Atrial Septal Defects
What is a PFO?
A PFO is a defect that occurs due to the failure of the foramen ovale after birth.
What is an ASD?
A congenital malformation where there is a communication between the two atria
What is an ASD?
A heart defect in which blood flows between the atria due to a failure of the septal tissue to form.
What is T-artifact?
An increased echogenicity at the edge of the interatrial septum as seen from the apical 4Ch.
What mitral valve defect can be seen with a Primum ASD?
Cleft MV
A patient with a left to right flow across the IAS, a dilated coronary sinus, and persistent Left Superior Vena Cava most likely has which type of ASD?
Coronary "Unroofed" Sinus ASD
What structural/hemodynamic changes do you see in patients with an ASD? What causes these changes?
Dilated RA and RV, Pulmonic stenosis secondary to ASD, Main pulmonary artery dilation. These are caused by volume overload.
What heart sound and murmur is heard with an ASD?
Fixed Split S₂ & Pulmonary Flow Murmur
Flow across an ASD shunt typically flows in which direction?
L to R
Where Should Contrast be Injected in Order to Diagnosis a Persistent Left Superior Vena Cava?
Left Arm
What type of valvular abnormality is sometimes associated with a secundum ASD?
Mitral Valve Prolapse
What mitral valve defect can be seen with a Secundum ASD? What percentage of cases are associated with this defect?
Mitral Valve Prolapse Aprox. 20%
What type of Valvular Abnormality is seen with Primum ASD?
Ostium Primum
What is the most common type of ASD?
Ostium Secundum
This type of atrial defect is a remnant from fetal circulation that is present in approx 25% of the population?
PFO
What pathology do you need to assess in patients with an ASD?
Paradoxical septal motion RV dilation Pulmonary artery enlargement. Mitral valve abnormalities Direction and severity of shunt. Presence and severity of regurgitation through the TV, PV, MV. Calculate Qp/Qs
What complications can arise from an untreated ASD?
Pulmonary hypertension, Eisemenger syndrome, Congestive Heart Failure, Atrial arrythmias, increased risk of stroke.
Which atrial defect involves the region of the fossa ovalis?
Secundum
What type of ASD is most commonly associated with PAPVR?
Sinus Venosus
Which type of ASD is the most rare?
Sinus Venosus
What are the four types of ASDs and their locations
Sinus Venosus-Superior-septal Ostium Secundum-Mid-septal Ostium Primum: Inferior-Septal Coronary Sinus: Inferior-Septal
How do you distinguish between an ASD and a PFO on Echo?
Size of defect-ASD will be larger.(>3mm) Location of defect Other defects present that may be associated with a certain type of ASD. T-artifact
What is the best view to diagnose a Sinus Venosus ASD?
Subcostal 4ch
In a patient with a hemodynamically significant ASD, which chamber(s) will be affected, what happens to these chamber(s) and what causes this to happen? In severe cases a patient will develop ___________ Syndrome?
The RV and RA will become dilated due to volume overload. Eisenmenger's Syndrome
