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Revision as of 19:14, 9 December 2011

Atrial Septal Defect Microchapters

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Patient Information

Overview

Anatomy

Classification

Ostium Secundum Atrial Septal Defect
Ostium Primum Atrial Septal Defect
Sinus Venosus Atrial Septal Defect
Coronary Sinus
Patent Foramen Ovale
Common or Single Atrium

Pathophysiology

Epidemiology and Demographics

Risk Factors

Natural History and Prognosis

Complications

Diagnosis

History and Symptoms

Physical Examination

Electrocardiogram

Chest X Ray

CT

MRI

Echocardiography

Transesophageal Echocardiography
Transthoracic Echocardiography
Contrast Echocardiography
M-Mode
Doppler

Transcranial Doppler Ultrasound

Cardiac Catheterization

Exercise Testing

ACC/AHA Guidelines for Evaluation of Unoperated Patients

Treatment

Medical Therapy

Surgery

Indications for Surgical Repair
Surgical Closure
Minimally Invasive Repair


Robotic ASD Repair
Percutaneous Closure
Post-Surgical Follow Up

Special Scenarios

Pregnancy
Diving and Decompression Sickness
Paradoxical Emboli
Pulmonary Hypertension
Eisenmenger's Syndrome
Atmospheric Pressure

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Case #1

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Priyamvada Singh, M.B.B.S. [2]; Cafer Zorkun, M.D., Ph.D. [3] Assistant Editor(s)-In-Chief: Kristin Feeney, B.S. [4]

Overview

Normally the emboli originating from the venous thrombus goes to the lung leading to pulmonary complications. However, in patients with atrial septal defects, a emboli can enter the arterial system through the defect. This may lead to rare complications like stroke and migraine. However, these defects are more common in patent forman ovale compared to atrial septal defect.

Paradoxical emboli

Venous thrombi (clots in the veins) are quite common. Embolization (dislodgement of thrombi) normally go to the lung and cause pulmonary emboli. In an individual with ASD, these emboli can potentially enter the arterial system [1], [2]. This can cause any phenomenon that is attributed to acute loss of blood to a portion of the body, including cerebrovascular accident (stroke), infarction of the spleen or intestines, or even a distal extremity (i.e.: finger or toe).

This is known as a paradoxical embolus because the clot material paradoxically enters the arterial system instead of going to the lungs.

References

  1. Loscalzo J (1986). "Paradoxical embolism: clinical presentation, diagnostic strategies, and therapeutic options". Am Heart J. 112 (1): 141–5. PMID 3728270.
  2. Ward R, Jones D, Haponik EF (1995). "Paradoxical embolism. An underrecognized problem". Chest. 108 (2): 549–58. PMID 7634897.

See also

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