Materiały źródłowe

• #1 Atrial Septal Defect – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK535440/

  Atrial septal defect (ASD) is one of the most common types of congenital heart defects, occurring in about 25% of children. […] This activity for healthcare professionals is designed to enhance learners’ proficiency in evaluating and managing ASDs. Participants gain a deeper understanding of the condition’s risk factors, etiology, pathophysiology, varied presentations, and best diagnostic and therapeutic approaches. […] Identify the signs and symptoms indicative of an atrial septal defect. […] Select clinically guided diagnostic tests to evaluate atrial septal defects. […] Select appropriate surgical techniques for treating atrial septal defects, considering individual patient characteristics and expected functional outcomes. […] Collaborate with the interprofessional team to educate, treat, and monitor patients with atrial septal defects to improve patient outcomes.

• #2 Atrial Septal Defect (ASD) – Pediatrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/pediatrics/congenital-cardiovascular-anomalies/atrial-septal-defect-asd

  An atrial septal defect (ASD) is an opening in the interatrial septum, causing a left-to-right shunt and volume overload of the right atrium and right ventricle. […] Diagnosis is by echocardiography. […] Diagnosis of an atrial septal defect is suggested by cardiac examination, chest x-ray, and ECG and is confirmed by 2-dimensional echocardiography with color flow and Doppler studies. […] Echocardiography confirms the presence of an ASD, defines the anatomic location and size of the defect, and assesses the degree of right atrial and right ventricular volume overload. […] Moderate to large ASDs should be closed, typically between ages 2 years and 6 years, using a transcatheter device when possible.

• #3 Atrial Septal Defect (ASD) in Children

  https://healthlibrary.sjchs.org/Library/TestsProcedures/90,P01766

  Atrial Septal Defect (ASD) in Children […] What is an atrial septal defect in children? […] The atrial septum is the wall between the two upper chambers of the heart (right and left atria). An atrial septal defect (ASD) is an abnormal hole in this wall. ASD is a heart problem that is present at birth (congenital). ASDs are common and account for about 10% to 15% of congenital heart disease. The clinical significance is typically related to the location and size of the ASD. […] What are the symptoms of an atrial septal defect in a child? […] Many children have no symptoms and seem healthy. If the ASD is large, your child may have symptoms. Your child may: […] Tire easily […] Have fast breathing […] Have shortness of breath […] Grow slowly […] Have respiratory infections often

• #4 Atrial septal defect (ASD) – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/atrial-septal-defect/diagnosis-treatment/drc-20369720

  Some atrial septal defects (ASDs) are found before or soon after a child is born. But smaller ones may not be found until later in life. […] If an ASD is present, a healthcare professional may hear a whooshing sound called a heart murmur when listening to the heart with a device called a stethoscope. […] Tests that help diagnose an atrial septal defect (ASD) include: […] Echocardiogram. This is the main test used to diagnose an atrial septal defect. Sound waves are used to make pictures of the beating heart. An echocardiogram shows the structure of the heart chambers and valves. It also shows how well blood moves through the heart and heart valves. […] Chest X-ray. A chest X-ray shows the condition of the heart and lungs. […] Electrocardiogram (ECG or EKG). This quick and painless test records the electrical activity of the heart. It can show how fast or how slow the heart is beating. An ECG can help find irregular heartbeats, called arrhythmias.

• #5 Atrial Septal Defect | Causes, diagnosis, & treatment | Children’s Wisconsin

  https://childrenswi.org/medical-care/herma-heart/conditions/atrial-septal-defect

  How is an atrial septal defect diagnosed? Your child’s physician may have heard a heart murmur during a physical examination, and referred your child to a pediatric cardiologist for a diagnosis. A heart murmur is simply a noise caused by the turbulence of blood flowing through the opening from the left side of the heart to the right. […] A pediatric cardiologist specializes in the diagnosis and medical management of congenital heart defects, as well as heart problems that may develop later in childhood. The cardiologist will perform a physical examination, listening to the heart and lungs, and make other observations that help in the diagnosis. The location within the chest that the murmur is heard best, as well as the loudness and quality of the murmur (harsh, blowing, etc.) will give the cardiologist an initial idea of which heart problem your child may have. However, other tests are needed to help with the diagnosis, and may include the following:

• #6 Atrial Septal Defect : An Overview of Diagnosis, Treatment and Outlook | Ganesh Diagnostic

  https://www.ganeshdiagnostic.com/blog/atrial-septal-defect-an-overview-of-diagnosis-treatment-and-outlook

  A thorough physical examination may reveal a distinctive heart murmur, characterized by a „split” or „fixed” second heart sound. […] Echocardiography: It is the primary imaging tool used to diagnose ASD, providing detailed information about the size, location, and characteristics of the defect. […] Timely identification of ASD allows healthcare professionals to provide early interventions, preventing complications and optimizing patient outcomes. […] The selection of the most suitable treatment modality is based on careful consideration of individual patient factors and the expertise of the medical team. […] Regular follow-up appointments with cardiologists are essential to monitoring the progress and healing of the Atrial Septal Defect closure. […] Complications following ASD treatment can include residual shunting, device-related issues, or the development of other cardiac conditions. […] The prognosis and long-term outlook for individuals with atrial septal defect (ASD) are generally favorable, especially with timely diagnosis and appropriate management. […] Early diagnosis and appropriate management are crucial to prevent complications and optimize outcomes.

• #7

  https://www.singhealth.com.sg/patient-care/conditions-treatments/atrial-septal-defect-heart-childhood-illnesses

  Atrial Septal Defect (ASD) is a defect or hole in the wall separating the two upper receiving chambers (the right and left atriums) of the heart. […] Most infants with ASD have no symptoms, and the ASD goes undiagnosed. The investigation of choice when an ASD is suspected is the echocardiogram. This will not only confirm the presence of the ASD, it will also allow the cardiologist to assess the number and sizes of the ASD(s), as well as its effects on the heart. […] The most common presentation of an ASD is that of a cardiac murmur. The murmur caused by the ASD is generally soft, and there can also be associated changes in the normal heart sounds. […] The chest X-ray and electrocardiogram are often non-specific; they can be totally normal in small ASDs. In larger defects, the chest X-ray can show enlargement of the heart and increased blood vessel markings in the lungs. The electrocardiogram can sometimes show subtle changes that lead a doctor to suspect the presence of an ASD.

• #8 Atrial Septal Defect (ASD): Symptoms, Causes, Diagnosis & Treatment options for ASD Closure

  https://ghealth121.com/treatments/asd-closure/

  Atrial Septal Defect (ASD) is a congenital heart condition that presents as a hole in the wall, or septum, between the heart’s two upper chambers, the left and right atria. This defect allows oxygen-rich blood from the left atrium to flow into the right atrium, disrupting the normal flow of blood through the heart. While many infants with ASD might not exhibit noticeable symptoms at birth, the condition can lead to significant health issues if left undiagnosed and untreated. For many babies born with ASDs, the defect may be so small that it does not cause any immediate problems or symptoms. These small ASDs might close spontaneously over time without requiring any medical intervention. […] By the age of 30 or later, adults who were born with ASD may begin to experience symptoms related to the condition. These symptoms can include shortness of breath, especially during physical exertion or sometimes even at rest. Individuals might also experience heart palpitations, which are irregular or rapid heartbeats that can be felt in the chest.

• #9 Atrial Septal Defect (ASD) in Children

  https://healthlibrary.sjchs.org/Library/TestsProcedures/90,P01766

  Atrial Septal Defect (ASD) in Children […] What is an atrial septal defect in children? […] The atrial septum is the wall between the two upper chambers of the heart (right and left atria). An atrial septal defect (ASD) is an abnormal hole in this wall. ASD is a heart problem that is present at birth (congenital). ASDs are common and account for about 10% to 15% of congenital heart disease. The clinical significance is typically related to the location and size of the ASD. […] What are the symptoms of an atrial septal defect in a child? […] Many children have no symptoms and seem healthy. If the ASD is large, your child may have symptoms. Your child may: […] Tire easily […] Have fast breathing […] Have shortness of breath […] Grow slowly […] Have respiratory infections often

• #10 Atrial septal defect (ASD) – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/atrial-septal-defect/diagnosis-treatment/drc-20369720

  Some atrial septal defects (ASDs) are found before or soon after a child is born. But smaller ones may not be found until later in life. […] If an ASD is present, a healthcare professional may hear a whooshing sound called a heart murmur when listening to the heart with a device called a stethoscope. […] Tests that help diagnose an atrial septal defect (ASD) include: […] Echocardiogram. This is the main test used to diagnose an atrial septal defect. Sound waves are used to make pictures of the beating heart. An echocardiogram shows the structure of the heart chambers and valves. It also shows how well blood moves through the heart and heart valves. […] Chest X-ray. A chest X-ray shows the condition of the heart and lungs. […] Electrocardiogram (ECG or EKG). This quick and painless test records the electrical activity of the heart. It can show how fast or how slow the heart is beating. An ECG can help find irregular heartbeats, called arrhythmias.

• #11 Atrial Septal Defect Workup: Laboratory Studies, Imaging Studies, Other Tests

  https://emedicine.medscape.com/article/162914-workup

  No specific laboratory blood tests are required in the workup of atrial septal defects (ASDs), although plasma B-type natriuretic peptide (BNP) levels have been positively correlated with the degree of shunting present. […] Echocardiography is the first-line imaging modality in congenital heart disease. […] An uncertain diagnosis can be clarified with 2-D TTE, which provides direct noninvasive visualization of most types of atrial septal defects (ASDs), including evaluation of the right atrium, right ventricle, and pulmonary arteries, as well as other associated abnormalities, and is thus the gold standard for assessment of ASDs. […] TEE is also useful in guiding device placement during catheter ASD occlusion procedures and in providing immediate intraoperative assurance that defect closure is accomplished.

• #12 Atrial Septal Defects – Clinical Manifestations, Echo Assessment, and Intervention

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4373719/

  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. […] 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. […] 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. […] The guidelines recommend diagnosing an ASD by demonstration of shunting across the interatrial septum, with evaluation of the right heart and for associated abnormalities. […] Two-dimensional transthoracic echocardiography (2D TTE) often serves this need, providing the necessary imaging information to establish the diagnosis of ASD and make informed clinical decisions.

• #13 Atrial Septal Defects – Clinical Manifestations, Echo Assessment, and Intervention

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4373719/

  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. […] 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. […] 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. […] The guidelines recommend diagnosing an ASD by demonstration of shunting across the interatrial septum, with evaluation of the right heart and for associated abnormalities. […] Two-dimensional transthoracic echocardiography (2D TTE) often serves this need, providing the necessary imaging information to establish the diagnosis of ASD and make informed clinical decisions.

• #14 Atrial Septal Defect | Structural Heart | Henry Ford Health – Detroit, MI

  https://www.henryford.com/services/structural-heart/conditions/atrial-septal-defect

  Some people come to us with an existing ASD diagnosis. […] Others may experience symptoms and come to us to determine the cause. […] During this visit, your doctor meets with you to: […] Possibly recommend more heart tests or scans. […] After your evaluation, your interventional cardiologist works with you to develop a customized treatment plan. […] Your plan may include a minimally invasive procedure or open-heart surgery to close the hole. […] If you have a large ASD, you could still benefit from having it closed as an adult. […] We can also prescribe medications to relieve any symptoms and reduce your risk of stroke. […] If you have heart failure symptoms or a large ASD that was not closed in childhood, we often perform minimally invasive repair. […] While we typically suggest minimally invasive techniques, some people still need open-heart surgery.

• #15 Atrial Septal Defect – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK535440/

  Diagnostic imaging is essential for determining the size of the defect and guiding treatment options. A transthoracic echocardiogram is the gold standard imaging modality, as it helps assess the size of the defect, the direction of blood flow, the presence of associated abnormalities (such as involvement of the endocardial cushions and atrioventricular valves), heart structure and function, pulmonary artery pressure, and the pulmonary/systemic flow ratio (Qp/Qs). […] Options for ASDs requiring closure include percutaneous and surgical interventions. Indications for treatment include stroke, a hemodynamically significant shunt greater than 1.5:1, and evidence of systemic oxygen desaturation. […] Despite the evolution of surgical methods, complications such as patch dehiscence, thromboembolism, and arrhythmias remain rare but noteworthy. […] Timely closure of significant ASDs typically results in favorable outcomes, with a reduced risk of long-term complications.

• #16 Atrial Septic Defects (ASD) | Symptoms, Diagnosis & Treatment

  https://www.cincinnatichildrens.org/health/a/asd

  The heart is divided into four chambers. The upper chambers, or atria, are divided by a wall called the septum. An atrial septal defect (ASD) is a hole in that septum. Atrial septal defects are one of the most common heart defects. […] Hearing a murmur on a physical exam is the most common reason an atrial septal defect is suspected. Echocardiography is the main method used to confirm that an atrial septal defect exists. […] Echocardiography can show the hole and its size, and any enlargement of the right atrium and ventricle from the extra work they are doing. […] An atrial septal defect can be discovered for the first time in adult life. ASDs come in many sizes. A small ASD may have no significant effect on a person’s health. If ASDs are large enough to cause the right heart chambers to get larger, repair is recommended. Secundum ASDs are the most common form. These can usually be closed without surgery, using a device. The other forms of ASDs require surgical correction. These are typically low-risk procedures. Doctors with congenital surgical experience is important.

• #17 Role of Echocardiography in the Diagnosis and Interventional Management of Atrial Septal Defects

  https://www.mdpi.com/2075-4418/12/6/1494

  This review centers on the usefulness of echo-Doppler studies in the diagnosis of ostium secundum atrial septal defects (ASDs) and in their management, both in children and adults. […] Transthoracic echocardiographic (TTE) examination is very useful in making the diagnosis of ASD in babies and children, as well as teenagers and adult subjects with thin build. In adolescents and adults with poor precordial and subcostal echo windows, transesophageal or intracardiac echocardiography is necessary to demonstrate all features of ASD. […] The ASD can be clearly visualized by two-dimensional (2D) echocardiograms. […] TTE studies are also useful in distinguishing ostium secundum ASD from ostium primum, sinus venosus, and coronary sinus ASDs and patent foramen ovale. […] The current guidelines for ASD closure were reviewed by respective Committees of the American College of Cardiology, American Heart Association, and European Society of Cardiology.

• #18 Role of Echocardiography in the Diagnosis and Interventional Management of Atrial Septal Defects

  https://www.mdpi.com/2075-4418/12/6/1494

  This review centers on the usefulness of echo-Doppler studies in the diagnosis of ostium secundum atrial septal defects (ASDs) and in their management, both in children and adults. […] Transthoracic echocardiographic (TTE) examination is very useful in making the diagnosis of ASD in babies and children, as well as teenagers and adult subjects with thin build. In adolescents and adults with poor precordial and subcostal echo windows, transesophageal or intracardiac echocardiography is necessary to demonstrate all features of ASD. […] The ASD can be clearly visualized by two-dimensional (2D) echocardiograms. […] TTE studies are also useful in distinguishing ostium secundum ASD from ostium primum, sinus venosus, and coronary sinus ASDs and patent foramen ovale. […] The current guidelines for ASD closure were reviewed by respective Committees of the American College of Cardiology, American Heart Association, and European Society of Cardiology.

• #19 Hemodynamic assessment of atrial septal defects – Torres – Journal of Thoracic Disease

  https://jtd.amegroups.org/article/view/19475/html

  Atrial septal defect (ASD) is one of the most common congenital cardiac anomalies. […] Diagnostic catheterization is usually not indicated unless there is suggestion of pulmonary hypertension on echocardiography. […] Advances in non-invasive imaging over the last decades have changed the diagnostic evaluation of ASD. […] Hemodynamic evaluation is indicated in patients with abnormal systemic saturation which suggests right-to-left shunting at the defect, or when elevated PAP is suspected on echocardiography. […] Transthoracic echocardiography is the primary diagnostic method to assess ASD including location, size and hemodynamics. […] The most pronounced echocardiographic finding associated with a left-to-right shunt is dilation of the right ventricle, which can be assessed with different echocardiographic methods.

• #20 Atrial Septal Defect Workup: Laboratory Studies, Imaging Studies, Other Tests

  https://emedicine.medscape.com/article/162914-workup

  Contrast echocardiography can provide additional confirmation of the presence of a shunt lesion. […] Color Doppler echocardiography is also helpful in demonstrating flow across the atrial septum. […] CMRI has successfully been used to identify the size and position of ASD. […] A major advantage of MRI is the ability to quantify right ventricular size/volume and function. […] When noninvasive techniques demonstrate the presence of an uncomplicated atrial septal defect (ASD) in a child, routine cardiac catheterization for diagnosis is unnecessary. […] However, cardiac catheterization may be useful if the clinical data are inconsistent, if clinically significant pulmonary arterial hypertension is suspected, or if concurrent coronary artery disease must be assessed in patients older than 40 years. […] The diagnosis of ASD may be confirmed by directly passing the catheter through the defect.

• #21 Atrial Septal Defect Workup: Laboratory Studies, Imaging Studies, Other Tests

  https://emedicine.medscape.com/article/162914-workup

  Contrast echocardiography can provide additional confirmation of the presence of a shunt lesion. […] Color Doppler echocardiography is also helpful in demonstrating flow across the atrial septum. […] CMRI has successfully been used to identify the size and position of ASD. […] A major advantage of MRI is the ability to quantify right ventricular size/volume and function. […] When noninvasive techniques demonstrate the presence of an uncomplicated atrial septal defect (ASD) in a child, routine cardiac catheterization for diagnosis is unnecessary. […] However, cardiac catheterization may be useful if the clinical data are inconsistent, if clinically significant pulmonary arterial hypertension is suspected, or if concurrent coronary artery disease must be assessed in patients older than 40 years. […] The diagnosis of ASD may be confirmed by directly passing the catheter through the defect.

• #22 Role of Echocardiography in the Diagnosis and Interventional Management of Atrial Septal Defects

  https://www.mdpi.com/2075-4418/12/6/1494

  The ultimate decision to insert the device is made after detailed TEE or ICE evaluation of the diameter and shape of the ASD and rims of the ASD and balloon sizing of the ASD. […] Three-dimensional (3D) echocardiographic studies were initially developed in the early 1990s. […] The standard practice at this time is to perform either TEE or ICE immediately prior to transcatheter occlusion of ASD. […] The technique of balloon sizing the atrial defects was developed by King and his associates in the late 1970s. […] Echocardiographic examination is useful in demonstrating the position of the device. […] Follow-up evaluation with TTE studies is performed to appraise the device position, to identify residual shunts, and to detect rare complications. […] Based on this review, it may be concluded that the non-invasive transthoracic and invasive transesophageal and intracardiac echocardiographic studies are of immense value, both in the diagnosis of ASDs and in their management.

• #23 Multi-hole Atrial Septal Defect: A diagnostic and therapeutic challenge

  https://www.oatext.com/multi-hole-atrial-septal-defect-a-diagnostic-and-therapeutic-challenge.php

  Atrial Septal Defect (ASD) is the third most common congenital heart defect. […] The diagnosis of the ASD should always include a 3D transesophageal echocardiogram for a detailed assessment of the interatrial septum. […] In cases of wide and complex multi-hole ostium secundum ASD, surgical closure is recommended. […] The approach of congenital heart disease specifically ostium secundum ASD should always include the performance of 3D transesophageal echocardiogram for a better visualization of the interatrial septum. […] The 3D transesophageal echocardiogram is the technique of choice in the evaluation of ASD because it is the most specific study in comparison with equivalent specimens. […] In complex multi-hole ostium secundum atrial septal defects, treatment must be surgical.

• #24 Atrial Septal Defect (ASD) | University of Michigan Health

  https://www.uofmhealth.org/conditions-treatments/ped-heart/conditions/atrial-septal-defect

  Atrial septal defect (ASD) is the second most common congenital heart defect, accounting for 10-15% of all congenital heart defects. […] The diagnosis is most often made due to the presence of a heart murmur and/or an abnormal second heart sound. […] In patients with a significant atrial septal defect, the electrocardiogram often shows increased right ventricular forces and may show right atrial enlargement. […] An echocardiogram is able to detect even small atrial septal defects with almost 100% accuracy and permits measurement of the size and description of the precise location of the defect on the atrial septum. […] Closure of an atrial septal defect is done if there is persistence of a moderate to large defect when the child is between four and six years of age. […] Although the benefits of closure of significant defects diagnosed in later adulthood are less clear, there is evidence that closure will improve health for many older patients. […] Atrial septal defects can be closed surgically. […] Another treatment option for some patients is transcatheter closure of the defect. […] Not all patients with atrial septal defects are candidates for transcatheter closure.

• #25 Atrial Septal Defect (ASD) | University of Michigan Health

  https://www.uofmhealth.org/conditions-treatments/ped-heart/conditions/atrial-septal-defect

  Atrial septal defect (ASD) is the second most common congenital heart defect, accounting for 10-15% of all congenital heart defects. […] The diagnosis is most often made due to the presence of a heart murmur and/or an abnormal second heart sound. […] In patients with a significant atrial septal defect, the electrocardiogram often shows increased right ventricular forces and may show right atrial enlargement. […] An echocardiogram is able to detect even small atrial septal defects with almost 100% accuracy and permits measurement of the size and description of the precise location of the defect on the atrial septum. […] Closure of an atrial septal defect is done if there is persistence of a moderate to large defect when the child is between four and six years of age. […] Although the benefits of closure of significant defects diagnosed in later adulthood are less clear, there is evidence that closure will improve health for many older patients. […] Atrial septal defects can be closed surgically. […] Another treatment option for some patients is transcatheter closure of the defect. […] Not all patients with atrial septal defects are candidates for transcatheter closure.

• #26 Atrial septal defect – Wikipedia

  https://en.wikipedia.org/wiki/Atrial_septal_defect

  The physical findings in an adult with an ASD include those related directly to the intracardiac shunt and those that are secondary to the right heart failure that may be present in these individuals. […] In transthoracic echocardiography, an atrial septal defect may be seen on color flow imaging as a jet of blood from the left atrium to the right atrium. […] A less invasive method for detecting a PFO or other ASDs than transesophagal ultrasound is transcranial Doppler with bubble contrast. […] The ECG findings in atrial septal defect vary with the type of defect the individual has. Individuals with atrial septal defects may have a prolonged PR interval (a first-degree heart block). The prolongation of the PR interval is probably due to the enlargement of the atria common in ASDs and the increased distance due to the defect itself. Both of these can cause an increased distance of internodal conduction from the SA node to the AV node.

• #27 Atrial septal defect (ASD) – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/atrial-septal-defect/diagnosis-treatment/drc-20369720

  Some atrial septal defects (ASDs) are found before or soon after a child is born. But smaller ones may not be found until later in life. […] If an ASD is present, a healthcare professional may hear a whooshing sound called a heart murmur when listening to the heart with a device called a stethoscope. […] Tests that help diagnose an atrial septal defect (ASD) include: […] Echocardiogram. This is the main test used to diagnose an atrial septal defect. Sound waves are used to make pictures of the beating heart. An echocardiogram shows the structure of the heart chambers and valves. It also shows how well blood moves through the heart and heart valves. […] Chest X-ray. A chest X-ray shows the condition of the heart and lungs. […] Electrocardiogram (ECG or EKG). This quick and painless test records the electrical activity of the heart. It can show how fast or how slow the heart is beating. An ECG can help find irregular heartbeats, called arrhythmias.

• #28 Atrial septal defect – WikEM

  https://wikem.org/wiki/Atrial_septal_defect

  Many ASDs go undiagnosed in childhood. […] By 40s, patients may develop symptoms. […] Small ASDs 5 mm in diameter may not generate symptoms. […] 5-10 mm defects lead to symptoms in 4th and 5th decade of life. […] 10 mm defects present with symptoms in 3rd decade. […] Atrial septal defect (ASD) is included in the differential diagnosis of congenital heart disease types. […] An ECG may show the crochetage pattern (92% specific) a notch near the apex of the R wave in inferior limb leads. […] TTE with Doppler can demonstrate most shunting. […] Agitated saline with Valsalva maneuver to increase right to left shunting is more diagnostic. […] Indications for ASD closure include right heart overload with RA or RV enlargement.

• #29

  https://www.singhealth.com.sg/patient-care/conditions-treatments/atrial-septal-defect-heart-childhood-illnesses

  Atrial Septal Defect (ASD) is a defect or hole in the wall separating the two upper receiving chambers (the right and left atriums) of the heart. […] Most infants with ASD have no symptoms, and the ASD goes undiagnosed. The investigation of choice when an ASD is suspected is the echocardiogram. This will not only confirm the presence of the ASD, it will also allow the cardiologist to assess the number and sizes of the ASD(s), as well as its effects on the heart. […] The most common presentation of an ASD is that of a cardiac murmur. The murmur caused by the ASD is generally soft, and there can also be associated changes in the normal heart sounds. […] The chest X-ray and electrocardiogram are often non-specific; they can be totally normal in small ASDs. In larger defects, the chest X-ray can show enlargement of the heart and increased blood vessel markings in the lungs. The electrocardiogram can sometimes show subtle changes that lead a doctor to suspect the presence of an ASD.

• #30 Atrial septal defect (ASD) – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/atrial-septal-defect/diagnosis-treatment/drc-20369720

  Some atrial septal defects (ASDs) are found before or soon after a child is born. But smaller ones may not be found until later in life. […] If an ASD is present, a healthcare professional may hear a whooshing sound called a heart murmur when listening to the heart with a device called a stethoscope. […] Tests that help diagnose an atrial septal defect (ASD) include: […] Echocardiogram. This is the main test used to diagnose an atrial septal defect. Sound waves are used to make pictures of the beating heart. An echocardiogram shows the structure of the heart chambers and valves. It also shows how well blood moves through the heart and heart valves. […] Chest X-ray. A chest X-ray shows the condition of the heart and lungs. […] Electrocardiogram (ECG or EKG). This quick and painless test records the electrical activity of the heart. It can show how fast or how slow the heart is beating. An ECG can help find irregular heartbeats, called arrhythmias.

• #31 Atrial Septal Defect | Causes, diagnosis, & treatment | Children’s Wisconsin

  https://childrenswi.org/medical-care/herma-heart/conditions/atrial-septal-defect

  Chest x-ray – a diagnostic test which uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film. With an ASD, the heart may be enlarged because the right atrium and ventricle have to handle larger amounts of blood flow than normal. Also, there may be changes that take place in the lungs due to extra blood flow that can be seen on an x-ray. […] Electrocardiogram (ECG or EKG) – a test that records the electrical activity of the heart, shows abnormal rhythms (arrhythmias or dysrhythmias), and detects heart muscle stress. […] Echocardiogram (echo) – a procedure that evaluates the structure and function of the heart by using sound waves recorded on an electronic sensor that produce a moving picture of the heart and heart valves. An echo can show the pattern of blood flow through the septal opening, and determine how large the opening is, as well as how much blood is passing through it.

• #32

  https://www.singhealth.com.sg/patient-care/conditions-treatments/atrial-septal-defect-heart-childhood-illnesses

  Atrial Septal Defect (ASD) is a defect or hole in the wall separating the two upper receiving chambers (the right and left atriums) of the heart. […] Most infants with ASD have no symptoms, and the ASD goes undiagnosed. The investigation of choice when an ASD is suspected is the echocardiogram. This will not only confirm the presence of the ASD, it will also allow the cardiologist to assess the number and sizes of the ASD(s), as well as its effects on the heart. […] The most common presentation of an ASD is that of a cardiac murmur. The murmur caused by the ASD is generally soft, and there can also be associated changes in the normal heart sounds. […] The chest X-ray and electrocardiogram are often non-specific; they can be totally normal in small ASDs. In larger defects, the chest X-ray can show enlargement of the heart and increased blood vessel markings in the lungs. The electrocardiogram can sometimes show subtle changes that lead a doctor to suspect the presence of an ASD.

• #33 Atrial Septal Defect Workup: Laboratory Studies, Imaging Studies, Other Tests

  https://emedicine.medscape.com/article/162914-workup

  Contrast echocardiography can provide additional confirmation of the presence of a shunt lesion. […] Color Doppler echocardiography is also helpful in demonstrating flow across the atrial septum. […] CMRI has successfully been used to identify the size and position of ASD. […] A major advantage of MRI is the ability to quantify right ventricular size/volume and function. […] When noninvasive techniques demonstrate the presence of an uncomplicated atrial septal defect (ASD) in a child, routine cardiac catheterization for diagnosis is unnecessary. […] However, cardiac catheterization may be useful if the clinical data are inconsistent, if clinically significant pulmonary arterial hypertension is suspected, or if concurrent coronary artery disease must be assessed in patients older than 40 years. […] The diagnosis of ASD may be confirmed by directly passing the catheter through the defect.

• #34 Atrial Septal Defect – Cardiac MRI

  https://cardiacmri.com/disease-guide/congenital-heart-disease/asd/

  Cardiac MRI is well suited for the examination of an ASD because it can accurately quantify the shunt, and its effect on cardiac structure and function. It can directly visualize blood flowing across the ASD. It is totally non-invasive and does not require contrast. […] In order to make the specific diagnosis of atrial septal defect, one must visualize blood flowing directly between the atria. […] However, visualizing a defect this way is sometimes problematic, especially when the ASD is less than 1 cm in diameter (because of partial volume averaging with slices that are often ~8 mm thick). Furthermore, merely visualizing an apparent defect in the interatrial septum is insufficient to make a diagnosis unless blood can be seen flowing directly across the septum. […] A more robust method for demonstrating a secundum ASD is to acquire phase-contrast images parallel to the septum at the level of the fossa ovalis.

• #35 Atrial Septal Defect – Cardiac MRI

  https://cardiacmri.com/disease-guide/congenital-heart-disease/asd/

  The best way to quantify the shunt ratio (Qp/Qs) is to divide the blood flow in the main pulmonary artery (Qp) by the blood flow in the ascending aorta (Qs). […] The severity of ASD can be quantified in terms of Qp/Qs and defect size. […] MRI is less invasive and is superior for quantifying the size of the shunt (Qp/Qs), as well as its affect on RV size and function.

• #36 Atrial Septal Defect in Adulthood

  https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2022/07/29/14/01/Atrial-Septal-Defect-in-Adulthood

  Atrial septal defect (ASD) is the most common congenital heart disease diagnosed in adulthood, accounting for 25-30% of diagnoses. […] Echocardiography remains the first-line imaging modality for ASDs. Information obtained by echo includes size and location of defects, assessment of right ventricular chamber size, and estimation of right ventricular pressures. […] Cardiac magnetic resonance imaging has an important role in the imaging of ASD when additional information is required after echocardiography and provides accurate measures of right ventricular size and function, location of pulmonary veins, and quantification of the pulmonary-to-systemic flow ratio (Qp:Qs). […] Diagnostic catheterization for adults with ASD should be reserved for patients with pulmonary hypertension, left heart disease, or older patients in which there are concerns for coronary artery disease.

• #37 Atrial Septal Defect – Cardiac MRI

  https://cardiacmri.com/disease-guide/congenital-heart-disease/asd/

  Cardiac MRI is well suited for the examination of an ASD because it can accurately quantify the shunt, and its effect on cardiac structure and function. It can directly visualize blood flowing across the ASD. It is totally non-invasive and does not require contrast. […] In order to make the specific diagnosis of atrial septal defect, one must visualize blood flowing directly between the atria. […] However, visualizing a defect this way is sometimes problematic, especially when the ASD is less than 1 cm in diameter (because of partial volume averaging with slices that are often ~8 mm thick). Furthermore, merely visualizing an apparent defect in the interatrial septum is insufficient to make a diagnosis unless blood can be seen flowing directly across the septum. […] A more robust method for demonstrating a secundum ASD is to acquire phase-contrast images parallel to the septum at the level of the fossa ovalis.

• #38 Atrial septal defect (ASD) – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/atrial-septal-defect/diagnosis-treatment/drc-20369720

  Cardiac magnetic resonance imaging (MRI) scan. This imaging test uses magnetic fields and radio waves to make detailed images of the heart. It might be done if other tests didn’t provide a sure diagnosis. […] Computerized tomography (CT) scan. This test uses a series of X-rays to create detailed pictures of the heart. It may be used if other tests don’t give enough information to make a diagnosis. […] A doctor trained in heart problems present at birth usually provides care for people with an atrial septal defect. This type of healthcare professional is called a congenital cardiologist. […] For atrial septal defect, questions to ask might include: What tests are needed? […] Is the atrial septal defect likely to close on its own? […] What are the treatment choices? […] What are the risks of repair surgery?

• #39 Atrial Septal Defect (ASD): Diagnosis & Treatment | NewYork-Presbyterian

  https://www.nyp.org/heart/congenital-heart-disease/atrial-septal-defect-asd/treatment

  How is Atrial Septal Defect (ASD) Diagnosed? Diagnosis […] When an atrial septal defect is suspected, a specialist may be able to confirm the diagnosis and can provide additional assessment before, and immediately after the birth. […] The definitive test to confirm an atrial septal defect diagnosis is an echocardiogram, in which sound waves (ultrasound) are used to provide images of the heart in motion. […] Imaging is more difficult in adults with a standard echocardiogram test, so the ultrasound camera may also be passed down the esophagus to image the heart from behind. This view is much closer to the wall where the atrial septal defect occurs and is the best test for assessing an atrial septal defect in adults. […] Secondary tests used to confirm an atrial septal defect diagnosis may include: […] Computed tomography (CT) scan – which provides a more detailed series of x-rays of the heart and its connections […] Cardiac magnetic resonance imaging (MRI) – a form of imaging that uses magnetic fields and radio waves to evaluate heart function and blood flow.

• #40 Atrial Septal Defect Workup: Laboratory Studies, Imaging Studies, Other Tests

  https://emedicine.medscape.com/article/162914-workup

  Contrast echocardiography can provide additional confirmation of the presence of a shunt lesion. […] Color Doppler echocardiography is also helpful in demonstrating flow across the atrial septum. […] CMRI has successfully been used to identify the size and position of ASD. […] A major advantage of MRI is the ability to quantify right ventricular size/volume and function. […] When noninvasive techniques demonstrate the presence of an uncomplicated atrial septal defect (ASD) in a child, routine cardiac catheterization for diagnosis is unnecessary. […] However, cardiac catheterization may be useful if the clinical data are inconsistent, if clinically significant pulmonary arterial hypertension is suspected, or if concurrent coronary artery disease must be assessed in patients older than 40 years. […] The diagnosis of ASD may be confirmed by directly passing the catheter through the defect.

• #41 Atrial Septal Defect Workup: Laboratory Studies, Imaging Studies, Other Tests

  https://emedicine.medscape.com/article/162914-workup

  Contrast echocardiography can provide additional confirmation of the presence of a shunt lesion. […] Color Doppler echocardiography is also helpful in demonstrating flow across the atrial septum. […] CMRI has successfully been used to identify the size and position of ASD. […] A major advantage of MRI is the ability to quantify right ventricular size/volume and function. […] When noninvasive techniques demonstrate the presence of an uncomplicated atrial septal defect (ASD) in a child, routine cardiac catheterization for diagnosis is unnecessary. […] However, cardiac catheterization may be useful if the clinical data are inconsistent, if clinically significant pulmonary arterial hypertension is suspected, or if concurrent coronary artery disease must be assessed in patients older than 40 years. […] The diagnosis of ASD may be confirmed by directly passing the catheter through the defect.

• #42 Hemodynamic assessment of atrial septal defects – Torres – Journal of Thoracic Disease

  https://jtd.amegroups.org/article/view/19475/html

  Atrial septal defect (ASD) is one of the most common congenital cardiac anomalies. […] Diagnostic catheterization is usually not indicated unless there is suggestion of pulmonary hypertension on echocardiography. […] Advances in non-invasive imaging over the last decades have changed the diagnostic evaluation of ASD. […] Hemodynamic evaluation is indicated in patients with abnormal systemic saturation which suggests right-to-left shunting at the defect, or when elevated PAP is suspected on echocardiography. […] Transthoracic echocardiography is the primary diagnostic method to assess ASD including location, size and hemodynamics. […] The most pronounced echocardiographic finding associated with a left-to-right shunt is dilation of the right ventricle, which can be assessed with different echocardiographic methods.

• #43 Atrial Septal Defect Workup: Laboratory Studies, Imaging Studies, Other Tests

  https://emedicine.medscape.com/article/162914-workup

  Contrast echocardiography can provide additional confirmation of the presence of a shunt lesion. […] Color Doppler echocardiography is also helpful in demonstrating flow across the atrial septum. […] CMRI has successfully been used to identify the size and position of ASD. […] A major advantage of MRI is the ability to quantify right ventricular size/volume and function. […] When noninvasive techniques demonstrate the presence of an uncomplicated atrial septal defect (ASD) in a child, routine cardiac catheterization for diagnosis is unnecessary. […] However, cardiac catheterization may be useful if the clinical data are inconsistent, if clinically significant pulmonary arterial hypertension is suspected, or if concurrent coronary artery disease must be assessed in patients older than 40 years. […] The diagnosis of ASD may be confirmed by directly passing the catheter through the defect.

• #44 Atrial Septal Defect Workup: Laboratory Studies, Imaging Studies, Other Tests

  https://emedicine.medscape.com/article/162914-workup

  Contrast echocardiography can provide additional confirmation of the presence of a shunt lesion. […] Color Doppler echocardiography is also helpful in demonstrating flow across the atrial septum. […] CMRI has successfully been used to identify the size and position of ASD. […] A major advantage of MRI is the ability to quantify right ventricular size/volume and function. […] When noninvasive techniques demonstrate the presence of an uncomplicated atrial septal defect (ASD) in a child, routine cardiac catheterization for diagnosis is unnecessary. […] However, cardiac catheterization may be useful if the clinical data are inconsistent, if clinically significant pulmonary arterial hypertension is suspected, or if concurrent coronary artery disease must be assessed in patients older than 40 years. […] The diagnosis of ASD may be confirmed by directly passing the catheter through the defect.

• #45 Atrial Septal Defect in Adulthood

  https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2022/07/29/14/01/Atrial-Septal-Defect-in-Adulthood

  Atrial septal defect (ASD) is the most common congenital heart disease diagnosed in adulthood, accounting for 25-30% of diagnoses. […] Echocardiography remains the first-line imaging modality for ASDs. Information obtained by echo includes size and location of defects, assessment of right ventricular chamber size, and estimation of right ventricular pressures. […] Cardiac magnetic resonance imaging has an important role in the imaging of ASD when additional information is required after echocardiography and provides accurate measures of right ventricular size and function, location of pulmonary veins, and quantification of the pulmonary-to-systemic flow ratio (Qp:Qs). […] Diagnostic catheterization for adults with ASD should be reserved for patients with pulmonary hypertension, left heart disease, or older patients in which there are concerns for coronary artery disease.

• #46 Hemodynamic assessment of atrial septal defects – Torres – Journal of Thoracic Disease

  https://jtd.amegroups.org/article/view/19475/html

  Echocardiography is also used during transcatheter intervention of ASD. […] An increase in oxygen saturation of 10% or more at the atrial level from the superior vena cava (SVC) and the persistence of the high saturation in the right ventricle and pulmonary arteries indicate the presence of left-to-right shunting at the atrial level. […] A heart catheterization is indicated to confirm the diagnosis and eventually enlarge the defect with balloon septostomy, static balloon angioplasty, or stent placement. […] Patients with hypoplastic tricuspid valves unable to handle full cardiac output should be considered for a bidirectional cavopulmonary anastomosis and ASD closure, i.e., 1 ventricle repair. […] Hemodynamics in children with isolated ASD is usually straight forward and require no further evaluation unless there is clinical or echocardiographic evidence of elevated PAP.

• #47 Atrial Septal Defect Workup: Laboratory Studies, Imaging Studies, Other Tests

  https://emedicine.medscape.com/article/162914-workup

  Contrast echocardiography can provide additional confirmation of the presence of a shunt lesion. […] Color Doppler echocardiography is also helpful in demonstrating flow across the atrial septum. […] CMRI has successfully been used to identify the size and position of ASD. […] A major advantage of MRI is the ability to quantify right ventricular size/volume and function. […] When noninvasive techniques demonstrate the presence of an uncomplicated atrial septal defect (ASD) in a child, routine cardiac catheterization for diagnosis is unnecessary. […] However, cardiac catheterization may be useful if the clinical data are inconsistent, if clinically significant pulmonary arterial hypertension is suspected, or if concurrent coronary artery disease must be assessed in patients older than 40 years. […] The diagnosis of ASD may be confirmed by directly passing the catheter through the defect.

• #48 Hemodynamic assessment of atrial septal defects – Torres – Journal of Thoracic Disease

  https://jtd.amegroups.org/article/view/19475/html

  Echocardiography is also used during transcatheter intervention of ASD. […] An increase in oxygen saturation of 10% or more at the atrial level from the superior vena cava (SVC) and the persistence of the high saturation in the right ventricle and pulmonary arteries indicate the presence of left-to-right shunting at the atrial level. […] A heart catheterization is indicated to confirm the diagnosis and eventually enlarge the defect with balloon septostomy, static balloon angioplasty, or stent placement. […] Patients with hypoplastic tricuspid valves unable to handle full cardiac output should be considered for a bidirectional cavopulmonary anastomosis and ASD closure, i.e., 1 ventricle repair. […] Hemodynamics in children with isolated ASD is usually straight forward and require no further evaluation unless there is clinical or echocardiographic evidence of elevated PAP.

• #49 Atrial Septal Defect (ASD): Symptoms & Treatments | University of Utah Health | University of Utah Health

  https://healthcare.utah.edu/cardiovascular/conditions/atrial-septal-defect

  Electrocardiogram (ECG). An electrocardiogram (or ECG) shows electrical activity inside your childs heart. ECGs can also find abnormal heartbeats (called arrhythmias) and can also see if your childs heart muscle is stressed. ASDs can cause both arrhythmias and heart stress. […] Echocardiogram (echo). An echocardiogram (or echo) uses sound waves to show a picture of your childs heart and heart valves while theyre moving. Echo tests can diagnose ASDs because they show how much blood flows through the hole in your childs atrial septum. Echo tests can also see how big this hole is. […] Cardiac catheterization. In this test, doctors use a thin, flexible tube called a catheter and place it close to your childs heart. Doctors use contrast dye to get very clear pictures of your childs heart. In some children, doctors also use cardiac catheterization to close your childs ASD.

• #50 About Atrial Septal Defect (ASD) | Congenital Heart Defects (CHDs) | CDC

  https://www.cdc.gov/heart-defects/about/atrial-septal-defect.html

  An atrial septal defect may be diagnosed during pregnancy or after the baby is born. […] During pregnancy, screening tests (prenatal tests) check for birth defects and other conditions. An ultrasound, a tool that creates pictures of the baby, may detect an atrial septal defect. However, it usually depends on the size of the hole and its location. If an atrial septal defect is suspected, a healthcare provider will need to confirm the diagnosis. […] In many cases, an atrial septal defect may not be diagnosed until adulthood. An atrial septal defect is often found by detecting a murmur when listening to a person’s heart with a stethoscope. If a murmur is heard or other symptoms are present, the healthcare provider might request more tests to confirm the diagnosis. The most common test is an echocardiogram, which is an ultrasound of the heart.

• #51 About Atrial Septal Defect (ASD) | Congenital Heart Defects (CHDs) | CDC

  https://www.cdc.gov/heart-defects/about/atrial-septal-defect.html

  An atrial septal defect may be diagnosed during pregnancy or after the baby is born. […] During pregnancy, screening tests (prenatal tests) check for birth defects and other conditions. An ultrasound, a tool that creates pictures of the baby, may detect an atrial septal defect. However, it usually depends on the size of the hole and its location. If an atrial septal defect is suspected, a healthcare provider will need to confirm the diagnosis. […] In many cases, an atrial septal defect may not be diagnosed until adulthood. An atrial septal defect is often found by detecting a murmur when listening to a person’s heart with a stethoscope. If a murmur is heard or other symptoms are present, the healthcare provider might request more tests to confirm the diagnosis. The most common test is an echocardiogram, which is an ultrasound of the heart.

• #52 Atrial septal defect (ASD)

  https://www.isuog.org/clinical-resources/patient-information-series/patient-information-pregnancy-conditions/heart/atrial-septal-defect-asd.html

  This leaflet is to help you understand what atrial septal defect (ASD) is, what tests you need, and the implication of being diagnosed for you and your baby. […] Once an ASD is suspected, a detailed evaluation of the fetal heart should be done to look for associated cardiac anomalies. Tests that may be offered by your provider include: A fetal echocardiography, which is a specialized ultrasound to look at the babys heart during the pregnancy. […] A postnatal ultrasound of your baby’s heart (echocardiogram) will be done to evaluate the atrial septal defect and make sure there are no other differences with the babys heart. Small ASDs may be followed over time with echocardiograms to monitor for spontaneous closure. However, moderate to large ASDs typically require closure by a device (cardiac catheterization) or surgical repair to avoid long-term volume problems that might overload the right side of the heart and/or lungs. Certain types of ASDs, (called Sinus venosus and coronary sinus ASDs) do not typically close spontaneously and require surgical closure.

• #53 Role of Echocardiography in the Diagnosis and Interventional Management of Atrial Septal Defects

  https://www.mdpi.com/2075-4418/12/6/1494

  This review centers on the usefulness of echo-Doppler studies in the diagnosis of ostium secundum atrial septal defects (ASDs) and in their management, both in children and adults. […] Transthoracic echocardiographic (TTE) examination is very useful in making the diagnosis of ASD in babies and children, as well as teenagers and adult subjects with thin build. In adolescents and adults with poor precordial and subcostal echo windows, transesophageal or intracardiac echocardiography is necessary to demonstrate all features of ASD. […] The ASD can be clearly visualized by two-dimensional (2D) echocardiograms. […] TTE studies are also useful in distinguishing ostium secundum ASD from ostium primum, sinus venosus, and coronary sinus ASDs and patent foramen ovale. […] The current guidelines for ASD closure were reviewed by respective Committees of the American College of Cardiology, American Heart Association, and European Society of Cardiology.

• #54 Role of Echocardiography in the Diagnosis and Interventional Management of Atrial Septal Defects

  https://www.mdpi.com/2075-4418/12/6/1494

  This review centers on the usefulness of echo-Doppler studies in the diagnosis of ostium secundum atrial septal defects (ASDs) and in their management, both in children and adults. […] Transthoracic echocardiographic (TTE) examination is very useful in making the diagnosis of ASD in babies and children, as well as teenagers and adult subjects with thin build. In adolescents and adults with poor precordial and subcostal echo windows, transesophageal or intracardiac echocardiography is necessary to demonstrate all features of ASD. […] The ASD can be clearly visualized by two-dimensional (2D) echocardiograms. […] TTE studies are also useful in distinguishing ostium secundum ASD from ostium primum, sinus venosus, and coronary sinus ASDs and patent foramen ovale. […] The current guidelines for ASD closure were reviewed by respective Committees of the American College of Cardiology, American Heart Association, and European Society of Cardiology.

• #55 Atrial Septal Defect | Schneeweiss Adult Congenital Heart Center

  https://www.congenitalheart.cuimc.columbia.edu/conditions-we-treat/atrial-septal-defect

  An atrial septal defect (ASD) is one of the most common forms of congenital heart disease found in adults. […] The diagnosis is generally confirmed with an echocardiogram. […] A sinus venosus ASD is located in the superior and posterior portion of the atrial septum. It is more difficult to visualize with echocardiography than the other forms of ASD which is a reason why there is often a delay in recognizing this defect. […] Surgical repair is recommended when there are signs and symptoms of a significant increase of blood flow into the right heart. […] ASD closure eliminates the excess blood flow which produces enlargement of the right side of the heart. […] Careful evaluation of such patients by experts in pulmonary hypertension is important.

• #56 Role of Echocardiography in the Diagnosis and Interventional Management of Atrial Septal Defects

  https://www.mdpi.com/2075-4418/12/6/1494

  This review centers on the usefulness of echo-Doppler studies in the diagnosis of ostium secundum atrial septal defects (ASDs) and in their management, both in children and adults. […] Transthoracic echocardiographic (TTE) examination is very useful in making the diagnosis of ASD in babies and children, as well as teenagers and adult subjects with thin build. In adolescents and adults with poor precordial and subcostal echo windows, transesophageal or intracardiac echocardiography is necessary to demonstrate all features of ASD. […] The ASD can be clearly visualized by two-dimensional (2D) echocardiograms. […] TTE studies are also useful in distinguishing ostium secundum ASD from ostium primum, sinus venosus, and coronary sinus ASDs and patent foramen ovale. […] The current guidelines for ASD closure were reviewed by respective Committees of the American College of Cardiology, American Heart Association, and European Society of Cardiology.

• #57 Atrial Septal Defect | TriHealth

  https://www.trihealth.com/services/heart-and-vascular-care/heart-and-vascular-conditions/atrial-septal-defect

  An atrial septal defect (ASD) is a congenital heart defect that allows blood to pass between the left and right atria via the interatrial septum. When this septum is missing or defective, venous blood and arterial oxygen-rich blood can mix and be pushed throughout the body with less oxygen than is needed. One specific type of ASD is patent foramen ovale (PFO). […] It may be discovered during a routine physical and confirmed with an echocardiogram. […] If left untreated, an ASD can result in heart failure or stroke. […] Treatments for atrial septal defects include: […] Our interventional cardiologists boast a 100 percent success rate on catheter-based closure of a patent foramen ovale (PFO).

• #58 Atrial Septal Defect – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK535440/

  Diagnostic imaging is essential for determining the size of the defect and guiding treatment options. A transthoracic echocardiogram is the gold standard imaging modality, as it helps assess the size of the defect, the direction of blood flow, the presence of associated abnormalities (such as involvement of the endocardial cushions and atrioventricular valves), heart structure and function, pulmonary artery pressure, and the pulmonary/systemic flow ratio (Qp/Qs). […] Options for ASDs requiring closure include percutaneous and surgical interventions. Indications for treatment include stroke, a hemodynamically significant shunt greater than 1.5:1, and evidence of systemic oxygen desaturation. […] Despite the evolution of surgical methods, complications such as patch dehiscence, thromboembolism, and arrhythmias remain rare but noteworthy. […] Timely closure of significant ASDs typically results in favorable outcomes, with a reduced risk of long-term complications.

• #59 Atrial septal defect – WikEM

  https://wikem.org/wiki/Atrial_septal_defect

  Many ASDs go undiagnosed in childhood. […] By 40s, patients may develop symptoms. […] Small ASDs 5 mm in diameter may not generate symptoms. […] 5-10 mm defects lead to symptoms in 4th and 5th decade of life. […] 10 mm defects present with symptoms in 3rd decade. […] Atrial septal defect (ASD) is included in the differential diagnosis of congenital heart disease types. […] An ECG may show the crochetage pattern (92% specific) a notch near the apex of the R wave in inferior limb leads. […] TTE with Doppler can demonstrate most shunting. […] Agitated saline with Valsalva maneuver to increase right to left shunting is more diagnostic. […] Indications for ASD closure include right heart overload with RA or RV enlargement.

• #60 Atrial Septal Defects – Clinical Manifestations, Echo Assessment, and Intervention

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4373719/

  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. […] 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. […] 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. […] The guidelines recommend diagnosing an ASD by demonstration of shunting across the interatrial septum, with evaluation of the right heart and for associated abnormalities. […] Two-dimensional transthoracic echocardiography (2D TTE) often serves this need, providing the necessary imaging information to establish the diagnosis of ASD and make informed clinical decisions.

• #61 Atrial Septal Defect: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/162914-overview

  A chronic, significant left-to-right shunt can permanently alter the PVR, leading to pulmonary arterial hypertension and, eventually, reversal of shunt (now becoming right to left), also known as Eisenmenger syndrome. […] The three major types of ASD account for 10% of all congenital heart disease and as much as 25-30% of congenital heart disease presenting in adulthood. […] Patients with ASD can be asymptomatic through infancy and childhood, although the timing of clinical presentation depends on the degree of left-to-right shunt. Symptoms become more common with advancing age. By age 40 years, 9 in 10 untreated patients exhibit exertional dyspnea, fatigue, palpitations, sustained arrhythmia, or indications of heart failure.

• #62 Atrial septal defect (ASD) – UF Health

  https://ufhealth.org/conditions-and-treatments/atrial-septal-defect-asd

  Atrial septal defect (ASD) is a heart defect that is present at birth (congenital). […] The health care provider will check how large and severe an ASD is based on the symptoms, physical exam, and the results of heart tests. […] An echocardiogram is a test that uses sound waves to create a moving picture of the heart. It is often the first test done. A Doppler study done as part of the echocardiogram allows the provider to assess the amount of shunting of blood between the heart chambers. […] ASD may not need treatment if there are few or no symptoms, or if the defect is small and is not associated with other abnormalities. Surgery to close the defect is recommended if the defect causes a large amount of shunting, the heart is swollen, or symptoms occur. […] In infants, small ASDs (less than 5 mm) will often not cause problems, or will close without treatment. Larger ASDs (8 to 10 mm), often do not close and may need a repair. […] Contact your provider if you have symptoms of an atrial septal defect.

• #63 Atrial Septal Defect – Children’s Hospital of Orange County

  https://choc.org/heart/congenital-heart-defects/atrial-septal-defect/

  Electrocardiogram (ECG or EKG). A test that records the electrical activity of the heart, shows abnormal rhythms (arrhythmias or dysrhythmias), and detects heart muscle stress. […] Echocardiogram (echo). A procedure that evaluates the structure and function of the heart by using sound waves recorded on an electronic sensor that produce a moving picture of the heart and heart valves. […] Once an atrial septal defect is diagnosed, your child’s cardiologist will evaluate your child periodically to see whether it is closing on its own. […] The decision to close the ASD may also depend on the size of the defect. […] Specific treatment for ASD will be determined by your child’s physician based on: […] The child’s age, overall health and medical history […] Extent of the defect […] The child’s tolerance for specific medications, procedures, or therapies […] Expectations for the course of the defect […] The family’s opinion or preference. […] Consult your child’s physician regarding the specific outlook for your child.

• #64 Atrial Septal Defect: Symptoms, Types & Treatment

  https://my.clevelandclinic.org/health/diseases/11622-atrial-septal-defect-asd

  An atrial septal defect (ASD) is a congenital heart defect. Its a hole in the atrial septum, the muscular wall between the two upper chambers (atria) of your heart. […] Larger ones may require percutaneous (nonsurgical) repair or surgery to lower the risk of serious complications. […] Healthcare providers diagnose atrial septal defects through a physical exam and tests that check your hearts structure and function. Your provider will run one or more tests to learn how an atrial septal defect affects your heart. Possible tests include: […] Your healthcare provider may prescribe medications to treat some symptoms of atrial septal defect. But medications cant close the hole. Providers can perform ASD closure through surgery or percutaneous (nonsurgical) repair. […] If you have an atrial septal defect, its important to keep all your medical appointments and follow your providers guidance. Atrial septal defects often call for watchful waiting.

• #65 Atrial Septal Defect (ASD) in Children | Valley Children’s Healthcare

  https://www.valleychildrens.org/heart/conditions/atrial-septal-defect

  The most common type of ASD may close on its own as your child grows. […] Once an ASD is diagnosed, your child’s cardiologist will check your child to see if the defect is closing on its own. An ASD will often be fixed if it hasn’t closed by the time a child starts school. The decision to close the ASD may also depend on the size of the defect or the symptoms caused by the defect. […] All children with an ASD need to be cared for by a pediatric cardiologist. Most children who have had an ASD repair will live healthy lives. After the repair, your child’s healthcare provider may want your child to take antibiotics. This will prevent an infection of the heart lining (bacterial endocarditis). […] With early diagnosis and repair of an ASD, children usually do very well. They don’t need much follow-up care. Children are more likely to have problems if an ASD is diagnosed later in life and never repaired. Or they may have problems if complications occur after closing the defect.

• #66 Role of Echocardiography in the Diagnosis and Interventional Management of Atrial Septal Defects

  https://www.mdpi.com/2075-4418/12/6/1494

  The ultimate decision to insert the device is made after detailed TEE or ICE evaluation of the diameter and shape of the ASD and rims of the ASD and balloon sizing of the ASD. […] Three-dimensional (3D) echocardiographic studies were initially developed in the early 1990s. […] The standard practice at this time is to perform either TEE or ICE immediately prior to transcatheter occlusion of ASD. […] The technique of balloon sizing the atrial defects was developed by King and his associates in the late 1970s. […] Echocardiographic examination is useful in demonstrating the position of the device. […] Follow-up evaluation with TTE studies is performed to appraise the device position, to identify residual shunts, and to detect rare complications. […] Based on this review, it may be concluded that the non-invasive transthoracic and invasive transesophageal and intracardiac echocardiographic studies are of immense value, both in the diagnosis of ASDs and in their management.

• #67 Atrial Septal Defect (ASD) | American Heart Association

  https://www.heart.org/en/health-topics/congenital-heart-defects/about-congenital-heart-defects/atrial-septal-defect-asd

  An opening or hole (defect) in the wall (septum) that separates the top two chambers of the heart (atria). […] This defect allows oxygen-rich blood to leak into the oxygen-poor blood chambers in the heart. ASD is a defect in the septum between the heart’s two upper chambers. […] If the ASD is large, it can be closed with open-heart surgery, or by cardiac catheterization using a device inserted into the opening to plug it. […] Closing a large ASD by open-heart surgery usually is done in early childhood, even in patients with few symptoms, to prevent complications later. […] Most large atrial septal defects now can be closed either with open-heart surgery or during a cardiac catheterization using a device inserted into the opening to plug it (referred to as interventional or therapeutic catheterization). […] Patients with a history of ASD should be seen periodically by a cardiologist to look for uncommon problems. […] The long-term outlook is excellent, and usually no medicines and no additional surgery or catheterization are needed.

• #68 Isolated atrial septal defects (ASDs) in children: Classification, clinical features, and diagnosis – UpToDate

  https://www.uptodate.com/contents/isolated-atrial-septal-defects-asds-in-children-classification-clinical-features-and-diagnosis

  Isolated atrial septal defects (ASDs) in children: Classification, clinical features, and diagnosis […] Atrial septal defects (ASDs) are common, accounting for approximately 10 to 15 percent of congenital heart disease. The clinical consequences of an ASD are related to the anatomic location of the defect, its size, and the presence or absence of other cardiac anomalies. […] The classification, clinical features, and diagnosis of isolated ASDs in children will be reviewed here. […] ASDs account for approximately 10 to 15 percent of congenital heart disease, with a reported birth prevalence of approximately 1 to 2 per 1000 live births. […] The apparent reported prevalence of ASD has increased because of increased use of echocardiography in the neonatal period. […] ASDs are classified based on their anatomic location, which generally reflects the abnormality of embryogenesis that led to the anomaly. […] The diagnosis of isolated ASDs in children will be reviewed here.

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