Atrial Septal Defect (ASD)
- MC- Secundum (Center)
- Primum (big on medial side)
- Sinus Venosus (at insertion of SVC, IVC)
- 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 :
2. S2 - Wide and fixed split
3. Grows up - Adult -
- 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
Clinical features at 6 - 10 wks
- Failure to thrive
- Recurrent infections
- Feeding difficulties
ECG : Left axis deviation.
Treatment : Early surgery.
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