Presentation
When an ostium primum atrial defect is present, the ECG reveals left axis deviation. When an ostium secundum atrial septal defect is present, the ECG reveals right axis deviation. [healio.com]
A genetic predisposition to develop pulmonary vascular disease is present in patients with severely increased pulmonary vascular resistance; the pulmonary vascular bed is hyperreactive (see Fig. 17). [encyclopedia.lubopitko-bg.com]
Presentation Infants and children with ASDs are usually asymptomatic. Rarely, infants may present with tachypnoea, poor weight gain and recurrent chest infections. [patient.info]
A prominent right ventricular cardiac impulse, manifested as a parasternal heave or lift, may be present. [merckmanuals.com]
Case reports Case 1 A 34-year-old woman presented with fainting spells over a 1 month duration. She had gestational diabetes 5 years before presentation but was not a known hypertensive. [dovepress.com]
Entire Body System
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Trisomy 21
As noted earlier, children with trisomy 21 are at higher risk than the general population of developing pulmonary vascular obstructive disease at a younger age. [emedicine.medscape.com]
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Falling
[…] in either direction across an atrial septal defect because the compliance of the right and left ventricles is virtually identical. 20, 49, 50 The right ventricle gradually becomes thinner and more compliant than the left ventricle in response to the fall [clinicalgate.com]
WAX, MD;Fall 1999 Sandwich cookie figure1c analogy of Amplatzer device:The two cookies form the two slices of the sandwich and the atrial septal defect the creme. [rjmatthewsmd.com]
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Pathologist
Springer Science & Business Media, 9 mar. 2013 - 241 pagini This book is designed primarily for anatomic pathologists to facilitate their task of accurately diagnosing embryos and fetuses. [books.google.ro]
Respiratoric
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Cough
On echocardiography, there may not be any shunting of blood noted except when the patient coughs. [marmur.com]
On echocardiography, shunting of blood may not be noted except when the patient coughs. Clinically, PFO is linked to stroke, sleep apnea, migraine with aura, and decompression sickness. [en.wikipedia.org]
Case 2 A 62-year-old woman presented with effort intolerance, orthopnea, paroxysmal nocturnal dyspnea, dry cough, and palpitation of 5 months duration. [dovepress.com]
The reversal of the shunt leads to cyanosis, as well as shortness of breath, coughing up blood, reduced exercise tolerance, syncope (fainting), palpitations, and atrial fibrillation (see figure 15a, figure 15b ). [rjmatthewsmd.com]
Gastrointestinal
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Failure to Thrive
Coronary sinus septal defect (4) Typical Presenting symptoms- Asymptomatic CHF in infancy and failure to thrive Exercise intolerance and shortness of breath, usually in the second decade of life Atrial arrhythmias Stroke secondary to paradoxical emboli [pedclerk.bsd.uchicago.edu]
Symptoms of Atrial Septal Defect (ASD, Ostium Secundum Defect) Most are asymptomatic until later in life; Susceptibility to chest infections is common; Subtle failure to thrive may occur in some children; Exertional dyspnoea ( shortness of breath ) and [healthengine.com.au]
Failure to thrive caused only by a secundum atrial septal defect is, similarly, a rare occurrence. No data indicate that an uncomplicated secundum atrial septal defect can cause pulmonary vascular disease in pediatric patients. [emedicine.medscape.com]
Neurologic
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Agitation
PFO demonstrated with saline agitation [echocardiografie.nl]
Contrast echocardiography with injection of agitated saline through a peripheral venous line can assist in the diagnosis of ASD in patients with restricted acoustic windows. [ 8 ] MRI and CT Cardiac MRI can be used to accurately define the anatomy of [patient.info]
If agitated saline is injected into a peripheral vein during echocardiography, small air bubbles can be seen on echocardiographic imaging. It may be possible to see bubbles travel across an ASD either at rest or during a cough. [marmur.com]
An agitated saline solution that filled the right atrium without any evidence of left to right shunting was used as contrast agent. [rjmatthewsmd.com]
Follow up The presence of residual shunts should be reassessed; this could be achieved with contrast echocardiography with agitated normal saline, which opacifies the right sided cardiac chambers and may demonstrate the un-opacified jet of the left to [elsevier.es]
Workup
ETIOLOGY Unknown DIAGNOSIS DIFFERENTIAL DIAGNOSIS • Primary pulmonary hypertension • Pulmonary stenosis • Rheumatic heart disease • Mitral valve prolapse • Cor pulmonale WORKUP • ECG • Chest x-ray examination • Echocardiography • Cardiac catheterization [encyclopedia.lubopitko-bg.com]
[…] embolism resulting in a right to left shunting of blood [36] Treatment [ edit ] Patent Foramen Ovale [ edit ] Most patients with a PFO are asymptomatic and do not require any specific treatment. [37] However, those who develop a stroke require further workup [en.wikipedia.org]
Treatment
The only successful treatment solutions is surgical treatment or artificial closure of the defect. Right time for surgical treatment can only be based on need for surgery and risks of surgery. [remedyland.com]
Many children with congenital heart defects don't need treatment, but others do. Treatment can include medicines, catheter procedures, surgery, and heart transplants. [icdlist.com]
Treatment for atrial septal defect Specific treatment for ASD will be determined by your child's physician based on: Your child's age, overall health, and medical history Extent of the disease Your child's tolerance for specific medications, procedures [childrensnational.org]
Treatment for Atrial Septal Defects Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is. [stlouischildrens.org]
Prognosis
The long term prognosis is excellent. Pulmonary hypertension with shunt reversal is a contraindication for surgery, however the pulmonary hypertension can frequently be treated with medicines. [en.wikipedia.org]
Complications Congestive heart failure Pulmonary arterial hypertension Prognosis Excellent prognosis if treated Sinus Venosus Atrial Septal Defect with Partial Anomalous Pulmonary Venous Return. [learningradiology.com]
Surgery, if necessary, is performed at a young age with an excellent prognosis. [heartlifeinsurance.com]
Etiology
Etiology and Pathophysiology Flow across ASD usually left-to-right shunt because of higher left-sided pressures: Minimal right-to-left shunting in early ventricular systole, especially during inspiration Increased right-sided pressure/pulmonary hypertension [unboundmedicine.com]
[…] iM StIll stUdInG Published on Mar 28, 2015 ATRIAL SEPTAL DEFECT ASD - CF, ETIOLOGY ,PATHO -PHYSIOLOGY, SIGNS & SYM, MANAGEMENT.....ETC ATRIAL SEPTAL DEFECT ( ASD) 1. ATRIAL SEPTAL DEFECT AKSHAY AGRAWAL 2. CONTENTS 1. Introduction 2. Defination 3. [slideshare.net]
Vikas Thakran Department of Cardiology, AIIMS, New Delhi - 110 029 India Source of Support: None, Conflict of Interest: None DOI: 10.4103/2395-5414.157579 Cyanosis in ASD has multiple causes requiring etiology directed management. [j-pcs.org]
ETIOLOGY Unknown DIAGNOSIS DIFFERENTIAL DIAGNOSIS • Primary pulmonary hypertension • Pulmonary stenosis • Rheumatic heart disease • Mitral valve prolapse • Cor pulmonale WORKUP • ECG • Chest x-ray examination • Echocardiography • Cardiac catheterization [encyclopedia.lubopitko-bg.com]
Etiology During normal embryonic development, the right horn of the sinus venosus encompasses the right superior vena cava (SVC) and inferior vena cava (IVC). [emedicine.medscape.com]
Epidemiology
Epidemiology Male : Female 1:2 Most commonly seen in children 8. [slideshare.net]
Epidemiology Incidence Predominant age: present from birth, may be diagnosed at any age Slight female predominance ( 2 ) No race predilection 2/1,000 live births Prevalence ASDs account for 13% of congenital heart disorders. [unboundmedicine.com]
EPIDEMIOLOGY & DEMOGRAPHICS • 80% of cases of ASD involve persistence of ostium secundum. • Incidence is higher in females. • ASD accounts for 8% to 10% of congenital heart abnormalities. [encyclopedia.lubopitko-bg.com]
Epidemiology United States data Sinus venosus atrial septal defects represent approximately 1% of congenital cardiac lesions. [emedicine.medscape.com]
Epidemiology [ 1 ] ASDs are the third most common congenital heart disease and occur as an isolated anomaly in 5% to 10% of all congenital heart defects. [patient.info]
Pathophysiology
Pathophysiology 6. Clinical features 7. Investigations 8. Risk Factors 9. Management 3. Introduction Septal defects are more common eg of non cyanotic heart disease. Most common congenital heart disease in adults. [slideshare.net]
Etiology and Pathophysiology Flow across ASD usually left-to-right shunt because of higher left-sided pressures: Minimal right-to-left shunting in early ventricular systole, especially during inspiration Increased right-sided pressure/pulmonary hypertension [unboundmedicine.com]
Pathophysiology Atrial septal defects allow blood to shunt from the left atrium to the right atrium. Shunting is minimal during infancy, but typically increases with age as the right ventricle becomes more compliant. [vhlab.umn.edu]
Pathophysiology In patients with acyanotic atrial septal defect (ASD), the shunt follows the left atrium - right atrium - right ventricle route. [metealpaslan.com]
Pathophysiology. Volume overload of the right atrium and right ventricle due to a large left-to-right shunt is determined by the size of the interatrial communication. [encyclopedia.lubopitko-bg.com]
Prevention
Antibiotics are given to patients with atrial septal defects that are undergoing dental procedures to prevent infection of the heart. Antibiotics are medications that prevent certain types of bacterial infections. [medfriendly.com]
What about preventing endocarditis? Most children with an ASD are not at increased risk for developing endocarditis. [heart.org]
A health care provider may recommend the atrial septal defect be closed for a child with a large atrial septal defect, even if there are few symptoms, to prevent problems later in life. [cdc.gov]
Several gauze pads and a large piece of medical tape will be placed on the site where the catheter was inserted to prevent bleeding. [childrensnational.org]