Atrial Septal Defects

Question 1

What is an ASD

Answer 1

A defect in the septum between the two atria

Question 2

What happens in ASDs

Answer 2

Leads to shunts with blood moving between the two atria

Question 3

Consequences of ASDs

Answer 3

Pressure becomes higher in the LA so blood moves into the RA. This means that blood continues to flow through th pulmonary vessels and lungs to get oxygenated (no cyanosis).
However the pulmonary HTN and right HF can lead to eisenmenger syndrome

Question 4

Types of ASDs

Answer 4

Ostium scondum, patent foramen ovale. ostrium primun

Question 5

Complications of ASDs

Answer 5

Stroke in context of VTE, AF or atrial flutter, pulmonary HTN, right sided HF, eisenmenger syndrome

Question 6

Type of murmur in ASDs

Answer 6

Mid systolic, crescendo-decescendo murmur loudest at upper left sternal border. Fixed split second heart sound

Question 7

What does it mean if the heart sound is fixed split

Answer 7

The heart sound does not change with inspiration or expiration

Question 8

Presentation of ASD

Answer 8

Picked up on antenatal scans, or newborn exams. May be asymptomatic in childhood and present in adulthood with dysopnoea, HF and stroke. SOB, difficulty breathing, poor feeding, weight gain, lower RTI

Question 9

Management of ASDs

Answer 9

Watch and wait, surgical correction using transvenous catheter closure or open heart surgery. Anticoagulation drugs, kept under surviellance