12.29.2011
ATRIAL SEPTAL DEFECT
Posted on 12:54 AM by know about heart
It is one of the most common congenital heart defects .It is most common in female.
Types:
1. Ostium secundum defects: It is the most common ASD(Atrial septal defect). It involves the fossa Ovalis that in utero was the foramen ovale.
2. Ostium primum defects: Result from a defect in the artrioventricular septum and are associated with a’cleft mitral valve’ (split anterior leaflets)
3. Sinus venosus type
Clinical feature:
Symptoms
§ Usually asymptoms until third or fourth decades
§ Exertional dyspnoea
§ Fatigue
§ Palpitation
§ If pulmonary hypertension
§ Cyanosis,clubbing, and features of heart failure.
Signs:
§Cardiac failure in neonatal period
§Repeated respiratory tract infection in childhood.
§Apex 0f the heart shifted horizontally to left
§Right ventricular heave present
§ Prominent Right ventricular impulse-left parasternal heave.
§ Wide fixed splitting of second heart sound
§ systolic flow murmur in pulmonary area
§ Systolic flow murmur in pulmonary area
§ Diastolic flow murmur in tricuspid area.
Investigation:
1. ECG
§ Incomplete RBBB
§ Left axis deviation in osteum primum defect
2. Chest x-ray P/A views:
§ Increased pulmonary vascular marking
§ Prominence of right Atrium, right ventricle and main pulmonary area.
3. Echocardiography:
§ RA, RV and pulmonary artery enlargement
§ Doppler echo demonstrates abnormal turbulent flow through it.
4. Fluoroscopy :Hilar dance is seen
5. Cardiac catheterization:
§Measurement of pulmonary flow
§Measurement of pulmonary pressure
Treatment
§ Surgical closure on transcatheter device closure
§ Closure is contraindicated with significant pulmonary hypertension.
§ Medical management includes antiarrhythmic therapy for associated atrial fibrillation or
§ Supraventricular tachycardia and treatment of heart failure it developed.
§ Restriction of activity
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