Atrial Septal Defect

- Symptoms of an Atrial Septal Defect include shortness of breath on exertion and palpitations.

- Physical examination of patients may present systolic ejection flow murmur in the left second intercostal space; a widely split, fixed S2 (i.e., it doesn't change with breathing).

- Lab results for patients with this condition show atrial fibrillation on the ECG

- imaging shows   increased pulmonary vascularity and paradoxical septal movement.

- the most common form is in the midseptum, in the area of the foramen ovale (ostium secondum); those in the lower septum (ostium primum) are  associated with AV valve anomalies (most common in Down's Syndrome); those in teh upper septum (sinus venosus) are associated with anomalous pulmonary venous return.
-  surgical or interventional angiographic closure of defect with prosthetic patch.  Operative repair is recommended in all symptomatic patients with ostium secundum defects regardless of size of defect.
- Oxygenated blood from the left atrium passes into the right atrium, increasing right ventricular output and pulmonary flow.
-  Acyanotic (left-to-right shunt); the most common congenital heart disease in adults.
- Sequelae of untreated atrial septal defects include paradoxic emboli, infective endocarditis, and congestive heart failure.








Reference:

1. Blackwell's Underground Clinical Vignettes: Anatomy, 3rd Ed.  Bhushan, Vikas, M.D., et al.  Blackwell Science Publishing. 2002.