Pages Below:
| |
Atrial Septal Defect
Secundum Atrial Defect
- 70% Congenital Heart Disease
is Secundum atrial defect
- usually isolated lesion
- more common in girls
- asymptomatic
- soft systolic flow murmur
- loudest over pulmonary area
- fixed splitting of second heart sound
- large defects
- hypertrophied right ventricle → left parasternal heave
- prominent a wave in jugular venous pulse
- ECG
- right bundle branch block
- CXR
- enlarged right atrium
- prominent pulmonary artery shadow
- evidence of increased blood flow through the lungs
Primum Atrial Defect
- affects endocardial cushion tissue
- close proximty to bundle of His
- defect between left ventricle and right atrium
- very large left to right shunt
- pulmonary hypertension
- may be mitral and tricuspid valve incompetence
- ECG
- extreme left axis deviation
- right bundle branch block
- early closure advisable
- mortality 10%
- risk of complete heart block
|