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Review
. 2015 Mar 23;8(Suppl 1):93-8.
doi: 10.4137/CMC.S15715. eCollection 2014.

Atrial septal defects - clinical manifestations, echo assessment, and intervention

Seth S Martin  1 , Edward P Shapiro  1 , Monica Mukherjee  1
Affiliations
Review

Atrial septal defects - clinical manifestations, echo assessment, and intervention

Seth S Martin et al. Clin Med Insights Cardiol. .

Abstract

Atrial septal defect (ASD) is a common congenital abnormality that occurs in the form of ostium secundum, ostium primum, sinus venosus, and rarely, coronary sinus defects. Pathophysiologic consequences of ASDs typically begin in adulthood, and include arrhythmia, paradoxical embolism, cerebral abscess, pulmonary hypertension, and right ventricular failure. Two-dimensional (2D) transthoracic echocardiography with Doppler is a central aspect of the evaluation. This noninvasive imaging modality often establishes the diagnosis and provides critical information guiding intervention. A comprehensive echocardiogram includes evaluation of anatomical ASD characteristics, flow direction, associated abnormalities (eg, anomalous pulmonary veins), right ventricular anatomy and function, pulmonary pressures, and the pulmonary/systemic flow ratio. The primary indication for ASD closure is right heart volume overload, whether symptoms are present or not. ASD closure may also be reasonable in other contexts, such as paradoxical embolism. ASD type and local clinical expertise guide choice of a percutaneous versus surgical approach to ASD closure.

Keywords: atrial septal defect; coronary sinus defect; echocardiography; ostium primum defect; ostium secundum defect; sinus venosus defect.

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Figures

Figure 1
Figure 1
Demonstration of right ventricular enlargement in a patient with a secundum atrial septal defect in the apical four-chamber view by 2D transthoracic echocardiography.
Figure 2
Figure 2
Left to right flow across a secundum atrial septal defect in the parasternal short axis view by 2D transthoracic echocardiography with color Doppler.
Figure 3
Figure 3
Sizing of secundum atrial septal defect by transesophageal echocardiography.
Figure 4
Figure 4
Fluoroscopic image of percutaneous atrial septal defect closure.
See this image and copyright information in PMC

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