ATRIAL SEPTAL DEFECT

Aliran darah pada

jantung normal

 Batasan :
Pirau yang terjadi
karena adanya
defek septum interatriale
yang memisahkan
kedua atrium.

DEFINITION
An atrial septal

defect is an opening
in the atrial septum,
or dividing wall
between the two
upper chambers of
the heart known as
the right and left
atria..

GROSS SPECIMENS

HEMODYNAMICS
RT.ATRIUM

RECEIVES BLOOD
FROM SUP. &
INF.VENA CAVA &
FROM LT. ATRIUM

RT.ATRIUM

ENLARGES

HEMODYNAMICS
LARGE VOL OF
BLOOD FROM
RT.ATRIUM

DELAYED

DIASTOLIC
MURMUR(LOW LT
STERNAL BORDER)
RT.VENTRICLE
ENLARGES
PULMONARY
EJECTION MURMUR

HEMODYNAMICS
PULM. VALVE

CLOSES LATE & P2

IS DELAYED
RV IS FULLY
LOADED,SO
FURTHER RISE IN
RV VOLUME
CANNOT OCCUR

WIDELY SPLIT S2

FIXED SPLIT S2
ACCENTUATED S2

PRESENTATION
recurrent chest infections
fatigue
sweating
rapid breathing
shortness of breath
poor growth

ON EXAMINATION
INSPECTION
PARASTRNL
IMPULSE

PALPATION
SYSTOLIC THRILL
AT 2ND LT SPACE

AUSCULTATION
WIDE FIXED SPLIT S2
ACCENTUATED P2
ESM AT LT 2nd & 3rd INTERSPACES
DELAYED DIASTOLIC MURMUR AT
LOW LT INTERSPACE

CXR FINDINGS
MOD.

CARDIOMEGALY
RA ENLARGEMENT
RV ENLARGEMENT
PROMINENT MAIN
PULM ARTERY
PLETHORIC LUNG
FIELDS

ECG CHANGES
RT AXIS DEVIATION
RT VENT

HYPERTROPHY
rsR PATTERN IN V1

ECHO PICTURES

SEVERITY ASSESMENT
INTENSITY OF THE TWO MURMURS
THE HEART SIZE

COMPLICATION
PULMONARY HYPERTENSION(ABOVE
20 YEARS)
DISAPPEARANCE OF DIASTOLIC
MURMUR
APPEARANCE OF PULM EJECN CLICK
LOUD PALPABLE P2
P2_STILL WIDELY SPLIT

MANAGEMENT
MEDICAL
ANTIBIOTICS FOR CHEST INFECTIONS
DIGOXIN TO INCREASE WORK OF
HEART
DIURETICS TO REDUCE PRELOAD

SURGICAL REPAIR:DEVICES