8 Questions
What is the second most common congenital heart defect?
Atrial septal defect (ASD)
What is the typical feature that a radiologist may recognize on a chest radiograph to suggest the diagnosis of ASD?
Radiographic features
What is the area around the fossa ovalis that could be removed without creating an epicardial fistula?
True atrial septum
What is the result of the infolding of the atrial wall with associated epicardial tissues?
Septum secundum
What is the floor of the fossa ovalis?
Septum primum
What is the ostium secundum?
A normal hole in the septum primum
What is the channel that allows right to left shunting to continue after the ostium primum closes?
The connection between the fossa ovalis and the ostium secundum
What is the consequence of the method of formation and the extent of the normal septum secundum?
The small size of the true atrial septum
Study Notes
Definition and Classification
- Atrial septal defect (ASD) refers to any communication that allows blood to shunt between the atria in adults, including defects in the endocardial cushion, sinus venosus, and coronary sinus.
- The true atrial septum is the small area around the fossa ovalis, which could be removed without creating an epicardial fistula.
Epidemiology
- Atrial septal defects account for 10% of congenital heart disease.
- ASDs are more common in women, with a male-to-female ratio of 1:2.
- A close family history of ASD is found in 2% of cases.
Associations
- ASDs are seen in association with Down syndrome, with 50% of individuals with Down syndrome having congenital heart disease, predominantly endocardial cushion defects.
- Endocardial cushion defects outnumber secundum ASD in Down syndrome.
Pathology
- Defects in the true septum are commonly known as ‘secundum ASDs’, but could also be described as fossa ovalis defects.
- A pathological ASD requires that the fossa ovalis is not closed by the underlying septum primum, which can be due to malformation of one or both of these structures.
Diagnosis and Complications
- Diagnosis is often delayed until adulthood when complications arise, such as atrial arrhythmias or pulmonary hypertension.
- The radiologist may be the first to suggest the diagnosis by recognizing typical features on a chest radiograph.
Test your knowledge on Atrial Septal Defect, a common congenital heart defect, including its diagnosis, symptoms, and treatment.
Make Your Own Quizzes and Flashcards
Convert your notes into interactive study material.
Get started for free
