Atrial Septal Defect Flashcards
What is an atrial septal defect?
A defect (a hole) in the septum (the wall) between the two atria
How does the blood move with an atrial septal defect?
From the left atrium to the right atrium because the pressure in the left atrium is greater
Why does blood move form the left atrium to the right atrium?
Because the pressure in the left atrium is greater
What does the increased flow to the right side of the heart lead to?
Right sided overload and right heart strain.
What can right sided overload result in?
Right heart failure and pulmonary hypertension.
What can pulmonary hypertension eventually lead to?
Eisenmenger syndrome.
What are the 2 types of atrial septal defect?
Ostium secondum
Ostium primum
What is the more common type of atrial septal defect?
Ostium secondum
What is Ostium secondum?
The septum secondum fails to fully close, leaving a hole in the wall.
What type of murmur does an atrial septal defect present with?
Ejection systolic murmur
Fixed splitting of S2
What can occur with an atrial septal defect resulting in a stroke?
Embolism may pass from venous system to left side of heart causing a stroke
How are atrial septal defects normally picked up?
Antenatal scans
New born examinations
How do atrial septal defects normally present in childhood?
Asymptomatically
How can an atrial septal defect present in childhood?
- Shortness of breath
- Difficulty feeding
- Poor weight gain
- Lower respiratory tract infections
What is the management of a small and asymptomatic defect?
Watching and waiting
How can an atrial septal defect be corrected?
Surgically using a transvenous catheter closure (via the femoral vein) or open heart surgery.
Which vein is used for a transvenous catheter closure?
Femoral vein
Which medication might you give an adult with an ASD?
Anticoagulants- Aspirin, Warfarin and NOACs
What are anticoagulants used for?
To reduce the risk of clots and stroke in adults
What complication of ASD might present in adulthood?
Stroke due to VTE
What is associated with Ostium secundum?
Holt-Oram syndrome (tri-phalangeal thumbs)
What might you see on an ECG in someone with Ostium Secundum?
ECG: RBBB with RAD
Right Bundle Branch Block with Right Axial Deviation
