Asd investigations and management
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This document discusses the investigation and management of atrial septal defects (ASD). Key points include: ECG, echocardiography, chest x-ray and cardiac catheterization are used to diagnose ASD. Echocardiography can image the interatrial septum from various views and detect flow between the atria with color Doppler. ASDs are often asymptomatic but can cause complications like pulmonary hypertension. Small and moderate ASDs may be treated with percutaneous device closure while larger defects or those with complications may require surgical repair via patch. The take home message is that small ASDs can often be asymptomatic for life while larger defects cause issues in adulthood, and definitive treatment is via device
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This document discusses congenital heart disease, specifically atrial septal defects and ventricular septal defects. It defines what each condition is, describes the causes and types, and outlines the pathophysiology, clinical features, diagnosis, and management. Atrial septal defects are abnormalities where blood passes from the left atrium to the right atrium, while ventricular septal defects allow blood to pass from the left ventricle to the right ventricle through a hole in the ventricular septum. Treatment may involve medication, surgery to repair the defects, or in some small cases, simply monitoring for spontaneous closure of the hole.
Seminar congenital cardiac disorders (pda,TA and AP Window)
Patent ductus arteriosus is a congenital heart disorder where the ductus arteriosus, a blood vessel connecting the pulmonary artery and aorta, fails to close after birth as it normally would. This allows blood to shunt from the aorta to the pulmonary artery, potentially causing heart failure. It can be diagnosed via echocardiogram, electrocardiogram, or chest x-ray and may be treated with medications like indomethacin or surgery.
Врожд. пороки сердца у взрослых Heart deferts(англ).ppt
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05 Bleeding Disorders In Children
1) Congenital heart disease (CHD) refers to defects present at birth that affect the structure and function of the heart. Causes are mostly unknown, though genetics play a role in some cases.
2) Statistics on CHD from Alder Hey Children's Hospital in 2003 show that around 1 in 120 births have some form of CHD, ranging from mild to severe defects requiring multiple operations and lifelong treatment. Common defects include Ventricular Septal Defects (VSD), Atrial Septal Defects (ASD), and Tetralogy of Fallot.
3) Treatment for CHD depends on the specific defect but may involve drug therapy, catheter procedures to implant devices, or
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1) Congenital heart disease (CHD) refers to defects present at birth that affect the structure and function of the heart. Causes are mostly unknown, though genetics play a role in some cases.
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3) Treatment for CHD depends on the specific defect but may involve drug therapy, catheter procedures to implant devices, or open heart surgery to repair or palliate the condition. Surgical options
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congenitalheartdiseases-221105151001-9038e702 (1).pdf
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Asd investigations and management
- 2. Investigations options….. ECG Chest x-ray Echocardiography Cardiac catheterization
- 3. ECG
- 4. ECG findings…….. Right axis deviation rSr’ or rSR’ in V1 Predominant s- waves in left precordial leads(V5- V6) Features of arrythmia
- 8. Echo. Findings……. Transthoracic 2D- IAS can be imaged from apical and subcostal four chamber view Subcostal view is best Echo drop out in mid portion for ASD secundum Color doppler imaging shows directly flow from LA to RA
- 10. Findings……. Now not diagnostic, used for device closure In ASD catheter passes through from RA to LA Small ASD- RA pressure tracing is normal, oxygen step up more than 10 % Large ASD- when RA and LA pressure tracing same and mean pressure tracing less than 3 mmHg
- 11. Continued….. When oxygen saturation 15% or more in RA than SVC or IVC, ASD is diagnosed In absence of ASD , RA oxygen saturation increase in- VSD with TR Rupture sinus valsalva aneurysm
- 12. Chest X-Ray
- 13. Findings….. Normal in small ASD Large ASD- cardiomegaly with RA and RV enlargement Lung vascularity increase Pulmonary conus full In pulmonary hypertension, lungs field become oligaemic (outer third, pruned tree like appearance)
- 14. MANAGEMENT
- 15. Medical management If asymtomatic – no treatment If complication developes- O2-inhalation diuretics spironolactone ACE inhibitor digoxin
- 16. Interventional procedure DEVICE CLOSURE Small and moderate size defect Closed percutanously through right heart Uses different devices Most recently- Amplatzer device anbiotic cover given before procedure Aspirin and clopidogrel given for 6 month after procedure
- 17. Continued….. Must fulfill following criteria- ASD less than 40mm diameter, clear AV valve and pul.veins and rim of atrial septum (<5mm)
- 18. Continued…. Contraindications… Ostium primum ASD Sinus venosus ASD Anomalous pulmonary venous drainage Severe pulmonary HTN
- 20. SURGICAL CLOSURE between age 5 to 10 yrs To avoid complcation- RV-failure, arrythmia, pul. HTN Qp:Qs ratio >2:1 Older pt surgical procedure is still worthwhile Surgery by partial sternal split with minimal skin incision by pericardial or Teflon patch
- 22. TAKE HOME MESSAGE…… Small ASD asymptomatic upto adulthood Large ASD symptomatic in adulthood Ostium secundum most common variety Examination- ESM and wide and fixed splitting 2nd heart sound 2-D echo- echo dropout of interatrial septum with T sign and left to rt color flow on color doppler Percutanous device closure or surgical patch closure is definitive treatment