Saturday, 19 September 2015

ASD

Atrial Septal Defect (ASD)

MC- Secundum (Center)✅
Primum (big on medial side)✅
Sinus Venosus (at insertion of SVC, IVC)✅

Seen in
Down's Syndrome✅
Lutembacher's syndrome ( ASD + MS/MR)✅
Ellis van creveld syndrome ( ASD + Polydactyly)✅
Holt oram syndrome ( Autosomal Dominant )✅

🍀Holt Oram Syndrome = Hand heart syndrome :

🌱Familial ASD syndrome

🌱With - VSD , Primary heart block , Atrial fibrillation, Bony Abnormality ( Thumb - absent / rudimentary)

🌱Pleiotropy - Multiple effects due to defect in single gene ( here TBX5)
🌱Can have absent radius.

🍀ASD Secundum :
1. Asymptomatic
2. S2 - Wide and fixed split
3. Grows up -
Adult -
CHF
Arrhythmias
Stroke
Eisenmenger syndrome

🌱ECG : Right axis deviation.

Treatment : Closure at 3-5yrs age by Dacron Patch

🍀ASD Primum :

1. Big cleft on the medial side
2. Also has MR (always)
Pansystolic at Apex
Radiate to axila and back
3. S2 - Wide and fixed split
4. It is severe ASD

therefore

Clinical features at 6 - 10 wks
Failure to thrive
Recurrent infections
Feeding difficulties
CHF
ECG : Left axis deviation.

Treatment : Early surgery.

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