Atrial Septal Defect (ASD)

Cardiology (12%) Core Clinical Conditions

2B: The Physician Associate is able to undertake the day to day management of the patient and condition once the diagnosis and strategic management decisions have been made by another.

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Definition Aetiology Pathophysiology Risk factor Sign and Symptoms Investigations Management

Definition

Atrial Septal Defect (ASD) is a congenital heart defect characterised by a hole in the septum between the left and right atrium of the heart. This allows oxygen-rich blood from the left atrium to mix with oxygen-poor blood from the right atrium, resulting in an increase in the heart's workload and a decrease in tissue oxygenation.

Aetiology

  • Combination of genetic and environmental 

  • Infection during pregnancy 

  • Use of some medications during pregnancy

Pathophysiology

An Elevated flow of blood to the lungs can increase the heart's burden which may result in heart failure. There is also an increased chance of causing decreased tissue oxygenation and organ perfusion.

Risk factors

  • Premature birth.

  • low birth weight.

  • Maternal infections during pregnancy.

  • Family history of congenital heart defects.

Sign and symptoms

  • In infants (usually asymptomatic) but can have:

  • Difficulty breathing

  • Rapid breathing

  • O/E: Heart murmur (Soft systolic ejection murmur)a

Investigations

  • CXR 

  • Cardiac MRI

  • ECHO

  • ECG

  • Cardiac catheterisation (rarely used)

Management

  • Mild cases - no intervention

  • Severe cases of ASD will be treated with surgery to close the hole in the heart.

 
 
 

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