Atrial septal defect natural history

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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

Case Studies

Case #1

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

Overview

The majority of atrial septal defect patients are asymptomatic until adulthood. Symptom onset and severity hinges largely on the size of the defect. Without intervention, the mortality rate for symptomatic adults is greater than 50%. Possible complications include atrial fibrillation, pulmonary hypertension and stroke.

Natural history

As many atrial septal defect patients are asymptomatic, it is common to survive into adulthood without any need for intervention. Many atrial septal defects smaller than 8mm in diameter spontaneously close during infancy. Spontaneous closer is uncommon in children and adults. Adulthood, however, can lead to onset of symptoms and altered life expectancy. Beyond 40-50 years of age, survival without intervention is under 50% with an attrition rate of about 6% per year. Complications may onset later in life and include associated conditions such as atrial fibrillation, pulmonary hypertension, and stroke.

Complications

Complications involving comorbidity

Atrial fibrillation | Pulmonary hypertension | Right heart failure | Stroke

Prognosis

References

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