Atrial septal defects (ASDs) are benign Benign Fibroadenoma acyanotic Acyanotic Tetralogy of Fallot congenital Congenital Chorioretinitis heart defects characterized by an opening in the interatrial septum that causes blood to flow Flow Blood flows through the heart, arteries, capillaries, and veins in a closed, continuous circuit. Flow is the movement of volume per unit of time. Flow is affected by the pressure gradient and the resistance fluid encounters between 2 points. Vascular resistance is the opposition to flow, which is caused primarily by blood friction against vessel walls. Vascular Resistance, Flow, and Mean Arterial Pressure from the left atrium (LA) to the right atrium (RA) (left-to-right shunt). Atrial septal defects account for approximately 15% of all cases of congenital Congenital Chorioretinitis heart disease (CHD), making ASDs the 2nd most common CHD. There are 4 types of ASD ASD Autism spectrum disorder (ASD) is a neurodevelopmental disorder marked by poor social skills, restricted interests/social interactions, and repetitive/stereotyped behaviors. The condition is termed a "spectrum" because of the wide variability in the severity of symptoms exhibited. Autism Spectrum Disorder based on the location of the defect along the atrial septum, but the most common is the ostium secundum defect. Atrial septal defects are usually detected during a routine physical examination and confirmed by an echocardiogram Echocardiogram Transposition of the Great Vessels. In infancy, most small ASDs close spontaneously by 2 years of age. Only patients Patients Individuals participating in the health care system for the purpose of receiving therapeutic, diagnostic, or preventive procedures. Clinician–Patient Relationship that are symptomatic require surgical closure. In general, most patients Patients Individuals participating in the health care system for the purpose of receiving therapeutic, diagnostic, or preventive procedures. Clinician–Patient Relationship with ASD ASD Autism spectrum disorder (ASD) is a neurodevelopmental disorder marked by poor social skills, restricted interests/social interactions, and repetitive/stereotyped behaviors. The condition is termed a "spectrum" because of the wide variability in the severity of symptoms exhibited. Autism Spectrum Disorder can expect a good overall outcome.
Last updated: 14 Mar, 2022
Atrial septal defect ( ASD ASD Autism spectrum disorder (ASD) is a neurodevelopmental disorder marked by poor social skills, restricted interests/social interactions, and repetitive/stereotyped behaviors. The condition is termed a “spectrum” because of the wide variability in the severity of symptoms exhibited. Autism Spectrum Disorder) is a communication Communication The exchange or transmission of ideas, attitudes, or beliefs between individuals or groups. Decision-making Capacity and Legal Competence between the right atrium (RA) and the left atrium (LA) secondary to a defect in the development of the atrial septum during embryogenesis. Atrial septal defect is usually a benign Benign Fibroadenoma condition and is classified as an acyanotic Acyanotic Tetralogy of Fallot congenital Congenital Chorioretinitis heart disease (CHD).
Atrial septal defects are classified based on the anatomic location of the defect:
Pathophysiology of atrial septal defect
The image depicts the change in blood
flow
Flow
Blood flows through the heart, arteries, capillaries, and veins in a closed, continuous circuit. Flow is the movement of volume per unit of time. Flow is affected by the pressure gradient and the resistance fluid encounters between 2 points. Vascular resistance is the opposition to flow, which is caused primarily by blood friction against vessel walls.
Vascular Resistance, Flow, and Mean Arterial Pressure in the presence of an atrial septal defect (
ASD
ASD
Autism spectrum disorder (ASD) is a neurodevelopmental disorder marked by poor social skills, restricted interests/social interactions, and repetitive/stereotyped behaviors. The condition is termed a “spectrum” because of the wide variability in the severity of symptoms exhibited.
Autism Spectrum Disorder). Note the decreased blood
flow
Flow
Blood flows through the heart, arteries, capillaries, and veins in a closed, continuous circuit. Flow is the movement of volume per unit of time. Flow is affected by the pressure gradient and the resistance fluid encounters between 2 points. Vascular resistance is the opposition to flow, which is caused primarily by blood friction against vessel walls.
Vascular Resistance, Flow, and Mean Arterial Pressure to the left ventricle (7) and the increased blood
flow
Flow
Blood flows through the heart, arteries, capillaries, and veins in a closed, continuous circuit. Flow is the movement of volume per unit of time. Flow is affected by the pressure gradient and the resistance fluid encounters between 2 points. Vascular resistance is the opposition to flow, which is caused primarily by blood friction against vessel walls.
Vascular Resistance, Flow, and Mean Arterial Pressure into the pulmonary
circulation
Circulation
The movement of the blood as it is pumped through the cardiovascular system.
ABCDE Assessment (11).
The signs and symptoms depend on the size of the defect and the severity of the shunt:
Upon physical examination, the following can be seen/detected:
Phonocardiograms of abnormal
heart sounds
Heart sounds
Heart sounds are brief, transient sounds produced by valve opening and closure and by movement of blood in the heart. They are divided into systolic and diastolic sounds. In most cases, only the first (S1) and second (S2) heart sounds are heard. These are high-frequency sounds and arise from aortic and pulmonary valve closure (S1), as well as mitral and tricuspid valve closure (S2).
Heart Sounds caused by the following
cardiac
Cardiac
Total Anomalous Pulmonary Venous Return (TAPVR) defects:
aortic
regurgitation
Regurgitation
Gastroesophageal Reflux Disease (GERD),
mitral valve prolapse
Mitral valve prolapse
Abnormal protrusion or billowing of one or both of the leaflets of mitral valve into the left atrium during systole. This allows the backflow of blood into left atrium leading to mitral valve insufficiency, systolic murmurs, or cardiac arrhythmia.
Mitral Valve Prolapse, mitral
stenosis
Stenosis
Hypoplastic Left Heart Syndrome (HLHS) (
MS
MS
Multiple sclerosis (MS) is a chronic inflammatory autoimmune disease that leads to demyelination of the nerves in the CNS. Young women are more predominantly affected by this most common demyelinating condition.
Multiple Sclerosis), aortic
stenosis
Stenosis
Hypoplastic Left Heart Syndrome (HLHS) (AS), tricuspid
regurgitation
Regurgitation
Gastroesophageal Reflux Disease (GERD), hypertrophic obstructive
cardiomyopathy
Cardiomyopathy
Cardiomyopathy refers to a group of myocardial diseases associated with structural changes of the heart muscles (myocardium) and impaired systolic and/or diastolic function in the absence of other heart disorders (coronary artery disease, hypertension, valvular disease, and congenital heart disease).
Cardiomyopathy: Overview and Types (HOCM), atrial septal defect (
ASD
ASD
Autism spectrum disorder (ASD) is a neurodevelopmental disorder marked by poor social skills, restricted interests/social interactions, and repetitive/stereotyped behaviors. The condition is termed a “spectrum” because of the wide variability in the severity of symptoms exhibited.
Autism Spectrum Disorder),
ventricular septal defect
Ventricular Septal Defect
Tetralogy of Fallot (VSD), and
patent ductus arteriosus
Patent ductus arteriosus
The ductus arteriosus (DA) allows blood to bypass pulmonary circulation. After birth, the DA remains open for up to 72 hours and then constricts and involutes, becoming the ligamentum arteriosum. Failure of this process to occur results in patent ductus arteriosus (PDA), a condition that causes up to 10% of congenital heart defects.
Patent Ductus Arteriosus (PDA) (
PDA
PDA
The ductus arteriosus (DA) allows blood to bypass pulmonary circulation. After birth, the DA remains open for up to 72 hours and then constricts and involutes, becoming the ligamentum arteriosum. Failure of this process to occur results in patent ductus arteriosus (PDA), a condition that causes up to 10% of congenital heart defects.
Patent Ductus Arteriosus (PDA))
Audio:
This audio file is an example of an ejection murmur and split S2 S2 Heart Sounds heard over the 2nd left intercostal space in an individual with an atrial septal defect. The crescendo-decrescendo murmur is heard between S1 S1 Heart Sounds and S2 S2 Heart Sounds, the latter of which is widely split.
Transthoracic
echocardiography
Echocardiography
Ultrasonic recording of the size, motion, and composition of the heart and surrounding tissues. The standard approach is transthoracic.
Tricuspid Valve Atresia (TVA) of
ASD
ASD
Autism spectrum disorder (ASD) is a neurodevelopmental disorder marked by poor social skills, restricted interests/social interactions, and repetitive/stereotyped behaviors. The condition is termed a “spectrum” because of the wide variability in the severity of symptoms exhibited.
Autism Spectrum Disorder, in apical 4-chamber view:
AD
AD
The term advance directive (AD) refers to treatment preferences and/or the designation of a surrogate decision-maker in the event that a person becomes unable to make medical decisions on their own behalf. Advance directives represent the ethical principle of autonomy and may take the form of a living will, health care proxy, durable power of attorney for health care, and/or a physician’s order for life-sustaining treatment.
Advance Directives: right atrium
AS: left atrium
VD: right ventricle
A0:
aorta
Aorta
The main trunk of the systemic arteries.
Mediastinum and Great Vessels: Anatomy
DSA: atrial septal defect
A case of sinus venosus
ASD
ASD
Autism spectrum disorder (ASD) is a neurodevelopmental disorder marked by poor social skills, restricted interests/social interactions, and repetitive/stereotyped behaviors. The condition is termed a “spectrum” because of the wide variability in the severity of symptoms exhibited.
Autism Spectrum Disorder complicated by Eisenmenger’s syndrome:
A chest radiograph shows a markedly enlarged
pulmonary trunk
Pulmonary Trunk
Truncus Arteriosus (red arrow), enlarged central pulmonary
arteries
Arteries
Arteries are tubular collections of cells that transport oxygenated blood and nutrients from the heart to the tissues of the body. The blood passes through the arteries in order of decreasing luminal diameter, starting in the largest artery (the aorta) and ending in the small arterioles. Arteries are classified into 3 types: large elastic arteries, medium muscular arteries, and small arteries and arterioles.
Arteries: Histology, and enlargement of the
cardiac
Cardiac
Total Anomalous Pulmonary Venous Return (TAPVR) silhouette.
The following conditions are associated with ASDs and can cause or modify the clinical features of ASDs: