Septal defects are more
common eg of non cyanotic heart
Most common congenital heart
disease in adults.
Basically it is opening in
interatrial septum due to
deficiency in septal tissue.
Holes of variable size in the interatrial septum,
atrioventricular ,or Interventricular septum enable
blood to be shunted between the left and right sides
Of the heart
Sinous venousus type
Ostium Secumdum - It occurs in central portion of
Ostium Primum -It occurs immediately above AV valves
and often associated with CLEFT in anterior valve leaflet .
More common In females.
Sinous Venosus Type-It occurs near orifice of superior
vena cava And often associated with anomalous pulmonary
venous drainage .
Male : Female = 1:2
Most commonly seen in children
In ASD the right atrium not only receives blood from
SVC and IVC but also from left atrium and is enlarged in size
Pulmonary vascular resistance which is low or normal at
childhood goes as high up as the patient reaches 3rd or 4th
decade giving rise to pulmonary hypertension .
As hypertension increases the initial left to right
reverses to right to left shunt - EISENMENGER
The patient may develop right heart failure or atrial
Visible and palpable Right Ventricle
1st heart sound and split with Tricuspid component
Wide fixed splitting of S2
Systolic thrill if loud murmur
• Pulmonary ejection systolic murmur – Increased
• Tricuspid murmur – is heard over left sternal edge
louder on inspiration
• Graham-Steell murmur – of pulmonary regurgitation if
• Late systolic murmur – occurs in Ostium
• Murmur of mitral incompetence – in Primum
Small peripheral pulse – due to reduced Left
Prominent pulmonary artery can be seen and traced
upto diaphragm , end on view of pulmonary artery is seen
ASD also reveals - mild to moderate cardiomegaly
- prominent right atrium and right ventricle
Right axis deviation in 85% of cases
Left axis deviation and prolonged PR interval seen in
Right Atrial enlargement
Mild right ventricular hypertrophy
Inverted P waves in Sinous Venosus type
Right Bundle Branch Block is seen which is partial
Complete heart block may be
revealed in ostium primum type
Large ASD may have prolonged PR
Reveals enlarged right ventricles with
paradoxical septal motion
Prompt treatment of respiratory tract infections.
Antiarrhythmic medications for atrial fibrillation and
supraventricular tachycardia that includes qunidine ,
procainamide and flucaniamide.
Usual measures for hypertension , coronary disease
and heart failure.
Usually with a patch of pericardium or a
prosthetic material or Percutaneous tanscatheter
device is used for closure of the defect.