Key result
Contrast TTE identifies a previously unrecognized ASD in a postpartum patient via bidirectional shunting.
Why the study?
Atrial septal defects can remain asymptomatic for years, but pregnancy and postpartum hemodynamic changes can trigger clinical manifestations.
Case Report (n=1)
Physiological and hemodynamic changes during the postpartum period can unmask previously unrecognized atrial septal defects, emphasizing the need for high clinical suspicion in postpartum patients with acute cardiopulmonary symptoms.
Supports ASD evaluation in postpartum pulmonary hypertension; leaves open whether systematic screening improves outcomes.
A BSTRACT Atrial septal defects (ASDs) are among the most common congenital heart defects diagnosed in adults. They may remain asymptomatic for many years; however, the physiological and hemodynamic changes associated with pregnancy and the postpartum period can trigger clinical manifestations. We describe a 23-year-old postpartum patient in whom severe pulmonary hypertension led to the diagnosis of a previously unrecognized ASD. Transthoracic contrast echocardiography (bubble test) revealed bidirectional right-to-left shunting. Despite the absence of right heart catheterization, prompt detection allowed timely management and planning for definitive surgical correction. This case highlights the importance of maintaining a high index of suspicion for ASDs in postpartum patients presenting with acute cardiopulmonary symptoms.
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Islam et al. (2026) conducted a case report in Postpartum Pulmonary Hypertension and Atrial Septal Defect (n=1). Transthoracic contrast echocardiography was evaluated. Transthoracic contrast echocardiography revealed bidirectional right-to-left shunting, leading to the diagnosis of a previously unrecognized atrial septal defect in a 23-year-old postpartum patient.
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