric or adult congenital cardiology for confirmation and a decision on closure, with no primary-care drug treatment. - Refer, with advice

Paediatric dose

Children follow the same pathway: recognise and refer. No primary-care medicine is implied.

Dose source

No dose - referral pathway, no medicine given in primary care

Why

Atrial septal defect is usually picked up on a murmur or incidental echo; the GP refers to paediatric or adult congenital cardiology for confirmation and a decision on closure, with no primary-care drug treatment.

Cautions
  • RED FLAG - Paradoxical embolism causing acute ischemic stroke: assess urgently and refer.
  • Signs of heart failure or pulmonary hypertension (breathlessness, poor growth, cyanosis) need prompt cardiology assessment.
  • No medicine is prescribed for this in primary care - this entry is for recognition and referral. Anything given is decided by the service it is referred to.

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.