Atrial Septal Defect Types :- Ostium secdum, Ostium Premium echo cardiography Of ASD View of ASD in ECHO

1. ATRIAL SEPTAL DEFECT
Made by:- Muskan Kapoor

2. INTRODUCTION
● It is a acyanotic heart disease with left to right shunt through the defect in
the interatrial septum.
● It is one of the commonest congenital defect.
● More in females than males (2:1)
● It is of two types
- Ostium secundum defect: this involves fossa ovalis. This is the
commonest type of ASD
- Ostium primum defect: is a defect in the atrial septum at the level of the
tricuspid and mitral valves.

3. FEATURES
● Good volume pulse
● A systolic murmur in 2nd intercostal space due to large flow of blood through
pulmonary valve.
● Wide and fixed splitting of second heart sound. Wide is due to delay in the
closure of pulmonary valve. Fixed because left and right atrial pressures are
equal throughout respiration.
● Chest X ray shows enlargement of heart. Pulmonary artery pulsations are
increased which can be seen on fluoroscopy.
● Echocardiography: shows right ventricle dilatation, hypertrophy, and
pulmonary artery dilatation.
● Colour doppler will measure the flow velocities which are increased.

4. ● Since a large volume of blood from the
left atrium is shunted to the right
atrium, then to the right ventricles and
pulmonary arteries , hence right
ventricle is overburdened, which
enlarges and produces pulsation under
the right border of sternum.
● The shunting of blood from the left
atrium to right atrium does not produce
murmur, this is exception, because
shunting is between two low pressured
chambers.
● In advanced cases pulmonary
hypertension may develop.

5. CLINICAL FEATURES
● It is asymptomatic in most of
the children and young adults.
● It is often detected at routine
clinical examination.
● Large shunt in children and
adults may present with
dyspnea, chest infections,
cardiac failure, arrhythmias,
endocarditis etc

6. ECHOCARDIOGRAPHY
● 2D echo:- position as well size
of defect
- Enlargement of RA, RV and
pulmonary arteries
- Associated anomalies such as
PS, MVP and anomalous
pulmonary venous return.

8. ● Color doppler:- Shunt
- Quantitative assessment of
pulmonary to systemic blood
flow ratio
- PWD : it reveals the characteristic
flow pattern with the maximum
L-R shunt occurring in diastole.

9. ● TEE:- used to detect sensuous
ASD.
- It is used to measure the rim of
the defect to the SVC & IVC
used in especially sinus
venosus ASD.
- RV pressure using TV
regurgitant jet velocity
- Help to assess shunt