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]

[…] 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]

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]

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]

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]

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]