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]

In patients with persistent elevation of pulmonary vascular resistance, especially those with Down syndrome, there may be no murmur, but a loud single S2 will be present. [merckmanuals.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]

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]

• Congestive Heart Failure

  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]

  Congestive heart failure is also related to the extra workload caused by recirculation of blood to the right side of the heart. [mottchildren.org]

  Congestive heart failure is an imbalance in the pumping action of the heart that causes inadequate blood circulation. Congestive heart failure can lead to death. [medfriendly.com]

  Most infants are asymptomatic but may develop congestive heart failure or elicit growth failure if the left-to-right shunt is significant. [vhlab.umn.edu]

• Dentist

  Children usually need to take antibiotics before visits to the dentist and before certain surgeries (such as on the respiratory tract) during the 6-month period after surgical repair. [merckmanuals.com]

  As your child gets older, make sure he or she brushes every day and sees a dentist regularly. Talk with your child's doctor and dentist about how to keep your child's mouth and teeth healthy. Special Considerations for Children and Teens Activity. [pediatricct.surgery.ucsf.edu]

• Weakness

  Most patients are asymptomatic but as cardiac failure develops they may present with shortness of breath, palpitations and weakness 7. [radiopaedia.org]

  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 weakness [healthengine.com.au]

  In atrial septal defects, the heart can become large, the heart muscle can become weak, and increased pressure in the pulmonary arteries can occur. The pulmonary arteries are blood vessels that carry blood from the heart to the lungs. [medfriendly.com]

• Underweight

  Few cases have been reported in adulthood because these patients frequently come to medical attention at an earlier age when symptoms such as dyspnea, fatigue, cyanosis, and tendency to underweight occur. [jcecho.org]

• Fever

  […] the doctor if your child has any of these symptoms: a bluish color around the mouth or on the lips and tongue poor appetite or difficulty feeding failure to gain weight or weight loss listlessness or decreased activity level a lasting or unexplained fever [kidshealth.org]

  Prevention of infective endocarditis: guidelines from the American Heart Association: a guideline from the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee, Council on Cardiovascular Disease in the Young, and the [uspharmacist.com]

• Systolic Murmur

  A mid-diastolic murmur may be present at the lower left sternal border when the atrial shunt is large. A cleft in the left AV valve results in a blowing apical systolic murmur of mitral regurgitation. [merckmanuals.com]

  Murmurs • Pulmonary ejection systolic murmur – Increased pulmonary flow • Tricuspid murmur – is heard over left sternal edge louder on inspiration • Graham-Steell murmur – of pulmonary regurgitation if pulmonary hypertension 13. • Late systolic murmur [slideshare.net]

  This valvular deformity resulted in a high pitched blowing systolic murmur, audible over the apical and lower left sternal areas, and left axis deviation and indications of left ventricular hypertrophy, determined by electrocardiography. [circ.ahajournals.org]

  Chest auscultation classically reveals an ejection systolic murmur heard at the left upper sternal border, attributed to increased flow across the pulmonary valve rather than blood shunting across the defect itself 7. [radiopaedia.org]

• Murmur of Mitral Insufficiency

  Additionally, because of the presence of a cleft mitral valve, there may be a murmur of mitral insufficiency. Sinus venosus ASD, which is typically associated with partial anomalous pulmonary venous connection, makes up approximately 5% of ASDs. [clinicaladvisor.com]

• Suggestibility

  In patients with large ASD, presence of tall R or R' in lead C1 suggests development of pulmonary hypertension. Size of defect determines the shunt flow which in turn results in most of the ECG abnormalities. [metealpaslan.com]

  Echocardiography Diagnosis is suggested by a doctor's findings during an examination of the infant. ECG may give an important clue to help make this diagnosis. Chest x-ray may be done to look at the size of the heart and the blood flow to the lungs. [merckmanuals.com]

  correlates with size of ASD and implies a greater degree of shunting 11 left axis deviation characteristic of ostium primum defects and anatomical distortion of the left bundle branch fascicles associated first degree AV block right axis deviation suggests [radiopaedia.org]

  Diagnosis Diagnosis is suggested by cardiac examination, chest x-rays, and ECG and confirmed by 2-dimensional echocardiography with color flow and Doppler studies. [babiesonline.co.za]

• Confusion

  The most confusing factor in the analysis of the data was the difference in age between groups 1 and 2. [revespcardiol.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]

[…] 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]

• Incomplete Right Bundle Branch Block

  Figure 1 The electrocardiogram of a 42-year-old woman with the ostium secundum type of atrial septal defect shows normal sinus rhythm with incomplete right bundle-branch block (RBBB), indicated by the rSR' pattern in leads V 1 and V 2 and the terminal [nejm.org]

  The 12-lead ECG will show an incomplete right bundle branch block and left axis deviation (in contrast to the secundum ASD which has a right axis deviation). [healio.com]

  When a person is suspected of having an ASD based on the findings of an incomplete right bundle branch block with a rSr' or rSR', the frontal plane QRS should be examined. [en.wikipedia.org]

  When you suspect a patient has an ASD based on the findings of an incomplete Right Bundle Branch Block with a rSr' or rSR' the next thing you should do is examine the frontal plane QRS. [ipfs.io]

  Auscultation of the heart sounds: a systolic ejection murmur, respiratory variations in the splitting of the second heart sound; in the ECG: presence of incomplete right bundle branch block with atrial flutter. [panafrican-med-journal.com]

• Ventricular Hypertrophy

  hypertrophy (RVH), indicated by the tall R waves in leads V 1 and V 2. [nejm.org]

  If a significant shunt is present, ECG may show right axis deviation, right ventricular hypertrophy, or right ventricular conduction delay (an rSR ′ pattern in V1with a tall R ′ ). [merckmanuals.com]

  With a significant shunt, ECG may show right axis deviation, right ventricular hypertrophy, or right bundle branch block (with rSR′ pattern in V1). [babiesonline.co.za]

  This valvular deformity resulted in a high pitched blowing systolic murmur, audible over the apical and lower left sternal areas, and left axis deviation and indications of left ventricular hypertrophy, determined by electrocardiography. [circ.ahajournals.org]

  In the ECG above, you can see an example of the rSR' pattern in V1 with a R' greater than S with T wave inversion which is commonly seen in volume overload right ventricular hypertrophy. [en.wikipedia.org]

• Abnormal ECG

  They may be noted on routine testing to have an abnormal chest X-ray or an abnormal ECG and may have atrial fibrillation. [en.wikipedia.org]

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]

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]

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]

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]

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]

Surgery, if necessary, is performed at a young age with an excellent prognosis. [heartlifeinsurance.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]

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]

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 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]

[…] perfused beating heart (atrial septal defect size 2 cm - 4.5 cm) [4] International Classification of Diseases The International Classification of Diseases (ICD) World Health Organization's classification used worldwide as the standard diagnostic tool for epidemiology [embryology.med.unsw.edu.au]

Epidemiology United States data Sinus venosus atrial septal defects represent approximately 1% of congenital cardiac lesions. [emedicine.medscape.com]

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]

What about preventing endocarditis? Most children with an ASD are not at increased risk for developing endocarditis. [heart.org]

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]

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]

Even if infants are growing well and do not have symptoms, surgical repair is usually done before the infant is 6 months old to prevent development of complications. [merckmanuals.com]