Which statement about fetal septal defects is true?

Which statement about fetal septal defects is true?

• A. Atrial septal defect may be asymptomatic or cause heart failure
• B. All septal defects require immediate surgery after birth
• C. Septal defects are always cyanotic
• D. Ventricular septal defects are never associated with heart failure

Answer: (A)

Understanding how atrial septal defects present helps explain why this statement is true. An ASD is a hole in the wall between the heart’s atria that allows blood to flow from the left atrium to the right. The impact depends on the size of the defect and the amount of shunting. Small ASDs often cause no symptoms and may be discovered incidentally. Larger ASDs can lead to increased pulmonary blood flow and volume overload of the right side of the heart, which can cause symptoms such as breathing difficulty, fatigue, or signs of heart failure, especially in infancy or early childhood. Because the clinical picture can range from asymptomatic to heart failure, the statement that an ASD may be asymptomatic or cause heart failure is accurate. In contrast, not all septal defects require immediate surgery after birth; many small defects close on their own or are monitored with planned treatment later if needed. Also, most septal defects are acyanotic, meaning they do not cause cyanosis; cyanosis occurs with certain shunts or complex defects. Ventricular septal defects can cause heart failure when large due to significant left-to-right shunting, so the claim that they are never associated with heart failure isn’t correct.

Understanding how atrial septal defects present helps explain why this statement is true. An ASD is a hole in the wall between the heart’s atria that allows blood to flow from the left atrium to the right. The impact depends on the size of the defect and the amount of shunting. Small ASDs often cause no symptoms and may be discovered incidentally. Larger ASDs can lead to increased pulmonary blood flow and volume overload of the right side of the heart, which can cause symptoms such as breathing difficulty, fatigue, or signs of heart failure, especially in infancy or early childhood. Because the clinical picture can range from asymptomatic to heart failure, the statement that an ASD may be asymptomatic or cause heart failure is accurate.

In contrast, not all septal defects require immediate surgery after birth; many small defects close on their own or are monitored with planned treatment later if needed. Also, most septal defects are acyanotic, meaning they do not cause cyanosis; cyanosis occurs with certain shunts or complex defects. Ventricular septal defects can cause heart failure when large due to significant left-to-right shunting, so the claim that they are never associated with heart failure isn’t correct.