Cardiology - Atrial Septal Defect Flashcards
1
Q
Definition
A
Defect in the septum between the 2 atria causing a left to right shunt due to the higher pressure in the left atria
2
Q
Aetiology
A
Maternal smoking in 1st trimester
Family history of CHD
Maternal diabetes
Maternal rubella
3
Q
Types of ASD
A
- Ostium secondum = septum secondum fails to fully close, leaving a hole in the wall.
- Patent foramen ovale = foramen ovale fails to close (not strictly classified as ASD).
- Ostium primum = septum primum fails to fully close, leaving a hole in the wall. This tends to lead to atrioventricular valve defects making it an atrioventricular septal defect.
4
Q
Symptoms
A
SIGNS
- Mid-systolic, crescendo-decrescendo murmur loudest at the upper left sternal border
- Wide fixed split S2 sound which doesn’t change with insp/exp
- Tachypnoea
SYMPTOMS
- SOB
- Difficulty feeding
- Poor weight gain
- Lower respiratory tract infections
5
Q
Investigations
A
ECG
Echo
6
Q
Treatment
A
- If small can be managed conservatively and will close within 12 months of birth
- Surgical closure, usually if ASD > 1cm
= transvenous catheter closure (via the femoral vein
= open heart surgery - Anticoagulants e.g. aspirin, warfarin, NOACs used to reduce risk of clots and stroke in adults
7
Q
Complications
A
Stroke from DVT
Atrial fibrillation
Pulmonary HTN
Eisenmengers syndrome