Secundum atrial septal defect

Case contributed by Erik Ranschaert


No prior cardiac history and mild exertional dyspnea.

Patient Data

Age: 60 years
Gender: Female

Communication between the right and left atrium through an ostium secundum atrial septal defect (ASD type II). The right ventricle is dilated with thinning of the myocardium due to volume overload from the left to right shunt via the ASD.

Case Discussion

Secundum ASD or ostium secundum atrial septal defect 

In this case, using cardiac CT the size of the ASD could be accurately measured (1.7 cm).

During respiratory inspiration, the negative intrathoracic pressure causes increased blood return into the right side of the heart. The shunting of blood from the left atrium to the right results in volume overloading of the right heart, resulting in an enlarged right ventricle.

Most individuals with an uncorrected secundum ASD don't have significant symptoms through early adulthood. About 70% develop symptoms by the time they are in their 40s. These patients will present with symptoms of dyspnea on exertion (shortness of breath with minimal exercise), congestive heart failure, or cerebrovascular accident(stroke).

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