Atrial septal defects – Clinical manifestations, echo assessment, and intervention

Research output: Contribution to journalReview articlepeer-review

Abstract

Atrial septal defect (ASD) is a common congenital abnormality that occurs in the form of ostium secundum, ostium primum, sinus venosus, and rarely, coronary sinus defects. Pathophysiologic consequences of ASDs typically begin in adulthood, and include arrhythmia, paradoxical embolism, cerebral abscess, pulmonary hypertension, and right ventricular failure. Two-dimensional (2D) transthoracic echocardiography with Doppler is a central aspect of the evaluation. This noninvasive imaging modality often establishes the diagnosis and provides critical information guiding intervention. A comprehensive echocardiogram includes evaluation of anatomical ASD characteristics, flow direction, associated abnormalities (eg, anomalous pulmonary veins), right ventricular anatomy and function, pulmonary pressures, and the pulmonary/systemic flow ratio. The primary indication for ASD closure is right heart volume overload, whether symptoms are present or not. ASD closure may also be reasonable in other contexts, such as paradoxical embolism. ASD type and local clinical expertise guide choice of a percutaneous versus surgical approach to ASD closure.

Original languageEnglish (US)
Pages (from-to)93-98
Number of pages6
JournalClinical Medicine Insights: Cardiology
Volume8
DOIs
StatePublished - Mar 23 2015

Keywords

  • Atrial septal defect
  • Coronary sinus defect
  • Echoca
  • Ostium primum defect
  • Ostium secundum defect
  • Sinus venosus defect

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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