ATRIAL SEPTAL DEFECT

Aliran darah pada jantung normal

Batasan : Pirau yang terjadi karena adanya defek septum inter-atriale yang memisahkan kedua atrium.

DEFINITIONAn atrial septal defect is an opening in the atrial septum, or dividing wall between the two upper chambers of the heart known as the right and left atria..

GROSS SPECIMENS

HEMODYNAMICSRT.ATRIUM RECEIVES BLOOD FROM SUP. & INF.VENA CAVA & FROM LT. ATRIUMRT.ATRIUM ENLARGES

HEMODYNAMICSLARGE VOL OF BLOOD FROM RT.ATRIUM

DELAYED DIASTOLIC MURMUR(LOW LT STERNAL BORDER) RT.VENTRICLE ENLARGESPULMONARY EJECTION MURMUR

HEMODYNAMICSPULM. VALVE CLOSES LATE & P2 IS DELAYEDRV IS FULLY LOADED,SO FURTHER RISE IN RV VOLUME CANNOT OCCURWIDELY SPLIT S2

FIXED SPLIT S2

ACCENTUATED S2

PRESENTATIONrecurrent chest infections fatigue sweating rapid breathing shortness of breath poor growth

ON EXAMINATION INSPECTIONPARASTRNL IMPULSEPALPATIONSYSTOLIC THRILL AT 2ND LT SPACE

AUSCULTATIONWIDE FIXED SPLIT S2ACCENTUATED P2ESM AT LT 2nd & 3rd INTERSPACESDELAYED DIASTOLIC MURMUR AT LOW LT INTERSPACE

CXR FINDINGSMOD. CARDIOMEGALYRA ENLARGEMENT RV ENLARGEMENTPROMINENT MAIN PULM ARTERYPLETHORIC LUNG FIELDS

ECG CHANGESRT AXIS DEVIATIONRT VENT HYPERTROPHYrsR PATTERN IN V1

ECHO PICTURES

SEVERITY ASSESMENTINTENSITY OF THE TWO MURMURSTHE HEART SIZE

COMPLICATIONPULMONARY HYPERTENSION(ABOVE 20 YEARS)DISAPPEARANCE OF DIASTOLIC MURMURAPPEARANCE OF PULM EJECN CLICKLOUD PALPABLE P2P2_STILL WIDELY SPLIT

MANAGEMENTMEDICALANTIBIOTICS FOR CHEST INFECTIONS DIGOXIN TO INCREASE WORK OF HEARTDIURETICS TO REDUCE PRELOAD

SURGICAL REPAIR:DEVICES