Delayed Closure of Secundum Atrial Septal Defect Leading to Eisenmenger Syndrome: A Case Report of Missed Intervention and Optimized Medical Therapy

Ida Ayu Nova Anggarita, Angga Rifqi Mujidiatama, Irmarisyani Sudirman

Abstract: Atrial septal defect (ASD) is frequently underdiagnosed until adulthood due to its often-silent early course. If left untreated, it may lead to serious complications such as Eisenmenger syndrome. This case report details the clinical course of a 45-year-old woman with a longstanding secundum ASD complicated by severe pulmonary hypertension and right-to-left shunting, following delays in planned percutaneous closure due to the COVID-19 pandemic. The patient presented with acute decompensated right heart failure and bronchopneumonia. Echocardiography and right heart catheterization confirmed irreversible pulmonary vascular disease. Management included pulmonary vasodilators, diuretics, infection control, and supportive therapy, while surgical closure was contraindicated. This case highlights the need for early diagnosis and continuous follow-up to prevent irreversible complications in congenital heart disease. However, delayed diagnosis and management continue to pose a significant clinical challenge, particularly in resource-limited healthcare settings.

Keywords: Atrial Septal Defect, Eisenmenger Syndrome, Pulmonary Hypertension, Right Heart Failure, Case Report

How to Cite?: Ida Ayu Nova Anggarita, Angga Rifqi Mujidiatama, Irmarisyani Sudirman, "Delayed Closure of Secundum Atrial Septal Defect Leading to Eisenmenger Syndrome: A Case Report of Missed Intervention and Optimized Medical Therapy", Volume 14 Issue 7, July 2025, International Journal of Science and Research (IJSR), Pages: 1255-1261, https://www.ijsr.net/getabstract.php?paperid=SR25717143555, DOI: https://dx.doi.org/10.21275/SR25717143555