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ATRIAL SEPTAL DEFECT BY DR.ANAND
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Normally, oxygen-poor (blue) blood returns to the right atrium from the body, travels to the right ventricle, then is pumped into the lungs where it receives oxygen. Oxygen-rich (red) blood returns to the left atrium from the lungs, passes into the left ventricle, and then is pumped out to the body through the aorta.
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An atrial septal defect allows oxygen-rich (red) blood to pass from the left atrium, through the opening in the septum, and then mix with oxygen-poor (blue) blood in the right atrium.
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DEFINITION An atrial septal defect is an opening in the atrial septum, or dividing wall between the two upper chambers of the heart known as the right and left atria..
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GROSS SPECIMENS
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EMBRYOLOGY The heart is forming during the first 8 weeks of fetal development. It begins as a hollow tube, then partitions within the tube develop that eventually become the septa (or walls) dividing the right side of the heart from the left. Atrial septal defects occur when the partitioning process does not occur completely, leaving an opening in the atrial septum.
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HEMODYNAMICS RT.ATRIUM RECEIVES BLOOD FROM SUP. & INF.VENA CAVA & FROM LT. ATRIUM RT.ATRIUM ENLARGES
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HEMODYNAMICS LARGE VOL OF BLOOD FROM RT.ATRIUM PASSES THRU NORMAL TRICUSPID VALVE & PULMONARY VALVE DELAYED DIASTOLIC MURMUR(LOW LT STERNAL BORDER) RT.VENTRICLE ENLARGES PULMONARY EJECTION MURMUR
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HEMODYNAMICS PULM. VALVE CLOSES LATE & P2 IS DELAYED
RV IS FULLY LOADED,SO FURTHER RISE IN RV VOLUME CANNOT OCCUR WIDELY SPLIT S2 FIXED SPLIT S2 ACCENTUATED S2
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PRESENTATION recurrent chest infections fatigue sweating
rapid breathing shortness of breath poor growth
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ON EXAMINATION INSPECTION PARASTRNL IMPULSE PALPATION
SYSTOLIC THRILL AT 2ND LT SPACE
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AUSCULTATION WIDE FIXED SPLIT S2 ACCENTUATED P2
ESM AT LT 2nd & 3rd INTERSPACES DELAYED DIASTOLIC MURMUR AT LOW LT INTERSPACE
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CXR FINDINGS MOD. CARDIOMEGALY RA ENLARGEMENT RV ENLARGEMENT
PROMINENT MAIN PULM ARTERY PLETHORIC LUNG FIELDS
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ECG CHANGES RT AXIS DEVIATION RT VENT HYPERTROPHY rsR’ PATTERN IN V1
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ECHO PICTURES
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SEVERITY ASSESMENT INTENSITY OF THE TWO MURMURS THE HEART SIZE
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COMPLICATION PULMONARY HYPERTENSION(ABOVE 20 YEARS)
DISAPPEARANCE OF DIASTOLIC MURMUR APPEARANCE OF PULM EJECN CLICK LOUD PALPABLE P2 P2_STILL WIDELY SPLIT
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MANAGEMENT MEDICAL ANTIBIOTICS FOR CHEST INFECTIONS
DIGOXIN TO INCREASE WORK OF HEART DIURETICS TO REDUCE PRELOAD
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SURGICAL REPAIR:DEVICES
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REPAIR
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ROBO REPAIR
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