Peds

Ostium Primum

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Ostium Primum

  • Epidemiology
  • Pathophysiology
  1. One of three types of Atrial Septal Defect
  2. Congenital opening in septum near AV valves
  3. Defect occurs during Embryonic development
  4. Associated with cleft mitral valve leaflet
  • Symptoms
  • Signs
  1. Rounded chest
  2. Precordial bulge (rare)
  3. No Cyanosis or finger Clubbing
  4. Accentuated precordial Apical Thrust
  5. Accentuated P2 with fixed splitting on respirations
  6. Systolic thrill near sternal border
  7. Systolic murmur
    1. Harsh systolic murmur at left sternal border
    2. Apical systolic murmur transmitted to axilla
      1. Mitral Regurgitation
  8. Mid-Diastolic Murmur at apex
  1. Cardiomegaly
  • 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