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Symptomatic atrial septal defect in infancy

N C Joshi1, R Dalvi, R H Merchant

  • 1Cardiology Clinic, B.J. Wadia Hospital for Children, Parel, Bombay.

Indian Pediatrics
|September 1, 1993
PubMed
Summary
This summary is machine-generated.

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Severe congestive heart failure in infants can be caused by isolated ostium secundum atrial septal defect (OS-ASD). Many infants with OS-ASD presented atypically, but most responded well to medical treatment.

Area of Science:

  • Pediatric Cardiology
  • Congenital Heart Disease

Background:

  • Isolated ostium secundum atrial septal defect (OS-ASD) is a congenital heart defect that can rarely cause severe symptoms in infants.
  • Congestive heart failure in infants due to OS-ASD is uncommon and may present with atypical clinical findings.

Purpose of the Study:

  • To outline the echocardiographic findings, clinical course, and outcomes of infants admitted with severe congestive heart failure and isolated OS-ASD.
  • To investigate the diagnostic challenges and treatment responses in this specific pediatric population.

Main Methods:

  • Retrospective review of 12 infants with severe congestive heart failure and isolated OS-ASD over a four-year period.
  • Analysis of echocardiographic data, clinical presentation, treatment interventions, and patient outcomes.

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Main Results:

  • All 12 infants presented with atypical findings, including a parasternal holosystolic murmur and absence of wide fixed splitting of the second heart sound, leading to no initial clinical suspicion of ASD.
  • M-mode echocardiography revealed increased right ventricular distensibility in the absence of pulmonary hypertension.
  • Ten infants responded well to medical decongestive therapy; two underwent successful surgical closure, and two showed spontaneous closure.

Conclusions:

  • Isolated OS-ASD can present atypically in infants with severe congestive heart failure.
  • Early medical management is effective for most infants, with surgical or spontaneous closure being viable options for non-responders or specific cases.