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Updated: Dec 16, 2025

Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
Published on: February 8, 2022
Atrial Septal Defect
Elisa A Bradley1, Ali N Zaidi2
1Department of Internal Medicine, Division of Cardiovascular Medicine, The Ohio State University, Columbus, OH, USA.
Insights
Atrial septal defects are common congenital heart conditions. While small defects may close naturally, larger ones often require intervention to prevent serious heart complications.
Area of Science:
- Cardiology
- Pediatric Cardiology
- Congenital Heart Disease
Background:
- Atrial septal defects (ASDs) are frequent congenital heart anomalies.
- They involve incomplete tissue formation in the interatrial septum.
- Unrepaired ASDs can lead to right heart overload, arrhythmias, and pulmonary hypertension.
Purpose of the Study:
- To summarize the characteristics, diagnosis, and management of atrial septal defects.
- To outline the different types and clinical presentations of ASDs.
Main Methods:
- Review of common congenital heart defects.
- Description of physical findings and diagnostic considerations for ASDs.
- Discussion of treatment options and contraindications.
Main Results:
- Three main types of ASDs exist: ostium secundum, ostium primum, and sinus venosus.
- Key physical findings include a midsystolic pulmonary murmur and fixed split S2.
- Spontaneous closure occurs in small defects; larger ones necessitate intervention.
Conclusions:
- ASDs range from asymptomatic to hemodynamically significant conditions.
- Management depends on defect size and clinical impact.
- Severe pulmonary arterial hypertension contraindicates defect closure.
Abstract:
Atrial septal defects are common congenital heart defects, characterized by insufficient/absent tissue at the interatrial septum. An unrepaired defect may be associated with right heart volume overload, atrial arrhythmia or pulmonary arterial hypertension. The 3 major types of atrial septal defect are: ostium secundum defect, ostium primum defect, and sinus venosus. Characteristic physical findings include a midsystolic pulmonary flow or ejection murmur, accompanied by a fixed split-second heart sound. Small defects may spontaneously close; larger defects may persist and result in hemodynamic and clinical sequelae requiring percutaneous or surgical intervention. Severe pulmonary arterial hypertension is a contraindication to closure.
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