textbook- atrial septal defect Flashcards
what are the two main types of ASD?
- ostium secundum (75%) (fossa ovalis in atrial midseptum. Not the same as FO) and
- ostium primum (15%) (opposing endocardial cushions. Are associated with AV valve anomalies)
communication at atria allows ____ to ____shunting of blood
communication at atria allows left to right shunting of blood
Because the pulmonary vascular resistance is ____ and the right ventricle is easily ______ (compliant), there is considerable increase in _____ heart output.
Because the pulmonary vascular resistance is low and the right ventricle is easily distended (compliant), there is considerable increase in right heart output.
Above the age of 30 there may be an increase in _____ ______ _______§, which gives rise to pulmonary hypertension
Above the age of 30 there may be an increase in pulmonary vascular resistance, which gives rise to pulmonary hypertension
above the age of 30 ______ arrhythmias are common. Particularly ____
atrial
atrial Fib
what happens to you if you have ASD? 5
get dyspnoea and heart failure quite young.
May also have cyanosis. haemoptysis and chest pain
what are the signs of ASD?
- AF
- increased JVP
- wide, fixed split S2
- pulmonary ejection systolic murmur
- pulmonary or tricuspid regurgitation
why may you get pulmonary or tricuspid regurgitation ?
because of pulmonary hypertension
what are the complications of ASD?
eisenmenger’s complex
paradoxical emboli
what is eisenmenger’s complex?
reversal of the left to right shunt,
why does eisenmenger’s complex occur?
the initial L-R shunt leads to pulmonary hypertension so you then get shunt reversal
what does eisenmenger’s complex cause?
cyanosis (±heart failure and chest infections)
what investigations are done?
ECG
- CXR
- Echo
- Cardiac catheterisation
which investigation is diagnostic ?
echo
what may be seen on ECG for primum defect ?
RBBB with LAD and prolonged PR interval (primum defect)
