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BY DR.ANAND
• Normally, oxygen-poor
(blue) blood returns to
the right atrium from the
body, travels to the right
ventricle, then is pumped
into the lungs where it
receives oxygen. Oxygen-
rich (red) blood returns
to the left atrium from
the lungs, passes into the
left ventricle, and then is
pumped out to the body
through the aorta.
• An atrial septal defect
allows oxygen-rich
(red) blood to pass
from the left atrium,
through the opening
in the septum, and
then mix with oxygen-
poor (blue) blood in
the right atrium.
DEFINITION
• INSPECTION • PALPATION
• PARASTRNL IMPULSE • SYSTOLIC THRILL AT
2ND LT SPACE
AUSCULTATION
• 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
• 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
REPAIR
ROBO REPAIR