Atrial septal defect transthoracic echocardiography: Difference between revisions

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{{Atrial septal defect}}
{{Atrial septal defect}}
{{CMG}}; '''Associate Editors-In-Chief:''' [[Priyamvada Singh|Priyamvada Singh, M.B.B.S.]] [mailto:psingh@perfuse.org], {{CZ}}; '''Assistant Editor-In-Chief:''' [[Kristin Feeney|Kristin Feeney, B.S.]] [mailto:kfeeney@perfuse.org]
{{CMG}}; '''Associate Editor(s)-In-Chief:''' [[Priyamvada Singh|Priyamvada Singh, M.B.B.S.]] [mailto:psingh@perfuse.org], {{CZ}}; '''Assistant Editor-In-Chief:''' [[Kristin Feeney|Kristin Feeney, B.S.]] [mailto:kfeeney@perfuse.org]


==Overview==
==Overview==

Revision as of 19:41, 22 August 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

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Transthoracic Echocardiography
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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-In-Chief: Kristin Feeney, B.S. [4]

Overview

Echocardiography is the preferred diagnostic tool in the evaluation of an atrial septal defect. Trans-thoracic echocardiography is an effective two-dimensional modality that can be used to identify suspected atrial septal defects.

Trans-thoracic echocardiography

  • Effective two-dimensional modality for visualizing an ostium secundum atrial septal defect.
  • Types:
  • Apical four chamber view
  • Subcoastal four chamber view
  • Provides imaging of:
  • Right ventricular enlargement
  • Paradoxical motion involving the ventricular septum
  • Right atrium enlargement

Advantages

  • Determines which type of defect exists.
  • Necessary to evaluate for anomalous pulmonary veins.
  • Evaluates for an atrial septal aneurysm.

Disadvantages

  • Apical four chamber view involves a parallel angle of the echocardiographic beams onto the atrial septum causing artifact in the echo
  • Subcostal four chamber view can be ineffective in overweight/obese patients.
  • Size of the defect seen in a TTE does not parallel the measurement of shunt flow from cardiac catheterization.

Sensitivity

  • One study found that subcostal approach could successfully visualize the majority of ostium primum and ostium secundum atrial septal defects.[1]
  • Visualization of sinus venosus atrial septal defect is less successful, less than 50% of the cases were properly imaged.[1]

References

  1. 1.0 1.1 Shub C, Dimopoulos IN, Seward JB, Callahan JA, Tancredi RG, Schattenberg TT; et al. (1983). "Sensitivity of two-dimensional echocardiography in the direct visualization of atrial septal defect utilizing the subcostal approach: experience with 154 patients". J Am Coll Cardiol. 2 (1): 127–35. PMID 6853907.

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