Atrial Septal Defect (ASD) |Types | MedStar Health

A congenital heart defect in which there is a hole in the heart

Medical illustration showing atrial septal defect of the heart.An atrial septal defect (ASD) is a hole in the wall that separates the top two chambers of the heart (atria), allowing blood to leak between the chambers. It’s a congenital heart defect, meaning you were born with it.

Small ASDs may never cause a problem, but larger holes can cause life-threatening problems, such as:

Our Adult Congenital Heart Center team offers a range of techniques to repair ASDs, from minimally invasive procedures to open-heart surgery.


There are several types of atrial septal defect:

  • Coronary sinus: This is rare and means part of the wall between the chambers is missing
  • Primum: This defect occurs in the lower part of the wall
  • Secundum: The most common ASD, it occurs in the middle of the wall
  • Sinus venosus: This rare defect occurs in the upper part of the wall


While an atrial septal defect is present from birth, you likely won’t exhibit symptoms until you’re older. Signs of an ASD may include:

  • Fatigue
  • Frequent lung infections
  • Heart murmur, a rasping or whooshing sound that can be heard between heartbeats through a stethoscope

  • Palpitations, or sensations of a racing heart or fluttering in your chest

  • Shortness of breath
  • Swelling of the legs, feet, or abdomen


Congenital heart defects can run in families. Talk to your doctor about genetic testing if you or a family member has an atrial septal defect.

Some conditions that occur during pregnancy can increase the risk of a baby having ASD, including:

  • Diabetes

  • Drug, tobacco, or alcohol use
  • Lupus
  • Obesity
  • Rubella, also known as German measles
  • Phenylketonuria (PKU)


Cardiac Catheterization

Cardiac catheterization is a minimally invasive way to diagnose and treat a variety of heart and vascular conditions by guiding thin, flexible tubes called catheters through blood vessels to problem areas.

Computerized Tomography (CT) Scan

The cardiac computed tomography scan, or cardiac CT, uses X-rays to create three-dimensional images of your heart and blood vessels.


An echocardiogram uses high-frequency sound waves to create images of your heart.

Electrocardiogram (ECG)

An electrocardiogram, also known as an ECG, measures the heart’s electrical activity.

Magnetic Resonance Imaging (MRI)

Magnetic resonance imaging, better known as cardiac MRI, is a combination of radio waves, magnets, and computer technology to create images of your heart and blood vessels.

Stress Tests

Stress tests are used to assess how your heart works during physical activity. There are several types of stress tests, including treadmill or bike stress tests, nuclear stress tests, stress echocardiograms, and chemically induced stress tests.

Transesophageal Echocardiogram (TEE)

Transesophageal echocardiogram allows us to take very detailed images of your heart structure from a probe in your esophagus.


Some small defects may require only monitoring or medications to reduce minor symptoms. Larger ASDs may need to be closed with either a catheter-based procedure or even surgery..

Heart Surgery

Heart surgery is an option to treat many heart conditions. You may need heart surgery either as a lifesaving procedure or when other treatments haven’t worked.

Minimally Invasive Heart Surgery

Minimally invasive heart surgery is used whenever possible to reduce risks and shorten recovery time after surgery to treat a variety of conditions.

Patent Foramen Ovale and Atrial Septal Defects Treatments

Treatments for patent foramen ovales (PFO) and atrial septal defects (ASD) such as medication, closure devices, and surgery, vary based on your symptoms and risk factors.

Additional information

Adult Congenital Heart Center

When you’re born with a heart problem, you may need complex care throughout your life. Our experts tailor this specialized care to your unique needs.

Ask MedStar Heart & Vascular Institute

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