Presentation
Over a 4-year period, 21 patients with TAPVC without extracardiac obstruction presented from 1 day to 10 months of age (mean 2.6 months). Of 21 patients, 17 (81%) presented after 1 month of age with moderate to severe congestive heart failure. [ncbi.nlm.nih.gov]
We present a case of a 25 year-old female patient who was asymptomatic until the age 22 when she started presenting exertion dyspnea and lower limbs edema, during her third pregnancy. [revistas.usp.br]
Hematological
-
Hemophilia A
Floating thrombus on an ASD occluder device in a patient with hemophilia A. Thorac Cardiovasc Surg 2001;49:312- 3. 23. Pinto FF, Sousa L, Fragata J. Late cardiac tamponade after transcatheter closure of atrial septal defect with Cardioseal device. [heartviews.org]
Entire Body System
-
Fatigue
Signs and symptoms of severe defects in newborns include Rapid breathing Cyanosis - a bluish tint to the skin, lips, and fingernails Fatigue Poor blood circulation Many congenital heart defects cause few or no signs and symptoms. [icdlist.com]
Larger shunts may cause slow weight gain in early childhood and exercise intolerance, dyspnea during exertion, fatigue, and/or palpitations in older patients. [merckmanuals.com]
Clinical manifestations in childhood include: rapid breathing, shortness of breath, fatigue, sweating, palpitations, frequent respiratory infections, and poor growth. Other symptoms often manifest by the age of 30 to 40 years. [orpha.net]
-
Falling
When right atrial blood escapes through the interatrial communication, pulmonary flow tends to fall reciprocally. [clinicalgate.com]
PFO tunnel in a 65 year old man presenting with cyanosis (sats 70-80%) after a fall. Treated initially with 10L/min mask oxygn and subsequently requiring ventillation and tracheostomy. Past history of pulmonary valvotomy in 1959. [3dechocardiography.com]
That is way 3D-RT ICE falls short of expectations and appears to gain less of an impact on the guidance of closure procedures than 3D-RT TEE. The benefits of imaging are related to the distance between transducer and target region ( Figure 6 ). [academic.oup.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]
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]
TTE is usually the first step in the workup for SVASD; however, only 12% of superior SVASDs can be visualized [3]. [hindawi.com]
[…] pulmonary 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]
Cardiac Catheterization
-
Pulmonary Arterial Pressure Increased
Indications for placement of an adjustable ASD included increased pulmonary artery pressures, increased pulmonary vascular resistance, reactive airway disease, previously increased or unknown pulmonary vascular resistance, small pulmonary arteries, and [ncbi.nlm.nih.gov]
Blocks
-
Incomplete Right Bundle Branch Block
ECG incomplete right bundle branch block (RBBB morphology with QRS duration between 110-120 ms) increased specificity with crochetage sign in the inferior (II, III, aVF) leads right precordial (V1-3) "defective T waves" describes biphasic morphology, [radiopaedia.org]
Investigations ECG ECG may be normal in infants and children with small shunts Typical findings include a tall P wave indicating right atrial enlargement, incomplete right bundle branch block pattern (rsR' in V1), and right axis deviation. [patient.info]
right bundle branch block ヘミ(片)ブロック hemiblock 【同】束枝ブロック fascicular block 左脚前枝ブロック left anterior fascicular block, left anterior hemiblock 左脚後枝ブロック left posterior fascicular block, left posterior hemiblock 一枝ブロック、一束ブロック monofascicular block 二枝ブロック、二束ブロック [jams.med.or.jp]
A common finding in the ECG is the presence of incomplete right bundle branch block, which is so characteristic that if it is absent, the diagnosis of ASD should be reconsidered. [en.wikipedia.org]
Treatment
Home Medical Procedures Cardiac Heart Conditions and Problems Atrial Septal Defect (ASD) treatment Atrial Septal Defect (ASD) treatment Atrial septal defect (ASD) is a form of congenital heart defect that enables blood flow between the left atrium (with [healthbase.com]
Their multidisciplinary approach encompasses every aspect of the relevant basic scientific principles, medical and pharmacologic treatments, and surgical techniques and equipment. [books.google.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]
The material is in no way intended to replace professional medical care by a qualified specialist and should not be used as a basis for diagnosis or treatment. [orpha.net]
[…] with that of medical treatment in an age-matched control group with unrepaired defects. [nejm.org]
Prognosis
Prognosis Small-to-moderate defects may be asymptomatic and life expectancy is not reduced. In some children, small openings may close spontaneously (occurring in up to four-fifths of cases with small openings in the first 18 months of life). [orpha.net]
When these differences are taken together, they do not indicate a more favorable prognosis for one group over the other. [nejm.org]
Prognosis[18] Isolated atrial septal defects repaired in childhood have excellent prognosis with survival similar to that of the general population. [patient.info]
[…] vessels visible to the periphery of the film eventual signs of pulmonary arterial hypertension chamber enlargement right atrium right ventricle note: left atrium is normal in size unlike VSD or PDA note: aortic arch is small to normal Treatment and prognosis [radiopaedia.org]
Long term followup of 34 adults with isolated left ventricular noncompaction (a distinct cardiomyopathy with poor prognosis). J Am Coll Cardiol. 2000;36:493-500. 10. Nugent AW, Daubeney PE, Chondros P, et al. [degruyter.com]
Etiology
OBJECTIVES: We describe the structure of, and suggest an etiology for, the interatrial communication which can occur through the mouth of the coronary sinus. [ncbi.nlm.nih.gov]
Etiology Several susceptibility genes have been identified. Diagnostic methods The defect is most often suspected during a physical examination. Cardiac auscultation reveals a systolic outflow murmur. [orpha.net]
The embryological etiology of this defect is incomplete absorption of the sinus venosus into the main chamber of the right atrium. Traditional diagnostic tests included TTE, TEE and cardiac catheterization. [scmr.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]
Medicine, London (a3) 3 St George's Hospital Medical School, Anatomy and Developmental Biology, London (a4) 4 Cardiac Unit, Institute of Child Health, University College, London, UK Abstract Objectives : We describe the structure of, and suggest an etiology [cambridge.org]
Epidemiology
Summary Epidemiology Overall, openings between the atrial chambers account for about 6 to 8% of all congenitally malformed hearts. As a group, such defects are detected in 1:1500 live births, with a female-to-male ratio of 2-4:1. [orpha.net]
The epidemiology of childhood cardiomyopathy in Australia. N Engl J Med. 2003;348:1639-1646. 11. Kohli SK, Pantazis AA, Shah JS, et al. [degruyter.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]
[…] transposition of the great arteries: prediction of neonatal desaturation. 61 Vaujois L...Raboisson MJ 28376948 2017 44 Surgical Strategy Toward Biventricular Repair for Severe Ebstein Anomaly in Neonates and Infancy. 61 Huang SC...Chen YS 28434546 2017 45 Epidemiology [malacards.org]
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
Based on pathophysiological insights regarding (1) the long-term impact of an obstructive pulmonary outflow tract in neonates with congenitally corrected transposition of the great arteries, (2) the importance of a restrictive versus a non-restrictive [ncbi.nlm.nih.gov]
Grasp the full scope of the pathophysiology of CHD with well-organized, expert guidance. Quickly search the contents online, download images in JPG or PPT format, and view 70 echocardiogram videos at expertconsult.com. [books.google.com]
Each characteristic determines, in part, the pathophysiology and need for therapy. Definition VSDs are described by the anatomic location of the defect as seen from the right ventricle. [pedsinreview.aappublications.org]
Pathophysiology Image : “Atrial Septal Defect.”. By Blausen.com staff (2014). “Medical gallery of Blausen Medical 2014”. WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010. ISSN 2002-4436. [lecturio.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
What about preventing endocarditis? Most children with an ASD are not at increased risk for developing endocarditis. [heart.org]
Prevention In most cases, atrial septal defects can't be prevented. If you're planning to become pregnant, schedule a visit with your health care provider. This visit should include: Getting tested for immunity to rubella. [mayoclinic.org]
[…] the defect, which offers no proven benefit in prevention of further events. [circ.ahajournals.org]
An optimal secondary stroke prevention strategy in patients with ASD and/or PFO is not clearly defined [9]. [cardiovascularultrasound.biomedcentral.com]
It also may serve as a secondary prevention of cryptogenic stroke and may prove more effective than any previous therapy for migraine headache. [psychiatrictimes.com]