Atrial Septal Defect

Aka: Atrial Septal Defect, ASD

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II. Types

  1. Ostium Primum
    1. Congenital opening in septum near AV valves
    2. Associated with cleft mitral valve leaflet
  2. Ostium Secundum
    1. Congenital defect at the fossa ovalis
  3. Sinus Venosus
    1. Defect posterior to fossa ovalis
    2. Associated with partial anomalous pulmonary return

III. Symptoms and Signs (See specific defect)

  1. Right Ventricular heave
  2. S2 Heart Sound with fixed wide split
  3. Systolic ejection murmur
    1. Grade II of VI
    2. Heard best at left upper sternal border
  4. Mid-Diastolic Murmur
    1. Flow rumble in the tricuspid valve region

IV. Diagnostics

  1. See Ostium Primum
  2. See Ostium Secundum

V. Course

  1. Spontaneous closure less common than VSD

VI. Management: Surgery Indications

  1. Large left to right shunt
  2. Congestive Heart Failure
  3. Pulmonary congestion

VII. References

  1. Saenz (1999) Am Fam Physician 59(7):1857-66 [PubMed]
  2. Cyran (1998) PREP review lecture, October, Phoenix
  3. Merenstein (1994) Pediatrics, Lange

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