房间隔缺损(ASD)
这是什么??
分隔心脏上两个腔室(心房)的壁(隔膜)上的开口或孔(缺陷)。.
这一缺陷使富氧血液流入心脏缺氧的血腔. ASD is a defect in the septum between the heart's two upper chambers. The septum is a wall that separates the heart's left and right sides.
More information for parents of children with ASD
原因是什么??
Every child is born with an opening between the upper heart chambers. It's a normal fetal opening that allows blood to detour away from the lungs before birth. 出生后, 该开口不再需要，通常在几周或几个月内关闭或变得非常小.
有时 the opening is larger than normal and doesn't close after birth. 大多数儿童的病因不明. Some children can have other heart defects along with ASD.
它是如何影响心脏的?
Normally, the left side of the heart only pumps blood to the body, and the right side of the heart only pumps blood to the lungs. 在一个自闭症儿童身上, 血液可以从左上心室(左心房)穿过这个洞到达右上心室(右心房)，然后进入肺动脉.
如果ASD很大, 额外的血液被泵入肺部动脉，使心脏和肺部工作更加困难，肺部动脉会逐渐受损.
If the hole is small, it may not cause symptoms or problems. Many healthy adults still have a small leftover opening in the wall between the atria, 有时被称为 卵圆孔未闭 (PFO).
ASD对我的孩子有什么影响?
患有自闭症谱系障碍的儿童通常没有症状. 如果开口小, it won't cause symptoms because the heart and lungs don't have to work harder. 如果开口大, 唯一不正常的发现可能是杂音(听诊器听到的噪音)和其他不正常的心音. 在患有严重自闭症的儿童中, 主要的风险是肺部的血管，因为泵入的血液比正常情况下多. Over time, usually many years, this may cause permanent damage to the lung blood vessels.
ASD可以修复吗?
如果开口小, it doesn't make the heart and lungs work harder. 手术和其他治疗可能不需要. Small ASDs that are discovered in infants often close or narrow on their own. 没有任何药物可以使自闭症谱系障碍比自然情况下缩小或更快地闭合.
如果ASD很大, 它可以通过开胸手术关闭, or by cardiac catheterization using a device inserted into the opening to plug it. 有时, if the ASD is an unusual position within the heart, 或者如果有其他心脏缺陷，比如将血液从肺部输送回心脏的静脉连接异常(肺静脉), the ASD can't be closed with the catheter technique. 那么就需要手术了.
Closing a large ASD by open-heart surgery usually is done in early childhood, 即使病人没有什么症状, 防止以后的并发症. Many defects can be sewn closed without using a patch.
我的孩子会做什么活动?
您的孩子可能不需要任何特别的预防措施，并且可以参加正常的活动而不会增加风险. 手术或导管关闭后, your child's pediatric cardiologist may advise some activity changes for a short time. 但在手术成功愈合或导管关闭后，通常不需要任何限制. 有时，在ASD关闭后的几个月里，会使用药物来预防血栓和感染.
我的孩子将来需要什么?
这取决于自闭症的类型, 你孩子的儿科心脏病专家可能会定期检查你的孩子，寻找不常见的问题. 在手术后很短的沙巴足球体育平台内关闭ASD, a pediatric cardiologist must regularly examine the child. 长期前景非常好, and usually no medicines and no additional surgery or catheterization are needed.
如何预防心内膜炎呢?
Most children with an ASD are not at increased risk for developing endocarditis. 您孩子的心脏病专家可能会建议您的孩子在ASD修复后的一段沙巴足球体育平台内，在某些牙科手术之前接受抗生素治疗. 请参阅 心内膜炎 了解更多信息.
更多关于自闭症成人的信息
原因是什么??
原因通常是未知的. 遗传因素有时也会起作用.
它是如何影响心脏的?
If the hole is small, it may have minimal effect on heart function. 心房之间存在较大缺损时, 大量的富氧(红色)血液从心脏左侧回流到右侧. 然后这些血液被泵回肺部，尽管已经被氧气补充过了. Unfortunately this creates more work for the right side of the heart.
This extra amount of blood flow in the lung arteries can also cause gradual damage.
ASD对我有什么影响?
一些ASD患者没有任何症状. 如果开口小, it won't cause symptoms because the additional work done by the heart and lungs is minimal. 如果开口大, it may cause mild shortness of breath, especially with exercise. 肺内血的增加可能增加病人对肺炎和支气管炎的易感性. 关于身体检查, 唯一不正常的发现可能是杂音(听诊器听到的噪音)和其他不正常的心音. However, 肺部血管逐渐受损, 肺部压力可能升高, 病人的病情会变得更加严重, 最终患上艾森曼格综合症, 下面描述.
If I had surgery to close an ASD in childhood, what can I expect?
A large ASD is usually closed in early childhood, 即使病人没有什么症状, 防止以后的并发症. 一些缺损用心包(心脏外的正常内膜)或合成材料(如涤纶)修补. However, many defects that required surgery may have been sewn closed without using a patch. 儿童期ASD闭合后预后良好，晚期并发症少见.
如果缺陷仍然存在怎么办? 成年后应该修复吗?
如果开口小, surgery or other treatments may not be needed.
现在，大多数较大的房间隔缺损都可以通过心内直视手术或心导管插入术来关闭，使用插入到开口的装置来堵塞它(称为 介入性或治疗性导尿). However, if the ASD is in an unusual position within the heart, 或者如果有其他心脏缺陷，比如将血液从肺部输送回心脏的静脉连接异常(肺静脉), the ASD cannot be closed with the catheter technique. 那么就需要手术了. 即使在成年后发现缺陷，患者也能从大缺陷的闭合中获益.
你可能遇到的问题
小的未修复或修复的房间隔缺损很少有任何后期问题. 那些有心悸或晕倒的人需要由他们的心脏病专家进行评估，可能需要药物治疗. Also, 如果自闭症谱系障碍是在晚年诊断出来的, the heart's ability to pump may have been affected, 导致心力衰竭. 这种情况需要使用利尿剂, drugs to help the heart pump better and drugs to control blood pressure. 如果出现肺动脉高压(这种情况并不常见)，有些人可能需要额外的药物治疗.
患有短暂性脑缺血发作(TIA)或中风并被发现患有PFO的患者可能会服用阿司匹林或其他血液稀释剂. 如果再次中风复发，服用药物, patients may be referred to have a PFO or small ASD closed (see below). 目前有专门的研究正在进行中，以确定药物治疗或关闭PFO在预防中风方面是否更好. 需要强调的是，绝大多数患有小pfo和ASD的人没有中风，也不需要关闭他们的缺陷.
持续的关心
我将来需要什么?
有ASD病史的患者应该定期去看心脏病专家，寻找不常见的问题. 在手术后很短的沙巴足球体育平台内关闭ASD, a cardiologist must regularly examine you. 长期前景非常好, and usually no medicines and no additional surgery or catheterization are needed.
医学随访
有时，在ASD关闭后的几个月里，会使用药物来预防血栓和感染. Only rarely will patients need to take medicine after six months. Your cardiologist can monitor you with noninvasive tests if needed. These include electrocardiograms, Holter monitors, exercise stress tests and echocardiograms. They will help show if more procedures, such as a cardiac catheterization, are needed.
活动的限制
大多数患者, 未修复的房间隔缺损和修复的asd不需要任何特别的预防措施，可以参加正常活动而不增加风险. 近期手术或导管闭合后, your cardiologist may advise some limits on your physical activity for a short time, 即使没有肺动脉高压. 手术或导管闭合成功后，通常不需要任何限制. The exception is that patients who have developed high pressures in the lungs (pulmonary hypertension; see Eisenmenger's syndrome)应该避免高水平的体育运动.
心内膜炎的预防
This isn't needed beyond six months after repair either by surgery or device.
怀孕
Once the ASD is closed and there's no leftover opening, the risk with pregnancy is very low. 如果有未修复的ASD，怀孕的风险会增加，但怀孕通常是安全的，除非有肺动脉高压. 一个大的未修复的ASD有时会导致怀孕期间的心力衰竭，但这通常是通过药物控制的 如果发现得早. There is a slight risk of stroke during pregnancy, so precautions against blood clots may be recommended.
你还需要手术吗?
Once an ASD has been closed, it's unlikely that more surgery will be needed. 很少，患者可能有一个残余的孔. Whether it will need to be closed depends on its size.
