0 Atrial Septal Defect (ASD)

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Atrial Septal Defect (ASD)

• MC- Secundum (Center)
• Primum (big on medial side)
• Sinus Venosus (at insertion of SVC, IVC)

Seen in 

• Down's Syndrome

• Lutembacher's syndrome ( ASD + MS/MR)

• Ellis van creveld syndrome ( ASD + Polydactyly)

• Holt oram syndrome ( Autosomal Dominant )

Holt Oram Syndrome = Hand heart syndrome : 

1. Familial ASD syndrome
2. With - VSD , Primary heart block , Atrial fibrillation, Bony Abnormality ( Thumb - absent / rudimentary)
3. Pleiotropy - Multiple effects due to defect in single gene ( here TBX5)
4. Can have absent radius.

ASD Secundum :

1. Asymptomatic

2. S2 - Wide and fixed split

3. Grows up - Adult - 

• CHF
• Arrhythmias
• Stroke
• Eisenmenger syndrome

ECG : Right axis deviation.

Treatment : Closure at 3-5yrs age by Dacron Patch

ASD Primum :

1. Big cleft on the medial side
2. Also has MR (always)

• Pansystolic at Apex
• Radiate to axila and back

3. S2 - Wide and fixed split

4. It is severe ASD

        therefore

      Clinical features at 6 - 10 wks

• Failure to thrive
• Recurrent infections
• Feeding difficulties
• CHF

ECG : Left axis deviation.

Treatment : Early surgery.

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