Atrial septal defect

Congenital heart disease were the most common heart disease take precedence 20-25% of the total, more women see. Autopsies on embryonic development and pathological anatomy of different sites, divided into three types : a secondary closure of the largest hole see. Defect site further away from the atrioventricular valve. In the process of embryonic development, the layout of primary or secondary absorb too much stunting the interval, the two can not be integrated. Under the existing secondary-site is divided into four types : central : the most common. vena type (low); Low position with the entrance of the inferior vena cava no boundaries. ?۠on cavity-type (high) : Located in the superior vena cava opening at the bottom; Right accompanied venous malformation, drain into the right atrium or superior vena cava. ?ܠmixed : high and low defect exist. Second, the original closure of the hole about 5-10%, defect, due to atrial septal stop growing prematurely, not with endocardial cushion fusion, and the remaining hole. There were also simple; Defect of the lower edge of a complete endocardial cushion, mitral three leaves no fracture. part atrioventricular canal : Hole is the primary closure of one of the most common in the original hole that is the lower edge of the upper ventricular septum, Mitral tricuspid valve attachment Department. Standing with mitral valve big split, resulting in mitral regurgitation and left ventricular and left ventricular blood, right atrium traffic. ۠complete atrioventricular canal : Apart from some of atrioventricular canal, there tricuspid valve split, two, tricuspid valve formed around two common valve, for the upper ventricular septal defect. 3, a common atrium primary and secondary atrial septal lack of development, the formation of a single atrium. 4 eggs Kong Park closure of the normal 20-25% of primary and secondary atrial septal incomplete fusion where Foramen Ovale closure. Generally do not cause heart triage rooms. The disease is often associated with other congenital malformations, such as partial anomalous pulmonary venous drainage, deformity left superior vena cava, mitral stenosis (Lutembacher's syndrome), pulmonary valve stenosis (the music's triple syndrome), ventricular septal defect, such as Ebstein. [Pathophysiological -- when normal infants right atrium, the wall thickness than adults, poor compliance, aging, Left atrial pressure above the right atrium. Flow from the left atrium by the atrial septal defect mouth into the right atrium, therefore, I tricuspid valve and right ventricle pulmonary blood flow increased, Right ventricular diastolic overload, early pulmonary artery spasm dynamic form of pulmonary hypertension, with the passage of course, Pulmonary arteriosclerosis and vascular lumen smaller, pulmonary hypertension increased formation obstructive pulmonary hypertension, there right atrium and right ventricle hypertrophy and dilated. Advanced pulmonary hypertension right heart failure, right atrial pressure above the left atrium, there will be a two-way streaming or right-to-left shunt. cyanosis appeared, known as Eisenmenger's Syndrome, left to right-size and the flow of defect size and left, right ventricular pressure proportional to the room. ??Performance -- a clinical symptoms and the defect size, presence of the other deformities. If for the simple and small defects often asymptomatic. Defect large majority of cases due to lung congestion and tired after a chest tightness, short breath, fatigue. Infants prone to respiratory infections. Primary Kong atrial defect or common early symptoms seriously and made rapid progress. Second, large signs defect may affect the development, the former District uplift heart, the left shift apexcardiogram was flattering beat. Left heart sector expanded left sternal edge II-III, 2-3 intercostal a briefing like soft-systolic murmur, with fine tremor, tricuspid district short diastolic murmur, pulmonary valve 2nd District Music hyperthyroidism and fixed split. If you have pulmonary hypertension. Some patients have pulmonary jet noise and the pulmonary valve area as a result of pulmonary valve regurgitation relative to the early diastolic murmur like quarrels (Graham Steell). If the hole for primary defect in apical can hear all kind systolic murmur briefing. Laboratories and other checks -- one, X-ray film increased pulmonary vascular and pulmonary trunk and abdomen pulsatile increase, and the right atrium, right ventricle increased Guitar narrow aorta, the primary hole left ventricular defect can be increased. 2, ECG is often associated with incomplete or complete right bundle branch block and right ventricular hypertrophy. 3, echocardiography pulmonary widened, and the right atrium, right ventricle increased, the interval for interruption. Contrast can see abnormal segregation. Doppler ultrasound; On the right side of the interval to be measured systolic spectrum from left to right shunt. 4, cardiac catheterization right heart catheterization found the right atrium oxygen content than the 1.9% volume IVC, 70% of cases of cardiac catheterization through the mouth defect from the right atrium into the left atrium. Right heart catheterization through various parts of measurable pressure and flow computing. As a primary suspect hole defect and pulmonary artery stenosis and pulmonary arteriovenous malformations such as abnormal drainage can be considered for angiocardiography. Diagnosis and differential diagnosis -- were based on the typical X-ray, electrocardiogram and echocardiography. and the cardiac catheterization diagnosis can be made, subject to and following the disease. A ventricular septal defect, X-ray, electrocardiogram and primary defect similar hole, However, ventricular septal defect in the left sternal edge III-IV intercostal systolic murmur a rough, accompanied by small tremor, Cardiac catheterization also help to identify. 2, light pulmonary valve stenosis and secondary hole defect identification. Pulmonary valve stenosis X-ray showed pulmonary vascular scarce, the right heart catheter in the right atrium into the right edge of ectopic pulmonary artery. Third, some anomalous pulmonary venous inflow primers right atrium X-ray, CT or chest film had abnormal vein shadow Right heart catheterization said catheter in the right atrium into the right edge of pulmonary I. spaces. 4, the expansion of primary pulmonary artery dilatation of the pulmonary valve area systolic jet noise, no abnormal electrocardiogram, X-ray showed pulmonary trunk expanded, but without pulmonary congestion, cardiac catheterization without segregation. 5, primary pulmonary hypertension and ECG signs similar atrial septal defect. X-ray see the right atrium, right ventricle increased pulmonary artery and pulmonary trunk expansion, but the distal pulmonary thinning smaller, Lateral clear lung, heart catheterization with abnormal pulmonary hypertension without segregation. [Treatment] where x-ray and ECG abnormalities. Right heart catheterization computing flow pulmonary circulation has reached more than 40% of the blood flow, there are obvious clinical symptoms, qualified persons as soon as possible to carry out the operation. Age 5-10 years old to be ideal. Pulmonary hypertension has been associated with two-way streaming or left to right shunt surgery is not appropriate.